Cardiac Arrest With Residual Blindness After Overdose of Tessalon® (Benzonatate) Perles

Antitussive Drugs—Past, Present, and Future

“…Benzonatate is administered orally and absorbed systemically with an onset of action of 15-20 minutes and with a 3-to 8-hour duration of action (Sweetman, 2008). The recommended dose for adults and children over 10 years of age is 100 to 200 mg every 8 hours as required, with a maximum daily dose of 600 mg. Its side effect profile is relatively benign, although recent concerns have been raised as to the safety of benzonatate with case reports of seizures (Winter et al, 2010) and cardiac arrest (Cohen et al, 2011). Benzonatate remains a prescription drug for the relief of cough in patients over the age of 10 years, but the FDA recently issued a drug safety communication about this drug.…”

Analysis of Benzonatate Overdoses Among Adults and Children from 1969–2010 by the United States Food and Drug Administration

“…Despite the long history of benzonatate use in the United States, limited published information is available regarding the frequency or severity of adverse outcomes associated with its overdose. The margin for toxicity above the therapeutic dose (toxicity index) for benzonatate is variable but may be relatively low, with serious outcomes reported in children at doses as low as 200 mg . A 7‐year, retrospective review of all single‐substance benzonatate ingestions cataloged in the National Poison Data System from 2000–2006 reported 2172 cases of benzonatate ingestion; four people died, and 116 (5%) had serious outcomes including tachycardia, agitation, seizures, coma, ventricular dysrhythmia, cardiac arrest, hypotension, and asystole .…”

Confabulation Resilience of the Developing Brain: A Brief Review

“…3. Case report by Cohen et al (2011): A 17-year-old girl suffered cardiac arrest due to overdose of benzonatate as part of a suicide attempt. After resuscitation an MR scan of her brain revealed diffuse infarcts in both the basal ganglia and the occipital lobes, and showed signs of white matter hypoxia in the frontal lobes compatible with anoxic injuries.…”