Benzonatate is a prescription cough medicine called Tessalon Perles that treats bothersome or persistent coughing. They are small liquid-filled capsules which do not affect the brain and numb the cough receptors in the airways, so that they do not have the urge to cough. Tessalon Perles are prescription only, meaning that they cannot be purchased over the counter, although they can be prescribed by a clinician, which is often a same day telehealth consultation. Here's what Tessalon Perles are for, how to get them, and the important safety rules to know.

TL;DR: Key takeaways

  • Tessalon Perles are the brand name for benzonatate, a prescription non-narcotic cough suppressant.

  • They numb the airway receptors that trigger coughing, working differently from cough syrups.

  • They're prescription-only, not available over the counter; a telehealth visit can get them same-day.

  • Capsules must be swallowed whole, never chewed or sucked, and kept away from children (they can be fatal to kids).

  • They relieve the cough symptom, so a clinician often addresses the underlying cause too.

What are Tessalon Perles?

As you may have heard the term and be wondering what it means, Tessalon Perles are a prescription cough medicine. The brand name is "Tessalon" while the capsules are soft and filled with a liquid, known as "Perles.

According to MedlinePlus, the active ingredient in Tessalon Perles is benzonatate, which is a non-narcotic cough suppressant (antitussive). Non-narcotic: It is non-opioid and does not have the same sleepiness or dependency issues as other cough medications. The distinctive round liquid-filled capsules (the "perles") have been available in the US since 1958 and are known as Tessalon. It's also known by the more familiar name of Tessalon pearls or alternatively by its generic term, benzonatate. It is prescription only – we shall return to this. For more information about the medicine itself, read our guide to benzonatate for cough which details the generic medicine. This page has information about Tessalon Perles specifically, what it is used for, how to obtain it and how to use it safely.

What are Tessalon Perles used for?

To know what Tessalon Perles for cough are, will help you understand when they are the correct choice. Their function is defined.

The Cleveland Clinic website states that Tessalon Perles treat the symptoms of cough, specifically a persistent, disruptive or nagging cough. It can occur when a person has a persistent cough due to a respiratory infection (such as bronchitis), a cough that disrupts sleep or a cough that doesn't go away despite using over-the-counter medications. The big difference to remember is that Tessalon Perles suppress a cough, but do not cure the cause of the cough. A cough is usually a symptom of a problem (infection, asthma, allergies, acid reflux) and so when the cough is suppressed, the underlying cause is not being treated. That's why it is recommended that a clinician first think about the reasons for coughing, not how to make it stop. Tessalon can help improve a person's sense of well-being, particularly when it comes to sleep, but while it is helping, the person is being treated for the underlying condition or it is going away.

How Tessalon Perles work

The unique thing about Tessalon Perles is that they are not like a regular cough syrup and knowing this is part of the reason why they are considered safe.

The ingredient in Tessalon is called benzonatate, which is chemically similar to local anesthetics, and works by paralyzing the stretch receptors in your airways and lungs that activate the cough reflex, the FDA says. It suppresses these receptors and lessens the coughing desire. This anesthetic effect is the reason why the capsules need to be swallowed whole – if they are chewed or dissolve in the mouth, they numb it and may lead to choking and in very rare cases severe reactions. Tessalon Perles typically begin to take effect in about 15-20 minutes and will remain effective for several hours. This unique action is responsible for their efficacy in treating a cough that is persistent and not affected by other therapies, and is the reason why the "swallow whole" rule is so significant.

Are Tessalon Perles over the counter? How to get them

A common question is whether you can just pick them up at the pharmacy. The answer to tessalon perles over the counter is no, and here's how you actually get them.

Tessalon Perles are prescription-only in the US, you can't buy them over the counter. To get them, a clinician needs to evaluate your cough and decide they're appropriate. The good news is that this is often quick and convenient:

  • Telehealth. A licensed clinician can assess your cough by video or secure questionnaire and, if Tessalon Perles are appropriate, send a prescription to your pharmacy, often the same day.

