With respiratory illnesses on the rise for both adults and children, many families are turning to cough medications for much-needed seasonal relief. Cook Children’s Health Care System is providing essential safety guidance regarding Tessalon Perles (benzonatate) after seeing cases of accidental ingestion. While effective for older children and adults, health experts are highlighting the importance of strict storage and dosing to prevent accidental ingestion in younger children.

 “Tessalon Perles are used to treat cough for kids over 10 but no safe dosing for younger children has been established,” said Mariana Wilson, M.D., medical director, Cook Children’s Medical Center- Prosper hospitalist. 

Because these liquid-filled capsules can resemble candy, they pose a significant risk to toddlers. Clinical data shows that even a small amount of benzonatate can be toxic to a young child; a recent tragedy in Denton County has prompted local experts to remind families of the need for secure storage.

“Unintentional poisoning can happen to anyone, at any age,” said Klaressa Broughton, poison prevention program coordinator at the Center for Community Health. Broughton explains that these incidents, affecting children from birth through age 18, primarily involved medications and unspecified non-drug poisonings.

In 2025, Cook Children’s Medical Center - Fort Worth saw an increase of poisoning encounters: 1,031 cases compared to 818 in 2024. Broughton explains that the top poisoning for 2025 involved children of all ages from birth to 18 and were related to medication and unspecified non-drug poisonings.  

“If the capsules are chewed, then release of benzonatate from the capsule in the mouth can produce a temporary numbing of the mouth and choking could occur,” explained Wilson. “If parents find a chewed capsule, even if it’s not completely consumed, they should call poison control or come to the ED,” said Wilson.

Cook Children’s experts share what care givers should know to keep their children safe.

Symptoms of Overdose

Symptoms of a benzonatate overdose can appear rapidly, often within 15 to 20 minutes of ingestion:

• Restlessness
• Tremors
• Convulsions
• Coma
• Cardiac arrest

“With technology at our fingertips, it is easy to turn to the internet browser for answers, but this can lead to unclear next steps,” said Broughton. “Calling the poison center at 1-800-222-1222 is free, confidential and all calls are answered by specially trained nurses, doctors and pharmacists.”

If a child becomes unresponsive, call 911 immediately.

Tips for Poison Prevention: 

Safe Medication Dosing 

• Follow the dosing directions listed on the medication by using the appropriate measuring items, such as a medicine cup or oral syringe.
• Double dosing is NOT twice as effective, and in many instances can cause internal damage.
• Adult medications may be too strong for children and should not be given in half doses. Only give medicine to your child that is intended for children.
• Print the medication schedule to keep the right dosage for your family. 

Safe Storage 

• Many people leave medications on bathroom and kitchen counters as well as bedroom nightstands as a visual reminder to take them. Avoid unintentional injury and store medication up high, locked, and out of reach.
• Hang purses and personal bags up high so children cannot reach prescriptions, vitamins, or other regularly used medications.
• Remember, when visiting friends and family, it is ok to have an open discussion about safe storage. 

Safe Disposal 

• DEA Drug Take Back Day is on April 25th from 10 a.m.-2 p.m.
• Visit a medication drop box at a local pharmacy. For more information on poison prevention, visit www.meddropbox.org.
• The best disposal option is to find a drug take-back location, which may be found in retail, hospital, pharmacies, and/or law enforcement facilities.
• Removing any unused or expired medication in the home can reduce the risk of access. 

 Related Stories:

• Expert Tips for a Safe Spring Break: Poison Prevention
• Know When to Use Telemedicine, Urgent Care, or the ER for Kids
• The Ultimate Holiday Safety Checklist

“We’re in an unprecedented time of low temperatures across the entire state. Because of that, we've had rolling power outages,” Dr. Selby explained. “Several families, including my own, don’t have enough gas to power their heaters. With families struggling to keep warm, I've seen a lot of families go to extreme measures, meaning they're putting things in their home that aren’t safe.”

Dr. Selby has seen families use propane or diesel-burning engines that are meant for outside use with adequate ventilation. Families are also using generators inside or too close to their homes or garages, which emits fumes and can cause carbon monoxide poisoning. While generators can help keep you warm and keep your lights on, using them inside your home does more harm than good.

During a press conference hosted by Cook Children’s Wednesday, Phillip Scott, M.D., pediatric hospitalist, said one patient was treated after inhaling fumes from a charcoal grill that the family was using too close to the home. "To treat this patients, what we do is put them on 100% oxygen," Dr. Scott said. "That helps flush the toxin out of their system and replace it with oxygen." 

Those at a higher risk for carbon monoxide poisoning include infants, children, pregnant women, the elderly and people with heart or breathing problems.

“Carbon monoxide poisoning prevents your blood from being able to bind to or carry oxygen. You suffocate while you are still breathing,” Dr. Selby explained. 

Families need to be aware of what type of heat source they are using and make sure it is safe for indoors. “If you are using anything that burns propane, like a camper stove, it needs to be used exclusively outside and away from the home,” Dr. Selby said. 

Signs of carbon monoxide poisoning can include:

• Headache
• Nausea
• Dizziness
• Vomiting
• Upset Stomach
• Chest Pain
• Confusion
• Flu-like symptoms

Here are some additional ways to keep your family safe during this time:

• Don’t use anything such as a BBQ grill or propane tank to heat your home.
• Don’t run a vehicle inside of a garage attached to your home.
• Don’t heat your home with a gas oven or stovetop.
• Don’t burn charcoal inside of your home. 
• Do seek medical attention if you suspect carbon monoxide poisoning.
• Do ensure the carbon monoxide detectors in your home are properly functioning and installed in areas that will wake you if it alarms.
• Do check for local resources, such as warming shelters, to keep your family safe. 

Another winter storm could bring several more inches of snow in the coming days. While trying to stay warm, remember safety is your top priority!