benzonatate / Generic mfg. - LARVOL DELTA

Rosuvastatin-Induced Acute Tubular Injury Not Associated with Rhabdomyolysis (KIDNEY WEEK 2025) - "In addition to valsartan, he was taking benzonatate, rosuvastatin, amlodipine, fish oil, vitamin C and albuterol. The pathogenesis for the mechanism of injury is not fully understood but there is some evidence for decreased receptor-mediated endocytosis in proximal renal tubules by statins. Practitioners must be cognizant of this potential complication of rosuvastatin use."

Acute Kidney Injury • Cardiovascular • Chronic Kidney Disease • Dyslipidemia • Fibrosis • Hypertension • Immunology • Nephrology • Renal Disease

TUSSIVE SYNCOPE IN A PATIENT WITH INFLUENZA B AND CHRONIC OBSTRUCTIVE PULMONARY DISEASE (CHEST 2025) - "After testing positive for Influenza B, he was prescribed oseltamivir. He was advised to continue his COPD medications, including triple therapy (fluticasone, umeclidinium, vilanterol) and ipratropium/albuterol inhalers...He returned to his primary care provider 3 days later, who started him on amoxicillin-clavulanate, benzonatate, and prednisone...He was treated with budesonide and albuterol nebulizers, tiotropium/olodaterol inhaler, IV methylprednisolone, diphenhydramine plus hydrocodone, and azithromycin... Patients with influenza and comorbidities such as COPD and coronary artery disease should be assessed for signs of syncope, particularly in those with prolonged and intense coughing episodes. Additionally, patient education and close monitoring are crucial to reduce the risk of fall-related injuries."

Clinical • Cardiovascular • Chronic Cough • Chronic Obstructive Pulmonary Disease • Coronary Artery Disease • Cough • Gastroenterology • Gastroesophageal Reflux Disease • Hypertension • Hypotension • Immunology • Infectious Disease • Influenza • Musculoskeletal Diseases • Obstructive Sleep Apnea • Orthopedics • Pulmonary Disease • Respiratory Diseases • Sleep Disorder

A COMMON COMPLAINT WITH AN UNCOMMON CAUSE (CHEST 2025) - "He was initially treated by his primary care physician with benzonatate, fluticasone nasal spray, and albuterol, which provided some relief...Treatment with budesonide/ formoterol was continued, pantoprazole was added, and he was scheduled for follow-up in three months... While the vast majority of chronic cough patients have an easily identifiable etiology, a systematic approach will permit clinicians to identify even extremely rare, and potentially fatal if left untreated, causes."

Allergic Bronchopulmonary Aspergillosis • Anemia • Asthma • Chronic Cough • Chronic Eosinophilic Leukemia • Chronic Obstructive Pulmonary Disease • Cough • Eosinophilia • Eosinophilic Granulomatosis With Polyangiitis • Gastroenterology • Gastroesophageal Reflux Disease • Hematological Disorders • Hematological Malignancies • Hypereosinophilic Syndrome • Langerhans Cell Histiocytosis • Leukemia • Myeloproliferative Neoplasm • Pulmonary Disease • Rare Diseases • Respiratory Diseases • Thrombocytopenia • Vasculitis • PDGFRA

DISPARITIES IN MANAGEMENT OF REFRACTORY CHRONIC COUGH: A RETROSPECTIVE DATABASE REVIEW (CHEST 2025) - "For all patients, benzonatate was the most prescribed antitussive (23%), followed by guaifenesin (13%), codeine (11%) and gabapentin (7%). Black patients were more likely to be prescribed benzonatate (OR: 1.205, CI 1.14-1.274), guaifenesin (OR: 1.316, CI 1.213-1.428), and dextromethorphan (OR: 1.453, CI 1.314-1.608) compared to White patients but they were less likely to receive codeine (OR: 0.882, CI 0.793-0.981) and amitriptyline (OR: 0.661, CI 0.5-0.873)... This study highlights significant racial disparities in the prescribing patterns for RCC therapies. Black patients were more likely to receive non-opioid antitussives but less likely to be prescribed opioid-based treatments such as codeine and tricyclic antidepressants such as amitriptyline. These differences may reflect systemic biases or variations in clinical decision- making and warrant further investigation into their underlying causes."

Retrospective data • Review • Allergic Rhinitis • Asthma • Chronic Cough • Chronic Obstructive Pulmonary Disease • Cough • Gastroesophageal Reflux Disease • Immunology • Inflammation • Renal Cell Carcinoma • Respiratory Diseases

UNEXPECTED PULMONARY FINDINGS IN A TRAVELER: A CASE OF LATENT TUBERCULOSIS IN AN ELDERLY PATIENT (CHEST 2025) - "was diagnosed with acute bronchitis and treated with albuterol and azithromycin, leading to symptom improvement...He was prescribed intranasal fluticasone, fluticasone/vilanterol inhaler, and tessalon perles, which resolved his symptoms... This case features the importance of screening for LTBI in elderly patients with new-onset pulmonary abnormalities, even if prior TB tests were negative. It emphasizes the increasing role of CT imaging in spotting asymptomatic pulmonary abnormalities that might need further investigation. A multidisciplinary approach is crucial for accurate diagnosis and management."

