Comparative Pharmacology
Head-to-head clinical analysis: TESSALON versus VICKS FORMULA 44.
Peer-Reviewed Evidence
Head-to-head clinical analysis: TESSALON versus VICKS FORMULA 44.
TESSALON vs VICKS FORMULA 44
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
VICKS FORMULA 44 contains dextromethorphan (NMDA receptor antagonist and sigma-1 receptor agonist; suppresses cough by acting on the medullary cough center) and doxylamine (first-generation antihistamine; H1-receptor antagonist; anticholinergic and sedative effects).
100 mg orally three times daily as needed for cough. Maximum 600 mg/day.
VICKS FORMULA 44 is a combination product containing dextromethorphan (cough suppressant) and doxylamine (antihistamine). The typical adult dose is 30 mg dextromethorphan/6.25 mg doxylamine (15 mL) orally every 6 hours as needed for cough and cold symptoms, not to exceed 4 doses per 24 hours.
None Documented
None Documented
Terminal elimination half-life is approximately 12-15 hours in adults; significant interindividual variability. No accumulation with q6h dosing.
Dextromethorphan: 3-6 hours (extensive metabolizers), up to 24 hours (poor metabolizers); doxylamine: 10-12 hours. Clinically, half-life may be prolonged in elderly, hepatic impairment, or CYP2D6 poor metabolizers.
Renal: <5% unchanged; primary route is hepatic metabolism with metabolites excreted renally and fecally; exact biliary/fecal % not established in humans.
Renal excretion of unchanged drug and metabolites (dextromethorphan and doxylamine): dextromethorphan is extensively metabolized; <10% excreted unchanged. Doxylamine: ~60% excreted renally as unchanged and metabolites.
Category C
Category C
Antitussive
Antitussive