Tesslon Perles Use in ESRD Patients

Introduction to Benzonatate

• The American Thoracic Society recommends that Tesslon Perles (benzonatate) can be used in ESRD patients without dose adjustment, as it is metabolized hepatically rather than renally, but extreme caution is warranted due to its narrow therapeutic window and potential for life-threatening toxicity 1

Renal Dosing Considerations

• No dose adjustment is required for benzonatate in ESRD patients because the medication undergoes hepatic metabolism rather than renal clearance, similar to rifampin and isoniazid 1
• Benzonatate is not removed by hemodialysis due to its pharmacokinetic properties, so supplemental dosing post-dialysis is unnecessary 1

Clinical Considerations

• Medication reconciliation is critical in ESRD patients to prevent prescribing cascades and identify all medications that could contribute to adverse outcomes, as recommended by the National Kidney Foundation 2
• ESRD patients have high symptom burden and multiple comorbidities that complicate medication management, according to the American College of Physicians 3