Benzonatate, sold under the brand name Tessalon among others, is a medication used to try to help with the symptoms of cough and hiccups. It is taken by mouth. Use is not recommended in those under the age of ten. Effects generally begin within 20 minutes and last up to eight hours.Side effects include sleepiness, dizziness, headache, upset stomach, skin rash, hallucinations, and allergic reactions. Excessive doses may cause seizures, irregular heartbeat, and death. Chewing or sucking on the capsule can lead to laryngospasm, bronchospasm, and circulatory collapse. It is unclear if use in pregnancy or breastfeeding is safe. It works by numbing stretch receptors in the lungs and suppressing the cough reflex in the brain.Benzonatate was approved for medical use in the United States in 1958. It is available as a generic medication. It is not available in many countries. In 2019, it was the 105th most commonly prescribed medication in the United States, with more than 6 million prescriptions. Medical uses
Cough
Benzonatate is a prescription non-opioid alternative for the symptomatic relief of cough. It has been shown to improve cough associated with a variety of respiratory conditions including asthma, bronchitis, pneumonia, tuberculosis, pneumothorax, opiate-resistant cough in lung cancer, and emphysema.Benzonatate also reduces the consistency and volume of sputum production associated with cough in those with chronic obstructive pulmonary disorder (COPD).Compared to codeine, benzonatate has been shown to be more effective in reducing the frequency of induced cough in experiments.Benzonatate does not treat the underlying cause of the cough.
Hiccups
Benzonatate has been shown to have use in the suppression of hiccups. Intubation
Benzonatate acts as a local anesthetic and the liquid inside the capsule can be applied in the mouth to numb the oropharynx for awake intubation. However, there can be life-threatening adverse effects when the medication is absorbed by the oral mucosa, including choking, hypersensitivity reactions, and circulatory collapse. Contraindications
Hypersensitivity to benzonatate or any related compounds is a contraindication to its administration. Side effects
Benzonatate is generally well-tolerated if the liquid-capsule is swallowed intact. Potential adverse effects to benzonatate include:

Constipation, dizziness, fatigue, stuffy nose, nausea, headache are frequently reported. Sedation, a feeling of numbness in the chest, sensation of burning in the eyes, a vague "chilly" sensation, itchiness, and rashes are also possible. Ingestion of a small handful of capsules has caused seizures, cardiac arrhythmia, and death in adults. Hypersensitivity reactions
Benzonatate is structurally related to anesthetic medications of the para-aminobenzoic acid (PABA) class which includes procaine and tetracaine. Procaine and tetracaine, previously used heavily in the fields of dentistry and anesthesiology, have fallen out of favor due to allergies associated with their metabolites. Similarly, severe hypersensitivity reactions to benzonatate have been reported and include symptoms of laryngospasm, bronchospasm, and cardiovascular collapse. These reactions are possibly associated with chewing, sucking, or crushing the capsule in the mouth. Improper use
Benzonatate should be swallowed whole. Crushing or sucking on the liquid-filled capsule, or "softgel," will cause release of benzonatate from the capsule and can produce a temporary local anesthesia of the oral mucosa.