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Medically reviewed by, Russell Braun RPH
You can feel the cold coming on and now your starting to cough. What can you use to suppress your cough? Then you remember a friend talking about using Tessalon Perles. As you can feel the urge to cough coming you wonder, are Tessalon Perles over the counter?
Tessalon Perles, What Are They Used For?
Tessalon perles (benzonatate) are used to suppress cough symptoms. This could be coughs caused by allergies, colds and other things that make it hard to breath. For instance many patients with COPD (chronic obstructive pulmonary disease) will have a persistent cough due to bronchitis or emphysema.
Tessalon perles helps to relive the urge to cough. Benzonatate works by numbing the vocal cords, larger airways and smaller air sacs in the lungs called alveoli. This is how it helps to stop your bodies natural reflex to cough when it senses something in these areas.
Tesslon perles are used by many doctors because they do not cause drowsiness and almost all other cough medicines do.
However, they should not be used in children under 10 years of age.
Are Tessalon Perles Over the Counter?
While there are several cough medications that are sold Over The Counter (OTC), tessalon perles are not one of them.
Both brand and generic products come in a 100mg and 200mg dosage form. Your doctor will decide which dose is right for you. Typically they are doses 8 hours apart, which comes out to three times per day.
Where Can I Get Benzonatate?
Unfortunately, benzonatate is only available with a prescription from your doctor. Even though benzonatate is a non-narcotic, it is not available OTC. Therefore, you will have to go to a pharmacy to pick up your prescription. You may also find that mail order pharmacies will deliver this to your home.
What Is a Comparable Alternative to Benzonatate?
The name perle also confuses some people. It was first marketed as a brand name product in the perle form which is just a soft gel form of a capsule. This makes it easier for the drug to dissolve quickly.
“Unfortunately, there are no comparable products to benzonatate that are available over the counter.”
One important note, benzonatate is is not a narcotic. Almost all the other prescription cough suppressants are narcotics. This is important because opioids are used as cough suppressants and they have been in the national spotlight over the addiction potential that has lead to the opioid epidemic. If you have concerns about opioids then benzonatate might be an option to ask your doctor about.
Don’t waste your money on random over the counter cough and cold medicines, ask your doctor or pharmacist for help!
What Is the Fastest Way to Cure a Cough?
Not surprisingly cough sends more people to pharmacies, doctors offices and emergency rooms than any other medical problem. This leads to patients looking for a quick fix.
Patients spend (and often waste) billions of dollars a year on products that are inappropriate for the following reasons.
- Wont treat the symptoms they have
- Are not as effective as placebo
- Contain ingredients they don’t really need
Do you really need a cough suppressant?
What should I take for my cough is probably the number one question pharmacists are asked. Most of the time patents are looking to self treat with over the counter options.
When you DO NOT need a cough suppressant
Coughing can be annoying, I understand why patients want to suppress it. What most people don’t realize is that coughing is a protective mechanism for the body. It is a way of getting phlegm and other drainage out of the lungs to prevent respiratory tract infections like pneumonia from happening.
If your cough is one that is “productive” then it should not be suppressed. A productive cough is one that is resulting in mucous and phlegm coming up into your mouth where it is either spit out or swallowed. When this is happening the body’s defense mechanism is working as designed.
Most coughs are caused by viruses and fewer doctors will give you an antibiotic for a virus due to resistance concerns. With no natural defense and no antibiotic you are setting yourself up to get a secondary bacterial infection from the virus if you suppress the cough.
If you want to shorten the time you are sick, and not spend extra money on urgent care, doctors office visit or an emergency room trips then stop using cough suppressants on productive coughs!
When you do need a cough suppressant
There are three cases where you should suppress your cough.
Dry coughs that do not produce any mucous or phlegm are called unproductive coughs. They are typically a result of inflammation of the airways and should be suppressed to let the airway heal. Typical causes of unproductive cough include:
- Smoking
- Allergies
- Asthma
- Heartburn or acid reflux
The cough is keeping you up at night. Regardless of if it is productive or non productive. Sleep is the best thing you can do to help your body heal. Make sure you get plenty of rest when you have a cough.
For milder pain you can use pain relievers such as ibuprofen or acetaminophen to help with this. When the pain becomes more severe, then it is time to start suppressing the cough, speak to your doctor at this point you will probably need a prescription cough suppressant.
What’s the Strongest Cough Medicine Over the Counter?
Evidence is mixed to support the efficacy of the hundreds of over the counter products that are marketed today for treating cough and cold symptoms. Many will have ingredients that don’t do anything to help with cough. However, they are marketed under a brand name that makes you think it would solve all your problems.
