Benzonatate is a prescription medication often used to treat and suppress severe coughs by anesthetizing the stretch receptors in the lungs and pleura. Its unique mechanism of action means it can often be combined with certain over-the-counter (OTC) cough syrups to address different aspects of a cough. However, understanding which active ingredients are compatible is crucial for avoiding adverse reactions and ensuring effective treatment.
Safely Combining Benzonatate with Expectorants
Expectorants are a class of medications designed to loosen and thin mucus in the airways, making it easier to clear from the lungs. Combining an expectorant with benzonatate is often recommended by healthcare providers to manage both a productive (wet) cough and the urge to cough itself.
The most common and well-tolerated expectorant for use with benzonatate is guaifenesin, found in products like Mucinex. The two medications work differently, providing a more comprehensive approach to treating coughs related to colds, bronchitis, and other respiratory conditions. Benzonatate addresses the central urge to cough, while guaifenesin helps address the underlying mucus buildup that causes a wet cough.
Practical Considerations for Combining Benzonatate and Guaifenesin
- Dosage Timing: While there are no significant interactions, it's wise to follow the individual dosing instructions for each medication. You might take your prescribed benzonatate at regular intervals and add the guaifenesin as needed for chest congestion.
- Symptom-Specific Use: This combination is most beneficial for coughs that start with a productive, mucousy phase and transition into a persistent, dry hack.
- Hydration: Expectorants like guaifenesin work most effectively when you are well-hydrated. Drinking plenty of water while on this combination can enhance its mucus-thinning effects.
Combining Benzonatate with Other Antitussives
Another type of cough medication is an antitussive, or cough suppressant, which works to quell the cough reflex. Dextromethorphan is a common OTC antitussive found in many syrups (e.g., Robitussin DM, Delsym). While some drug interaction checkers may show no interaction, experts generally advise against combining dextromethorphan with benzonatate unless specifically instructed by a healthcare provider.
The primary reason for caution is that both are cough suppressants, and combining them could lead to excessive cough suppression. This can be particularly problematic if the cough is productive, as it can hinder the body's natural clearing mechanism. Some sources also warn of potentially increased sedative side effects, though this is less common. The risk of central nervous system (CNS) side effects like dizziness and confusion can be intensified, making it crucial to choose one cough suppressant at a time unless directed otherwise.
Benzonatate and Other Syrups to Avoid
Nighttime or "PM" cough and cold products should generally be avoided when taking benzonatate. These typically contain older antihistamines, such as diphenhydramine (Benadryl) or doxylamine, which cause significant drowsiness. Since benzonatate can also cause dizziness and sedation, combining it with these products can lead to excessive drowsiness, impaired cognitive function, and an increased risk of accidents.
Similarly, combination syrups containing codeine should not be taken with benzonatate without explicit medical advice. Both are powerful cough suppressants, and the combination could lead to dangerous respiratory depression.
Comparison of Common Syrups with Benzonatate
| Feature | Guaifenesin (Expectorant) | Dextromethorphan (Antitussive) | Doxylamine/Diphenhydramine (Sedating Antihistamine) |
|---|---|---|---|
| Mechanism of Action | Thins and loosens mucus | Suppresses cough reflex in the brain | Dries up nasal passages and causes drowsiness |
| Safety with Benzonatate | Generally safe; often combined by doctors | Avoid combining unless advised by a doctor due to risk of excessive cough suppression and intensified side effects | AVOID combining due to high risk of excessive sedation and CNS depression |
| Primary Use | Wet, productive cough with congestion | Dry, hacking cough | Nighttime relief for multiple cold symptoms (often with sedation) |
| Combined Effect | Comprehensive treatment for both mucousy and dry coughs | Possible intensified side effects; unnecessary suppression | Severe drowsiness, dizziness, impaired judgment |
Alternative and Adjunctive Treatments
For those seeking alternatives or additional relief without combining cough suppressants, other options exist. For a dry cough, some studies suggest honey can be an effective and soothing alternative to some OTC medications. For a wet cough, staying hydrated and using a humidifier can help loosen mucus and provide symptomatic relief.
If your cough is accompanied by other cold or flu symptoms, it is typically safe to use standard pain relievers and fever reducers like acetaminophen (Tylenol) or ibuprofen (Advil) with benzonatate. Nasal decongestants like pseudoephedrine (Sudafed) are also generally safe to use, as they do not affect the cough reflex or cause significant sedation. However, always check the labels of any combination products to ensure they don't contain a component to be avoided, such as a sedating antihistamine or another antitussive.
Conclusion
When considering what cough syrup can I take with benzonatate, the safest and most common combination is with an expectorant like guaifenesin, which addresses different aspects of a cough. It is essential to avoid combining benzonatate with other sedating medications or cough suppressants like dextromethorphan unless directed by a healthcare professional. Always read product labels carefully, check for combination ingredients, and consult with a doctor or pharmacist to confirm the safety of any medication combination, especially if you have pre-existing health conditions or are taking other prescription drugs. Using a conservative and informed approach will help ensure your cough treatment is both effective and safe.
Authoritative Outbound Link
For a detailed list of drug interactions with benzonatate, consult the Drugs.com interaction checker: Benzonatate Interactions Checker - Drugs.com
