What are Klonopin and Benzonatate?
To understand the risks of combining these two medications, it is important to first understand what each one does individually.
Klonopin (Clonazepam)
Klonopin is the brand name for the generic drug clonazepam, a benzodiazepine. It is a powerful central nervous system (CNS) depressant prescribed to treat panic disorders, anxiety, and certain seizure disorders. Benzodiazepines work by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA), which slows down brain activity. This effect produces a calming, sedative-like feeling. Because of its CNS-depressant properties, Klonopin can cause drowsiness, dizziness, and impaired coordination on its own.
Benzonatate (Tessalon)
Benzonatate is a non-narcotic cough suppressant prescribed to relieve coughing in adults and children over 10. Unlike some other cough medications that act on the brain to suppress the cough reflex, benzonatate works by numbing the stretch receptors in the lungs and airways. While its primary action is not on the CNS, benzonatate can still cause CNS side effects, including dizziness, drowsiness, confusion, and potential hallucinations, particularly at higher doses. This is a crucial point of concern when considering drug interactions.
Why Combining Klonopin and Benzonatate Is Dangerous
The primary danger of combining Klonopin and benzonatate lies in their overlapping effects on the central nervous system. Both medications can cause sedation and respiratory depression, and taking them together can have an additive or synergistic effect, meaning the risks are multiplied rather than simply added.
Excessive Sedation and Impairment
- Drowsiness and Dizziness: Both medications can cause drowsiness and dizziness individually. When taken together, the intensity of these effects can increase dramatically. This can significantly impair your ability to perform daily activities safely, such as driving, operating heavy machinery, or even walking steadily.
- Cognitive Impairment: The combination can lead to a more severe impairment of attention, judgment, and psychomotor skills, affecting your thinking and concentration.
Respiratory Depression
- Slowed or Difficult Breathing: The most life-threatening risk of combining CNS depressants is respiratory depression. This condition involves slowed or shallow breathing and can be particularly dangerous for individuals with pre-existing respiratory conditions. In severe cases, it can lead to coma or death.
Other Adverse Effects
- Increased Risk of Falls: The combination of dizziness, impaired coordination, and sedation increases the risk of accidental injuries and falls.
- Confusion and Hallucinations: Although rarer, benzonatate has been linked to psychiatric side effects like confusion and hallucinations. Taking it with another CNS-active medication like Klonopin may increase this risk.
Comparison of Klonopin and Benzonatate Effects
| Feature | Klonopin (Clonazepam) | Benzonatate (Tessalon) | Combined Effects (Klonopin + Benzonatate) |
|---|---|---|---|
| Drug Class | Benzodiazepine | Non-narcotic Antitussive (cough suppressant) | Synergistic CNS Depressant |
| Primary Purpose | Treat panic disorder, anxiety, seizures | Relieve cough by numbing lung receptors | Not a recommended combination; treating both simultaneously is dangerous |
| Effect on CNS | Strong depressant; slows brain activity | Mild to moderate CNS side effects; potential for sedation and confusion | Greatly increased depressant effect |
| Common Side Effects | Drowsiness, dizziness, impaired coordination | Dizziness, headache, nausea, drowsiness | Excessive sedation, profound drowsiness, impaired coordination |
| Most Serious Risk | Dependency, withdrawal, respiratory depression (especially with other CNS depressants) | Allergic reactions, overdose risk (especially from chewing), potential mental health side effects | Significantly elevated risk of respiratory depression, coma, and death |
What to Do If You've Combined Klonopin and Benzonatate
If you have taken both medications and experience any of the following symptoms, it is crucial to seek immediate medical attention:
- Unusual or extreme sleepiness
- Slowed or difficult breathing
- Unresponsiveness or unrousable sleep
- Profound dizziness or lightheadedness
If you believe you or someone else is experiencing an overdose or severe reaction, do not wait. Call 911 or your local emergency services immediately.
Alternative Approaches to Cough Relief
If you are taking Klonopin, it is important to explore safer alternatives for managing a cough. Your doctor or pharmacist may suggest:
- Non-sedating antihistamines: Unlike older antihistamines (like diphenhydramine) that cause drowsiness, newer versions like loratadine (Claritin) do not typically interact with Klonopin.
- Non-pharmacological remedies: This includes staying hydrated, using a humidifier, drinking warm beverages, and using saline nasal sprays.
- Alternative cough suppressants: Your doctor may recommend a cough medication that does not cause significant CNS side effects.
The Critical Importance of Medical Consultation
Never combine medications without first consulting with a healthcare provider. Only a doctor can accurately assess your medical history, current medications, and overall health to determine the safest treatment plan for you. They may adjust dosages, provide alternative medications, or offer guidance on how to space out your doses to minimize risk. Inform your doctor about all medications you are taking, including over-the-counter drugs, vitamins, and supplements.
Conclusion
While the urge to relieve bothersome symptoms like a persistent cough is understandable, it is essential to prioritize medication safety. The potential for a dangerous drug interaction between Klonopin and benzonatate due to increased central nervous system depression makes this combination highly inadvisable in most cases. The risk of excessive sedation, impaired motor skills, and, most critically, respiratory depression is significant. The only safe and recommended course of action is to seek a medical professional's guidance before combining these or any other medications. Your doctor can help you find a safe and effective treatment plan that does not put your health at unnecessary risk.
For more information on the risks of benzodiazepines, you can visit the FDA website.