Most consumers are desperate for some relief when shopping for these products. Consequently, people don’t buy these products with they are feeling healthy. The combination of marketing tactics and desperation usually end up in consumers buying a product that doesn’t really do much to make them feel better.
There is also a strong placebo effect associated with cough and cold medications. Placebo are pills with no active ingredients that are used as a control group in clinical studies. The drug in question is tested against the placebo. Many times a placebo pill will have a positive effect, simply because the person thinks that the pill is helping them.
There are few studies where over the counter cough and cold drugs outperform placebo.
Don’t waste your money on random over the counter cough and cold medicines, ask your doctor or pharmacist for help!
Is Benzonatate Better Than Cough Syrup?
Benzonatate appears to be similar to placebo in stopping cough. This article goes more in depth on using benzonatate for sore throat.
What is The Fastest Way to Get Mucus Out of Your Lungs?
The fastest way to clear mucus seems to be a combination of two medications. Taking benzonatate together with guaifenesin, also known by the brand name Mucinex. The combination was found to be more effective than placebo at stopping cough. This is according to a study that looked at the inhibition of viral cough published in respiratory medicine.
“Therefore, taking benzonatate and guaifenesin together are better than most OTC cough syrups.”
What is the Generic for Tessalon?
Benzonatate is the generic form of Tessalon Perles. It is a much cheaper option than paying for the brand name product.
Most insurance plans will cover benzonatate, since it is the generic of Tessalon Perles. There is really no reason to take the brand name product as it costs 10 times more!
| Drug | Quantity | Day supply | Cost |
| Benzonatate 100mg | 30 | 10 | $6.00* |
| Tessalon Perles | 30 | 10 | $60.00* |
*Cost per GoodRx, subject to change.
Many drug discount cards will have lower prices than what your insurance copay would be. If you fill this via your insurance, make sure to see if the cash price is cheaper than your copay.
Related:
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Don’t forget to Add on Guaifenesin!
As mentioned above taking guaifenesin with Tessalon Perles has been shown in clinical trials to help suppress cough. Guaifenesin is available OTC and can even be bought online and delivered right to your front door.
| Drug | Days supply | Cost |
Guaifenesin ER 600mg | 20 | $13.99* |
Mucinex 600mg  | 20 | $14.29* |
Mucinex 600mg | 50 | $32.44* |
How Long Does it Take For Benzonatate to Work?
- Benzonatate starts working in your body within 15-30 minutes.
- Benzonatate should be taken every eight hours to keep cough at bay.
You should not chew or suck on the perles!
If you feel numbness in your mouth it is due to the benzonatate and it means you are not swallowing it quickly enough. Some other side effects from chewing or sucking on the perles:
- Nausea
- Vomiting
- Diziness
- Headache
The best thing to do is swallow them whole with plenty of water. The capsules are soft which is helpful for a sore throat from coughing. The soft capsule is easier to swallow with an painful, irritated throat.
Prescription Vs. OTC Cough Medicine
Prescription cough suppressants contain combinations of opioids and antihistamines. Opioids have been proven to be effective, but are a major risk for causing addiction and abuse. Antihistamines make you sleepy, but can actually cause respiratory infections to get worse.
That being said these should be reserved for short term use when severe coughing is keeping you up or causing pain.
The only over the counter cough suppressants that has been shown in some studies to be effective are dextromethorphan and guaifenesin. A database review of studies on PubMed (which is like google for the medical professionals) done by the Cochrane group stated the following:
“There is no good evidence for or against the effectiveness of OTC medicines in acute cough”
Why do people spend so many millions of dollars a year on cough medicines then? The answer probably lies in the placebo effect.
Another study from PubMed concluded that “placebo treatment has significant anti cough activity.”
Essentially your mind wants it to work because you feel so bad, and it does by making protective neurotransmitters according to the research.
The bottom line, many combination drugs are out there that will not help stop your cough. Don’t waste your money! Look for dextromethorphan, guaifenesin or nothing.
Non Drug Options For Cough
The number one non drug option is honey. Yep, that is right natural honey made from bees. One teaspoonful three times a day has been shown to be more effective than placebo and dextromethorphan.
Using a vaporizer in your bedroom when you sleep is also a good way to prevent your throat from becoming dry. Many types and brands are available, such as the one below.
Finally, drink plenty of water. Staying hydrated when you are sick is key to keeping your body in a state where it can defend itself against viral and bacterial attackers.
Get Dr. Jason Reed’s exclusive list of medication questions you MUST ask your doctor, FREE Click here!
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