Comparative Pharmacology
Head-to-head clinical analysis: DELSYM versus TESSALON.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DELSYM versus TESSALON.
DELSYM vs TESSALON
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Dextromethorphan is a non-competitive NMDA receptor antagonist and sigma-1 receptor agonist, which suppresses cough by elevating the threshold for coughing in the medullary cough center.
Benzonatate is a local anesthetic structurally related to tetracaine that inhibits pulmonary stretch receptors and reduces the cough reflex by decreasing the sensitivity of vagal afferent fibers in the respiratory tract.
60 mg orally every 12 hours (extended-release suspension).
100 mg orally three times daily as needed for cough. Maximum 600 mg/day.
None Documented
None Documented
Terminal elimination half-life of dextromethorphan is approximately 11 hours (range 9-14 hours) in extensive metabolizers; in poor metabolizers (CYP2D6 deficiency), half-life can exceed 24 hours, leading to accumulation.
Terminal elimination half-life is approximately 12-15 hours in adults; significant interindividual variability. No accumulation with q6h dosing.
Renal excretion of unchanged drug and metabolites, primarily dextrorphan glucuronide; <5% excreted unchanged in urine. Biliary/fecal elimination is negligible.
Renal: <5% unchanged; primary route is hepatic metabolism with metabolites excreted renally and fecally; exact biliary/fecal % not established in humans.
Category C
Category C
Antitussive
Antitussive