Management of Cough in Patients with Seizure Disorders

Safety Profile of Benzonatate in Seizure Patients

The American College of Physicians and other guideline societies do not list benzonatate among agents requiring caution in seizure patients, unlike amantadine and rimantadine which carry explicit warnings 1, 2, 3, 4.
The Centers for Disease Control and Prevention (CDC) guidelines specifically address seizure risks with various medications but do not list benzonatate as a medication that requires caution in seizure patients 1, 2, 3, 4, 5.

Amantadine is associated with an increased incidence of seizures in patients with seizure disorders, requiring close observation for increased seizure activity 1, 2, 3, 4.
Rimantadine may cause seizures or seizure-like activity in persons with a seizure history who are not receiving anticonvulsant medication 1, 2, 3, 4.
Zanamivir and oseltamivir have been associated with seizure events during postmarketing surveillance, although no epidemiologic studies have demonstrated an increased seizure risk 1, 2, 3, 4, 5.

The American Heart Association (AHA) recommends that nothing should be put in the mouth and no food, liquids, or oral medicines should be given to a person experiencing a seizure or who has decreased responsiveness after a seizure, classified as a Class 3-Harm recommendation 6.
The AHA guidelines advise waiting until the patient returns to baseline mental status (typically 5-10 minutes after seizure cessation) before administering any oral medications 6.
Activation of Emergency Medical Services (EMS) is recommended for seizures lasting >5 minutes, multiple seizures without return to baseline, first-time seizures, or failure to return to baseline within 5-10 minutes 6.