  • Urgent care or a retail clinic, for a same-day in-person visit.

  • Your primary care provider, especially if you have an ongoing relationship or a persistent cough that needs a fuller workup.

August's online urgent care offers a $39 visit where a licensed clinician can evaluate your cough and prescribe appropriate treatment when warranted, starting with a free AI symptom check, and the free August AI Symptom Checker can help you gauge your symptoms first. Because Tessalon treats the symptom, a clinician will also consider whether your cough needs treatment for an underlying cause. A visit never guarantees a prescription, the clinician decides what's right for your situation.

Tessalon Perles generic and dosing basics

Two practical questions come up a lot: whether there's a cheaper generic, and how they're taken. Here's what to know, with the important note that dosing is a clinician's call.

On the generic: yes, a tessalon perles generic exists, it's benzonatate, the same active ingredient, available in generic capsules that are typically much less expensive than the brand. Clinicians frequently prescribe generic benzonatate, and it works the same way. If cost is a concern, ask your prescriber or pharmacist about the generic.

On dosing: Tessalon Perles come in capsule strengths (commonly 100mg and 200mg), and the tessalon perles dose is set by your prescriber based on your situation, so follow their instructions and the label rather than any general figure. The universal rules that apply to everyone: swallow the capsule whole (never chew, suck, crush, or dissolve it), don't take more than prescribed, and never take two doses at once, if you miss a dose, skip it and resume your normal schedule. These aren't just guidelines; as the next section explains, they're genuine safety rules.

The safety rules that matter most

This is the most important part of the article, because Tessalon Perles carry specific, serious safety warnings. Please read this before taking them or keeping them at home.

Keep them away from children, they can be fatal to kids. The FDA warns that accidental ingestion by children under 10 can cause death, and deaths have occurred in very young children who swallowed as few as one or two capsules. The round, liquid-filled "perles" can look like candy to a child. Always store Tessalon Perles in a child-resistant container, out of sight and reach. If a child accidentally swallows any, call Poison Control (1-800-222-1222) and get emergency help immediately, overdose signs can appear within 15 to 20 minutes. Tessalon is not recommended for children under 10.

Swallow capsules whole, never chew, suck, crush, or dissolve them. Because benzonatate is a numbing agent, releasing it in the mouth can numb your throat and cause choking, and sometimes serious reactions affecting breathing and circulation. If your mouth or throat feels numb, don't eat or drink until it passes, and seek medical attention if it worsens.

Don't take extra. Overdose is dangerous in adults and teens too, and can cause seizures, irregular heart rhythms, and other serious effects, with signs appearing rapidly. Take only the dose your clinician prescribed, and never double up.

What drugs should not be taken with Tessalon Perles?

It's smart to ask what to avoid combining with Tessalon Perles. The honest answer is nuanced, and the safest approach is simple.

Benzonatate (the ingredient in Tessalon Perles) doesn't have a long list of classic dangerous drug interactions, but there are real cautions. Because it can cause drowsiness, dizziness, or mental confusion in some people, combining it with other sedating substances, alcohol, sedatives, or other central-nervous-system depressants, can add to those effects. There have also been reports of confusion or hallucinations when it's taken with certain other medications. Rather than rely on a memorized list, the safe practice is to tell your prescriber and pharmacist about everything you take, including other cough and cold products (to avoid doubling up on similar ingredients), prescription drugs, over-the-counter medicines, and supplements, so they can check for concerns specific to you. Avoid alcohol while taking Tessalon Perles. And if you feel unusually confused, dizzy, or unwell after taking them, especially alongside other medications, contact your clinician.

When to see a clinician about your cough

Since Tessalon Perles need a prescription and a cough can have many causes, knowing when to seek care, and when it's urgent, helps you treat the right thing safely.