Clinical • Chronic Cough • Cough • Immunology • Infectious Disease • Mood Disorders • Pneumonia • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Identifying Pediatric Drug Safety Knowledge Gaps: An Integrated Approach Leveraging Real-World Data, a Biomedical Knowledge Base, and Postmarketing Surveillance Data. (PubMed, Pharmacotherapy) - "Approved in 1958, Benzonatate, a nonnarcotic antitussive agent has a limited safety evidence with only nine PE/PK publications in six decades. Moreover, it is frequently prescribed off-label for cough relief despite questionable effectiveness, and high-risk of serious ADEs. Our findings reveal a disconnect between clinical practice and suppporting safety evidence. As such, there is critical need to study the safety of this drug using emerging real-world data for real-world evidence. In summary, this study presents an approach that is systematic, objective, reproducible, and data driven to identify and prioritize drug-ADE combinations with limited evidence."

Journal • P4 data • Real-world evidence • Cardiovascular • CNS Disorders • Cough • Epilepsy • Pediatrics • Respiratory Diseases

Corticosteroids, Antitussives, and Inhalers for Lower Respiratory Tract Infections in US Primary Care: A Prospective Cohort Study. (PubMed, J Gen Intern Med) - "Despite having no evidence of benefit and well-known harms, systemic corticosteroids and benzonatate were commonly prescribed. Adequately powered pragmatic trials in primary care settings are badly needed to provide appropriate data to guide practice."

Journal • Cough • Infectious Disease • Pulmonary Disease • Respiratory Diseases

Outcomes of benzonatate exposures reported to a single United States poison center: a 20-year review. (PubMed, Clin Toxicol (Phila)) - "Unintentional exposures did not result in clinically significant adverse effects. Although benzonatate can result in serious toxicity, adults with unintentional exposures may be candidates for home management."

Journal • CNS Disorders • Depression • Epilepsy • Pediatrics • Psychiatry

Ocrelizumab-induced Cryptogenic Organizing Pneumonia in a Patient With Multiple Sclerosis (ATS 2025) - "Prior outpatient treatments included pseudoephedrine, benzonatate, inhaled albuterol, doxycycline, cefdinir, and prednisone, all without relief of symptoms. Our case represents an additional instance of organizing pneumonia induced by anti-CD20 agents. As our patient developed symptoms at 3.5 years after initiation, it provides additional data regarding the timing of organizing pneumonia presentation with anti-CD20 agents."

Clinical • CNS Disorders • Infectious Disease • Interstitial Lung Disease • Migraine • Multiple Sclerosis • Pain • Pneumonia • Pulmonary Disease • Respiratory Diseases

Non-asthmatic Eosinophilic Bronchitis (ATS 2025) - "Her symptoms had been non-remitting despite various locations to different parts of the United States and outside the country, inhaled bronchodilator use, benzonatate use, and guaifenesin use. Several trips to the emergency room and urgent care centers left her with doxycycline and oral steroids, which did not abate her symptoms...Pulmonary function testing usually shows no objective evidence of variable airflow obstruction, a normal airway hyperresponsiveness (a provocative concentration of methacholine of > 16 mg/mL, producing a 20% decrease in FEV1), and sputum eosinophilia. Nonasthmatic eosinophilic bronchitis usually responds well to inhaled corticosteroids therapy."

Asthma • Chronic Cough • Cough • Eosinophilia • Infectious Disease • Novel Coronavirus Disease • Pulmonary Disease • Respiratory Diseases

Effusion Confusion (ATS 2025) - "He had been diagnosed with COVID 19 twelve days prior, treated as outpatient with steroid, tessalon perles and albuterol, without improvement...He was treated with solumedrol, ceftriaxone and doxycycline, and furosemide without significant symptomatic improvement...Across several studies, COVID-19 has been linked with pericardial effusions, tamponade, clotting disorders, parenchymal lung changes and pleural effusions (1) . Though the frequency of pleural effusions is low, around "7.3%" in COVID-19 patients in two meta-analysis, often they represent a increased severity of illness and mortality, warranting close monitoring of such patients."

