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Anyone else love Tessalon?


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My first rotation in school was Internal Medicine, and my preceptor was this amazing, good-humored, workaholic old dude. Half his patients were over 65, and so was he, I think. It was from Dr. B that I learned the value of a good pair of Chelsea boots (seriously, they go with everything), as well as the virtues of benzonatate for cough.

 

This stuff has apparently been around forever. After decades of use it still has a ridiculously low profile for side-effects and interactions. It has a low potential for abuse (and the only way to really misuse it is to break open the gelcaps and use it to numb your tongue; why anyone would do that is a mystery).

 

I find that I prescribe it a LOT during cough and cold season, and patients tend to be pretty happy with it as far as I can tell. It's a nice way to not prescribe codeine, as far as I'm concerned. But I don't see it used a lot in the notes for patients who have their PCP with my health system.

 

Is this some old-timer med that I have adopted? How common is this?

 

Not that I'm insecure about it, quite the opposite in fact, but I'm curious. Sometimes I feel like whoever makes the stuff should send me on a golf weekend or something.

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My use of benzonatate is about equal to tussionex pennkinetic.  Only one of them has been studied in a trial showing efficacy - tussionex.  I really like benzonatate for that postnasal drip "tickle" cough that people get - it tends to work remarkably well for that.  I find that when the stimulus is reactive airway the benzonatate can help desensitize the stretch receptors, especially in conjunction with good old albuterol.  But when the cough is deeper is in bronchitis or pneumonia or influenza, the tussionex seems to work better.  This is only my experience, but as mentioned a controlled trial has been performed and tussionex showed a modest benefit. 

 

YMMV

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Awesome, thanks, I'll read up on it.

 

Especially now that hydrocodone is Sched II, I feel like the thing I mentioned about plain benzonatate being an alternative to codeine is even more important (and honestly I might be tempted to go to codeine before anything with hydrocodone, just to save the administrative headaches), but you can't argue with results.

 

EDIT TO ADD:

 

 

 

  I really like benzonatate for that postnasal drip "tickle" cough that people get - it tends to work remarkably well for that.

 

Exactly. Most of the people who think they have "bronchitis" have a chest cold, which is taking forever to clear because of the constant drainage from up top. I explain to them that they should cough sometimes, to avoid blocking up the airways and courting real bronchitis, but benzonatate half an hour before bedtime can be a good way to get some sleep, so you can get up and hawk big glorious disgusting loogies in a steamy shower in the morning.

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Tessalon is the bomb. Just make sure to tell folks not to suck on them as that can cause laryngospasm. we had a peds code at our facility a few years ago when a parent gave tessalon to a 3 yr old thinking they were "cough drops". kid had resp failure, got intubated, etc and ended up doing fine. so, as long as they can swallow pills and understand the concept(say age >12) they are a great option.

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I used it too. Works well. I write in "SWALLOW WHOLE DO NOT CHEW" on the script.

 

I'm adding that to my scripts and caution parents to not give to anyone under 12.   I've never prescribed it for a peds patient.   

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I'm adding that to my scripts and caution parents to not give to anyone under 12. I've never prescribed it for a peds patient.

I wanted to edit my post but tapatalk disabled edit for some reason but it should say "DO NOT SUCH OR CHEW SWALLOW WHOLE" Sorry... These fandangled gizmos drive me nuts sometimes :P
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I'm surprised you guys have had success with tessalon, or any class of cough suppressant for that matter.  Many trials have shown that most otc and prescription meds are either no better than placebo or show slight effectiveness at best.

 

http://journal.publications.chestnet.org/article.aspx?articleid=1084262#t1

 

http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001831.pub2/abstract;jsessionid=D20DEF464FAEDAA8E41DA902F85CB243.f02t01

 

Evidence for antitussive use in cough from URI's is not good.  

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