Version May 2024
Anesthesia, ocular: Ophthalmic: Instill 1 to 2 drops in affected eye(s) as needed. For tonometry and other procedures of short duration, instill just prior to evaluation. For minor surgical procedures, instill every 5 to 10 minutes for up to a maximum of 3 doses. For prolonged anesthesia, instill every 5 to 10 minutes for up to a maximum of 5 doses.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
(For additional information see "Tetracaine (ophthalmic): Pediatric drug information")
Note: Approval in pediatric patients may vary by products; refer to product-specific labeling.
Ophthalmic anesthesia: Infants, Children, and Adolescents: Ophthalmic solution: Instill 1 drop as needed. Note: In adult patients, doses are separated by 5 to 10 minutes and the maximum number of doses (3 to 5 doses) is dependent on procedure length; fewer doses may be required in young infants; instill initial drop just prior to procedure/evaluation (Ref).
There are no dosage adjustments provided in manufacturer's labeling.
There are no dosage adjustments provided in manufacturer's labeling.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
Frequency not defined: Ophthalmic: Chemosis, conjunctival erythema (transient), lacrimation, photophobia, transient burning or stinging in the eyes
<1%, postmarketing, and/or case reports: Hypersensitivity reaction (corneal)
Hypersensitivity to tetracaine or any component of the formulation.
Concerns related to adverse effects:
• Hypersensitivity: Immediate type allergic corneal reactions, characterized by epithelial keratitis/filament formation, necrotic epithelium sloughing, stromal edema, descemetitis, and iritis, have been reported rarely. Use with caution in patients with known allergies; if signs of sensitivity develop, discontinue use.
Disease-related concerns:
• Cardiac disease: Use with caution in patients with cardiac disease.
Special populations:
• Contact lens wearers: Some formulations may contain benzalkonium chloride, which may be adsorbed by soft contact lenses; remove contacts prior to administration and wait at least 15 minutes before reinserting.
Other warnings/precautions:
• Administration: For topical ophthalmic use only; not for injection or intraocular use. Do not use intracamerally (may lead to damage of the corneal endothelial cells). The anesthetized eye should be protected from irritation, foreign bodies, and rubbing to prevent inadvertent damage.
• Prolonged use: Prolonged and continuous use is not recommended (diminished duration of anesthesia, delayed healing, and severe keratitis may occur). Prolonged use or abuse may also lead to corneal epithelial toxicity, manifesting as epithelial defects, which may progress to permanent corneal damage.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Solution, Ophthalmic, as hydrochloride:
Altacaine: 0.5% (12 ea, 15 mL [DSC], 30 mL)
Tetcaine: 0.5% (15 mL [DSC]) [contains chlorobutanol (chlorobutol), edetate (edta) disodium]
TetraVisc: 0.5% (12 ea [DSC], 5 mL [DSC]) [contains benzalkonium chloride]
TetraVisc Forte: 0.5% (12 ea [DSC], 5 mL [DSC]) [contains benzalkonium chloride, edetate (edta) disodium]
Generic: 0.5% (1 mL, 4 mL, 5 mL, 15 mL)
Yes
Solution (Altacaine Ophthalmic)
0.5% (per each): $6.25
0.5% (per mL): $0.48
Solution (Tetracaine HCl Ophthalmic)
0.5% (per mL): $3.74
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Ophthalmic: For topical ophthalmic use only; not for injection or intraocular use. Do not use intracamerally (may lead to damage of the corneal endothelial cells). To avoid contamination, do not touch dropper tip to any surface. Instruct patient to avoid touching eye for 10 to 20 minutes following administration.
Ophthalmic: For ophthalmic use only. Apply drops to conjunctiva of affected eye(s); avoid contact of bottle tip with skin or eye; patients should not touch the eye for 10 to 20 minutes after instillation of anesthetic drop due to potential for accidental injury from poor sensitivity.
Anesthesia, ocular: Local anesthesia for various ophthalmic procedures requiring rapid, short-acting topical anesthesia, including tonometry, gonioscopy removal of corneal foreign bodies, conjunctival scraping for diagnostic purposes, suture removal from the cornea or conjunctiva, and other short corneal and conjunctival procedures.
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Methemoglobinemia Associated Agents: May enhance the adverse/toxic effect of Local Anesthetics. Specifically, the risk for methemoglobinemia may be increased. Risk C: Monitor therapy
Animal reproduction studies have not been conducted.
It is not known if tetracaine (ophthalmic) is present in breast milk. The manufacturer recommends that caution be exercised when administering tetracaine (ophthalmic) to breastfeeding women.
Ester local anesthetic blocks both the initiation and conduction of nerve impulses by decreasing the neuronal membrane's permeability to sodium, potassium, and other ions, which results in inhibition of depolarization with resultant blockade of conduction
Onset of action: Anesthetic: Within 30 seconds
Duration of action: 10 to 20 minutes
Metabolism: Hepatic; detoxified by plasma esterases to aminobenzoic acid
Excretion: Urine
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