Bronchiectasis • Cardiovascular • Congestive Heart Failure • Cough • Genito-urinary Cancer • Heart Failure • Hodgkin Lymphoma • Infectious Disease • Oncology • Prostate Cancer • Pulmonary Disease • Respiratory Diseases • Solid Tumor

Unmasking Hypersensitivity Pneumonitis: A Complex Case of Environmental Exposures and COVID-19 (ATS 2025) - "He tested positive for COVID-19 at that time and was treated with benzonatate and Combivent...He was doing very well on clinic follow-up 1.5 weeks after finishing his prednisone taper. He continued to take fluticasone/salmeterol, which he believes helps...However, other differentials include interstitial lung disease secondary to adalimumab, COVID-19 pneumonitis, or possible asthma exacerbation. This case underscores the importance of surveying for environmental exposures in dyspneic patients especially when symptoms are persistent despite treatment. This also highlights that respiratory viral infections, and in this scenario, COVID-19, may contribute to the development of hypersensitivity pneumonitis."

Clinical • Asthma • Cough • Gastroenterology • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammation • Inflammatory Bowel Disease • Interstitial Lung Disease • Novel Coronavirus Disease • Pain • Pneumonia • Pulmonary Disease • Ulcerative Colitis

A COUGH THAT CAUSED A SODIUM CHANNEL BLOCKADE: A CURIOUS CASE OF FLECAINIDE TOXICITY - Rebecca Garber (ACC 2025) - "Understanding the pharmacokinetics of these frequently used medications is imperative to prevent harmful side effects.Case: A 77 year old male with history of chronic kidney disease stage 3b and paroxysmal atrial fibrillation on Apixaban and Flecainide presented to the hospital after a syncopal episode...There was concern for subclinical seizures causing the patient's altered mental status, so he was started on Lacosamide... When prescribing medications, it is imperative to think of side effects and pharmacodynamics, especially with antiarrhythmics and antiepileptics. Moreover, patients must also be counseled regarding over-the-counter medications, such as Tessalon Perl cough drops, which are sodium channel blockers, as they can interfere with prescribed medications."

Clinical • Atrial Fibrillation • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Cough • Epilepsy • Infectious Disease • Nephrology • Novel Coronavirus Disease • Renal Disease • Respiratory Diseases

Morphological and Phylogenetic Analyses of Ceratomyxa tessaloniensis n. sp. In Astyanax mexicanus De Fillipi, 1853 (Characiformes: Characidae) from the Flexal River, Tessalônica Community, Amapá, Amazon, Brazil. (PubMed, Acta Parasitol) - "Phylogenetic analysis grouped Ceratomyxa tessaloniensis n. sp., with strong nodal support for the exclusive clade of freshwater species, being a new species described for the State of Amapá, the first described in A. mexicanus and the first species with the presence of non-wormlike plasmodia in South America."

Journal

Surviving the Stridor: Navigating Critical Pediatric Airway Stenosis to ECMO Intervention (ASA 2024) - "We present a case of a 15 y/o patient with medical history of depression with attempted suicide by overdose of Tessalon pearls...Case highlights include an emphasis on maintaining spontaneous respiration, deciding to initiate heliox, and employment of ECMO cannulation. Ultimately, quick perioperative decision-making by the OR team allowed for subsequent tracheal dilations with thoracic surgery and successful ECMO decannulation."

Clinical • CNS Disorders • Depression • Pediatrics • Psychiatry

An Underestimated Toxin: The Case of Intentional Benzonatate Overdose Resulting in Seizure and Cardiac Arrest (ATS 2024) - "Return of circulation was achieved after two rounds of ACLS with epinephrine and she was intubated at the scene. Benzonatate is an excellent example of a common drug with a narrow therapeutic window whose toxicity is under-recognized. Our case demonstrates benzonatate overdose and quintessential toxidrome and prompts consideration of prescribing practices and patient safety instructions."

Clinical • Anesthesia • Cardiovascular • CNS Disorders • Cough • Epilepsy • Metabolic Disorders • Pediatrics • Psychiatry • Respiratory Diseases

Characterizing hub biomarkers for post-transplant renal fibrosis and unveiling their immunological functions through RNA sequencing and advanced machine learning techniques. (PubMed, J Transl Med) - "Four potential hub biomarkers most associated with post-transplant renal fibrosis, as well as four potentially effective small molecules, were identified, providing valuable insights for studying the molecular mechanisms underlying post-transplant renal fibrosis and exploring new targets."

Biomarker • Journal • Machine learning • Metastases • Post-transplantation • Chronic Kidney Disease • Fibrosis • Immunology • Nephrology • Renal Disease • Transplantation • CD3G • FCGR2A • GZMH

Medication Trends in the Military: A Comparative Analysis of Prescribing Patterns Among Service Members Seen by a Pharmacist and Implications for Medical Readiness. (PubMed, Mil Med) - "Understanding medication patterns among ADSMs may be able to help health care professionals proactively address pharmacological challenges and optimize pharmaceutical use in this unique population. This knowledge can also aid in the development of training modules focused on medication side effects, interactions, counseling, and implications on military deployment for the most commonly used medications. Future examination into prescribing cascades and medication use related to proton-pump inhibitors, docusate, benzonatate, and muscle relaxants may identify opportunities to provide better care or lower cost."

