What is the drug Tessalon Perles used for? A Comprehensive Guide

October 8, 2025 •

4 min read

The FDA approved benzonatate, the active ingredient in Tessalon Perles, in 1958 for symptomatic cough relief in patients over 10 years of age. This prescription medication is primarily used for its local anesthetic properties, which help to suppress the reflex that causes coughing.

Quick Summary

Tessalon Perles is a prescription-only, non-narcotic cough suppressant (benzonatate) for adults and children aged 10 and older. It works by numbing the stretch receptors in the lungs and airways, reducing the urge to cough from respiratory issues.

Key Points

Prescription Only: Tessalon Perles (benzonatate) is a non-narcotic cough suppressant available only by prescription.
Numbing Action: It works by anesthetizing the stretch receptors in the lungs and airways, which reduces the urge to cough.
Swallow Whole: The perles must be swallowed whole without chewing, sucking, or crushing to prevent serious side effects like choking and allergic reactions.
Not for Young Children: Use is contraindicated in children under 10 due to the high risk of fatal overdose.
Cough Relief: It is used for short-term relief of coughs from the common cold, bronchitis, and pneumonia, but not typically for chronic, productive coughs.
Potential Interactions: Combining Tessalon Perles with other CNS depressants, like sedatives or opioids, can increase the risk of adverse effects.
Fatal Overdose Risk: Accidental ingestion, especially by children, can cause rapid overdose symptoms and has resulted in death.

What is Tessalon Perles (Benzonatate)?

Tessalon Perles is the brand name for the generic prescription drug benzonatate, a non-opioid antitussive agent. It is available as a soft, liquid-filled capsule called a 'perle' and is used to provide symptomatic relief from coughs. Unlike many over-the-counter (OTC) cough medicines, Tessalon Perles requires a doctor's prescription due to its specific mechanism of action and serious risks if not taken correctly.

The Specific Role of Benzonatate

Benzonatate is chemically related to ester-type local anesthetics like procaine and tetracaine. This chemical relationship is central to its therapeutic effect and its potential dangers, especially if the capsule is broken or chewed. It offers a different approach to cough relief compared to many OTC options that rely on other drug classes.

How Tessalon Perles Works: The Mechanism of Action

Benzonatate's primary mechanism is its anesthetic effect on the respiratory system. It works by acting on the sensory nerves involved in the cough reflex in several key areas.

Peripheral Anesthesia: The medication anesthetizes the stretch receptors of the vagal afferent fibers located in the lungs, bronchi, and pleura. By dampening the activity of these receptors, the drug reduces the signal that initiates the cough reflex at its source.
Central Inhibition: It may also work centrally by inhibiting the transmission of the cough reflex in the medulla, the part of the brain that controls involuntary functions like coughing.

This combined peripheral and central action effectively reduces the frequency and severity of coughing. After swallowing the perle, the antitussive effects typically begin within 15 to 20 minutes and can last for 3 to 8 hours.

Indications: When is Tessalon Perles Prescribed?

Tessalon Perles is used for the symptomatic relief of coughs caused by various conditions, including:

Common Cold: Provides relief from the persistent, dry cough that often accompanies a viral cold.
Bronchitis: Helps calm the irritating cough associated with inflamed bronchial tubes.
Pneumonia: Can be prescribed to manage the cough in patients recovering from pneumonia, though it does not treat the underlying infection.
Other Respiratory Conditions: Used for coughs related to other breathing problems, including asthma and emphysema, though it is not recommended for chronic coughs with excessive phlegm.

It is important to note that Tessalon Perles is not a cure for these conditions, but rather a tool to manage the symptom of coughing.

Dosage, Administration, and Crucial Safety Warnings

The dosage of Tessalon Perles is determined by a healthcare provider.

The most critical instruction is to swallow the capsule whole.

Do Not Chew, Suck, or Crush: Breaking the perle in the mouth releases the anesthetic benzonatate too quickly, which can cause temporary but dangerous numbness of the mouth, tongue, throat, and face.
Risk of Serious Reactions: This numbing can lead to choking or cause severe hypersensitivity reactions, including bronchospasm and laryngospasm, which can be fatal.
Accidental Ingestion in Children: Accidental ingestion in children, particularly those under 10, can lead to fatal overdose, with symptoms appearing within 15–20 minutes. Always store this medication out of the reach of children.