See a clinician to evaluate a cough that's persistent (lasting more than a few weeks), recurrent, or bothersome enough to want prescription relief, they can determine the cause and whether Tessalon Perles or another approach fits. Seek prompt or emergency care, not a routine visit, if your cough comes with trouble breathing, chest pain, coughing up blood, high fever, or bluish lips, or for a cough in a young child. These can signal something serious that needs immediate attention. A cough is usually minor and self-limited, but a persistent or severe one deserves a proper evaluation, both to treat it effectively and to rule out underlying conditions like asthma, reflux, or infection. Tessalon Perles can help with the symptom, but making sure you're addressing the cause is what a clinician adds.

Frequently Asked Questions

Tessalon Perles are used for the symptomatic relief of cough, especially a persistent or disruptive one that over-the-counter remedies haven't calmed. They're a prescription non-narcotic cough suppressant containing benzonatate, which numbs the airway receptors that trigger the cough reflex. They're often used for coughs from respiratory infections or coughs interfering with sleep. Importantly, they relieve the cough itself but don't treat its underlying cause, so a clinician usually considers why you're coughing too.

Yes. Tessalon Perles is the brand name, and benzonatate is the generic (active ingredient), they're the same medication. Generic benzonatate capsules work the same way as brand-name Tessalon Perles and are typically much less expensive, which is why clinicians often prescribe the generic. So if you're prescribed either "Tessalon Perles" or "benzonatate," you're getting the same cough medicine. You may also see the brand spelled "Tessalon pearls," a common variation.

No. Tessalon Perles (benzonatate) are prescription-only in the US, so you can't buy them over the counter. To get them, a clinician must evaluate your cough and decide they're appropriate, which can often be done through a same-day telehealth visit. Over-the-counter cough options (like dextromethorphan) exist for milder coughs, but Tessalon Perles specifically require a prescription. Any website selling them without one isn't legitimate.

A clinician needs to prescribe them. The convenient route is often telehealth: a licensed clinician assesses your cough by video or questionnaire and, if Tessalon Perles are appropriate, sends a prescription to your pharmacy, frequently the same day. You can also see urgent care, a retail clinic, or your primary care provider. Because the medicine treats the symptom, the clinician will also consider whether your cough needs treatment for an underlying cause. A visit never guarantees a prescription.

Because they're a numbing agent. Benzonatate is related to local anesthetics, so chewing, sucking, or crushing a capsule releases the drug in your mouth, numbing your mouth and throat instead of your airways. This can cause choking and, in some cases, serious reactions affecting breathing and circulation. Always swallow the capsule whole. If your mouth or throat feels numb, don't eat or drink until it resolves, and seek medical attention if symptoms worsen. This is a genuine safety rule.

Tessalon Perles are not recommended for children under 10, and they can be fatal to young children who accidentally swallow them, deaths have occurred in very young children who took as few as one or two capsules. The round, liquid-filled capsules can look like candy. Always store them in a child-resistant container, out of reach. If a child accidentally ingests any, call Poison Control (1-800-222-1222) and seek emergency care immediately, overdose signs can appear within 15 to 20 minutes.

Tessalon Perles typically begin reducing cough within about 15 to 20 minutes of taking them, with the effect lasting a few hours, which is why they're taken multiple times a day as prescribed. If they don't seem to help, or your cough worsens or persists, contact your clinician rather than taking extra, never double up on doses. There may be a more effective option or an underlying cause of the cough that needs treatment.

Yes, and it's dangerous. Overdose can cause seizures, irregular heart rhythms, coma, and cardiac arrest, and can happen in adults and teens, not just children, with signs appearing rapidly (within 15 to 20 minutes). Never take more than prescribed or two doses at once; if you miss a dose, skip it. If an overdose is suspected, call Poison Control (1-800-222-1222) or seek emergency care immediately. Take Tessalon Perles only exactly as your clinician directs.