Journal • Inflammation • Pain • Psychiatry

Patterns of Cough Medication Prescribing among Patients with Chronic Cough in Florida: 2012-2021. (PubMed, J Clin Med) - "CC patients in Florida had limited CM use with increasing trends in use of benzonatate, dextromethorphan, and gabapentinoids and a decreasing trend in opioid antitussive use. CC patients, particularly with chronic prescription CM use, experienced substantial disease burden."

Journal • Chronic Cough • Cough • Immunology • Oncology • Pulmonary Disease • Respiratory Diseases

ENDOBRONCHIAL ACTINOMYCOSIS ASSOCIATED WITH CHICKEN BONE ASPIRATION (CHEST 2023) - "Patient takes lisinopril for hypertension and works at a tire mold shop (aluminum exposure)...Patient had previously been treated for his cough several times with antibiotics, steroids, benzonatate and antitussives without resolution...Treatment includes foreign body removal and prolonged (months) courses of penicillin, amoxicillin, tetracycline, or clindamycin. Endobronchial actinomycosis can present as a chronic cough unresponsive to antibiotics and inhalers. This case raises the necessity of taking an excellent clinical history and maintaining a high clinical index of suspicion in the management of endobronchial lesions."

Bronchiectasis • Cardiovascular • Chronic Cough • Cough • Fibrosis • Gastrointestinal Disorder • Hypertension • Immunology • Infectious Disease • Lung Cancer • Oncology • Pneumonia • Pulmonary Disease • Respiratory Diseases • Solid Tumor

A CASE OF SPONTANEOUS LUNG HERNIATION WITH DIAPHRAGMATIC TEAR AFTER SEVERE COUGH (CHEST 2023) - "He received benzonatate, prednisone, and ipratropium bromide-albuterol inhaler and was discharged. Spontaneous lung herniation is a rare condition that requires prompt diagnosis and treatment. Conservative management or surgical repair may be required depending on the location and severity of the herniation and close follow-up is necessary to monitor possible recurrence."

Clinical • Cardiovascular • Cough • Genetic Disorders • Infectious Disease • Inflammation • Musculoskeletal Diseases • Novel Coronavirus Disease • Obesity • Orthopedics • Pain • Pneumonia • Pulmonary Disease • Respiratory Diseases • Rheumatology

"Tessalon Perles!!" (@LauraDoverMD)

Harvesting Septations: Loculated MSSE Empyema in a 70-Year-Old Agricultural Worker (ATS 2023) - "The patient had these symptoms for a total of 3 months but had failed outpatient treatment including a course of antihistamines and then a course of prednisone, azithromycin, albuterol, and Tessalon Perles. Typically, such severe infections are caused by MDR bacteria and have a significant display of systemic symptoms due to the purulent nature of the infection, none of which our patient possessed. Although there was no reported growth on pleural samples, this is not uncommon.CONCLUSION As MSSE was a causal factor confirmed by blood cultures, it is important not to discount something as simple as MSSE to be a contaminant: a more serious underlying infection may be present."

Cataract • Dermatology • Gastroesophageal Reflux Disease • Immunology • Infectious Disease • Ophthalmology • Orthopedics • Pneumonia • Psoriasis • Respiratory Diseases

Prescription Antitussive Use Trajectories and Their Characteristics Among Patients with Chronic Cough in Florida (ISPOR 2023) - "Opioid antitussives, dextromethorphan, and benzonatate are commonly used for symptomatic relief of cough despite a lack of proven efficacy and safety evidence for CC. In Florida, over 70% of CC patients did not have any antitussive prescription, and CC patients with chronic antitussive use was low. CC patients with chronic antitussive use had a higher burden of CC-related comorbidities and medication use at baseline. Chronic antitussive use may indicate unmet or suboptimal management of CC in a subset of CC patients."

Clinical • Allergic Rhinitis • Asthma • Chronic Cough • Cough • Gastroenterology • Gastroesophageal Reflux Disease • Immunology • Inflammation • Otorhinolaryngology • Pulmonary Disease • Respiratory Diseases • Sinusitis

Benzonatate as a local anesthetic. (PubMed, PLoS One) - "This study demonstrates that benzonatate does act as a local anesthetic at the peripheral nerve, with sensory and motor nerve blockade. Benzonatate interacts with tetrodotoxin and Tween 80 to prolong nerve blockade. However, benzonatate causes significant myotoxicity, even at subtherapeutic concentrations."

Journal • Anesthesia • Inflammation