List of Common and Serious Side Effects

While generally well-tolerated when used as directed, Tessalon Perles can cause side effects.

Common Side Effects

Drowsiness or dizziness
Headache
Nausea, upset stomach, or constipation
Stuffy nose
Skin rash or itching

Serious Side Effects (Requires Immediate Medical Attention)

Numbness or tingling in the mouth, throat, or face from a broken capsule
Mental confusion or visual hallucinations
Severe drowsiness or unsteadiness
A choking feeling or numbness in the chest
Signs of allergic reaction (hives, difficult breathing, swelling of face, lips, tongue, or throat)

Comparison Table: Tessalon Perles vs. Other Cough Medicines


Feature	Tessalon Perles (Benzonatate)	Over-the-Counter (e.g., Dextromethorphan)	Over-the-Counter (e.g., Guaifenesin)
Availability	Prescription only	Widely available without a prescription	Widely available without a prescription
Mechanism	Anesthetizes stretch receptors in lungs and airways	Acts centrally on the brain's cough center	Expectorant; thins and loosens mucus
Primary Use	Suppresses unproductive (dry) cough	Suppresses unproductive cough	Helps with wet, chesty coughs
Best For	Short-term relief of irritating, dry coughs	Short-term relief of general coughs	Clearing congestion and mucus
Caution	Fatal overdose risk in children; must swallow whole	May cause nausea; risk of interaction with certain drugs	Not for persistent coughs (smoking, asthma)

Potential Drug Interactions

Patients should inform their doctor and pharmacist of all medications they are taking to avoid potential interactions. Caution is advised when taking Tessalon Perles with other drugs that cause drowsiness, such as:

Opioids
Sleeping pills
Muscle relaxers
Anxiety medications
Older antihistamines (e.g., diphenhydramine)

Combining Tessalon Perles with these drugs can increase the risk of excessive sedation and central nervous system (CNS) side effects like confusion and dizziness.

Conclusion

Tessalon Perles (benzonatate) is a valuable and effective prescription medication for providing symptomatic relief of coughs caused by various respiratory ailments. Its unique mechanism of action, which involves peripherally numbing the cough reflex, distinguishes it from many over-the-counter alternatives. However, its use comes with crucial safety considerations, particularly the absolute necessity to swallow the capsule whole to prevent potentially life-threatening reactions. The severe risk of accidental overdose in children also mandates strict storage precautions. Ultimately, Tessalon Perles should be used as directed by a healthcare professional, with careful adherence to all administration and safety guidelines to ensure its benefits outweigh the inherent risks. You can find more comprehensive drug information and warnings from reputable sources like Drugs.com.

Frequently Asked Questions

The antitussive effects of Tessalon Perles typically begin within 15 to 20 minutes of swallowing the capsule and can last for 3 to 8 hours.

Tessalon Perles is not recommended for chronic coughs that produce large amounts of mucus or phlegm, such as those caused by smoking, asthma, or emphysema. It is more effective for dry, irritating coughs.

Chewing, sucking, or crushing the capsule will release the benzonatate and cause temporary local anesthesia (numbness) of the mouth, tongue, and throat. This can lead to a choking sensation or a severe, possibly fatal, allergic reaction.

Tessalon Perles is not approved for use in children younger than 10 years old. Accidental ingestion by young children has led to fatal overdoses, and the medication must be kept out of their reach.

You should consult a doctor or pharmacist before combining Tessalon Perles with other medications, especially those that cause drowsiness, such as opioids, sleeping pills, or some antihistamines. Over-the-counter medications containing dextromethorphan should also be avoided due to increased side effect risk.

No, Tessalon Perles (benzonatate) is a non-narcotic oral antitussive. It is not an opioid and is not considered a controlled substance.

Common side effects include drowsiness, headache, dizziness, nausea, upset stomach, constipation, and stuffy nose.

Store the medication at room temperature and protect it from moisture and light. Keep it in its child-resistant container and, most importantly, out of the reach of children.