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Tetrahydrozoline (ophthalmic): Drug information

Tetrahydrozoline (ophthalmic): Drug information
(For additional information see "Tetrahydrozoline (ophthalmic): Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: US
  • Eye Drops [OTC];
  • GoodSense Eye Drops Adv Relief [OTC];
  • GoodSense Eye Drops [OTC];
  • GoodSense Relief Eye Drops [OTC];
  • Visine Advanced Relief [OTC] [DSC]
Pharmacologic Category
  • Adrenergic Agonist Agent;
  • Imidazoline Derivative;
  • Ophthalmic Agent, Vasoconstrictor
Dosing: Adult
Ocular decongestant

Ocular decongestant: Ophthalmic: Instill 1 to 2 drops in the affected eye(s) up to 4 times daily.

Dosing: Kidney Impairment: Adult

There are no dosage adjustments provided in the manufacturer’s labeling.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer’s labeling.

Dosing: Older Adult

Refer to adult dosing.

Dosing: Pediatric
Ocular decongestant

Ocular decongestant (Visine products only): Children ≥6 years, and Adolescents: Ophthalmic: Refer to adult dosing.

Dosing: Kidney Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer’s labeling.

Dosing: Hepatic Impairment: Pediatric

There are no dosage adjustments provided in the manufacturer’s labeling.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

Frequency not defined.

Cardiovascular: Hypertension, palpitations, tachycardia

Central nervous system: Headache, transient burning or stinging in the eyes

Neuromuscular & skeletal: Tremor

Ophthalmic: Blurred vision

Warnings/Precautions

Disease-related concerns:

• Diabetes: Use with caution in patients with diabetes.

• Glaucoma: Use with caution in patients with narrow-angle glaucoma.

• Hyperthyroidism: Use with caution in patients with hyperthyroidism.

Dosage form specific issues:

• Benzalkonium chloride: Some products may contain benzalkonium chloride, which may be absorbed by soft contact lenses.

Other warnings/precautions:

• Accidental ingestion: Accidental ingestion by children of over-the-counter (OTC) imidazoline-derivative eye drops and nasal sprays may result in serious harm. Serious adverse reactions (eg, coma, bradycardia, respiratory depression, sedation) requiring hospitalization have been reported in children ≤5 years of age who had ingested even small amounts (eg, 1 to 2 mL). Contact a poison control center and seek emergency medical care immediately for accidental ingestion (FDA Drug Safety Communication 2012).

• Self-medication (OTC use): For ophthalmic use only. When used for self-medication, discontinue and contact a health care provider if eye pain, vision changes, continued redness, or eye irritation occurs or if condition worsens or persists >72 hours; do not use with contacts (remove prior to use). Do not use if solution changes color or becomes cloudy. Do not touch tip of container to any surface and replace cap after use. When using this product, pupils may become temporarily enlarged; overuse may cause more eye redness.

Dosage Forms: US

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution, Ophthalmic, as hydrochloride:

Eye Drops: 0.05% (15 mL) [contains benzalkonium chloride, edetate (edta) disodium]

GoodSense Eye Drops: 0.05% (15 mL); Tetrahydrozoline hydrochloride 0.05%, dextran 0.1%, polyethylene glycol 1%, and povidone 1% (15 mL [DSC]) [contains benzalkonium chloride, edetate (edta) disodium]

GoodSense Eye Drops Adv Relief: Tetrahydrozoline hydrochloride 0.05%, dextran 0.1%, polyethylene glycol 1%, and povidone 1% (15 mL) [contains benzalkonium chloride, edetate (edta) disodium]

GoodSense Relief Eye Drops: Tetrahydrozoline hydrochloride 0.05% and zinc sulfate 0.25% (15 mL) [contains benzalkonium chloride, edetate (edta) disodium]

Visine Advanced Relief: Tetrahydrozoline hydrochloride 0.05%, dextran 0.1%, polyethylene glycol 1%, and povidone 1% (15 mL [DSC]) [contains benzalkonium chloride, edetate (edta) disodium]

Generic Equivalent Available: US

Yes

Pricing: US

Solution (Visine Ophthalmic)

0.05% (15 mL): $4.04

Disclaimer: The pricing data provide a representative AWP and/or AAWP price from a single manufacturer of the brand and/or generic product, respectively. The pricing data should be used for benchmarking purposes only, and as such should not be used to set or adjudicate any prices for reimbursement or purchasing functions. Pricing data is updated monthly.

Administration: Adult

For ophthalmic use only; wash hands prior to use. Do not touch tip of container to any surface, the eyelids, or the surrounding area. Remove contact lenses prior to administering products containing benzalkonium chloride; after instilling drops, wait at least 10 minutes before inserting contact lenses. Do not insert contacts if eyes are red.

Administration: Pediatric

Ophthalmic: Visine products only: For ophthalmic use only; wash hands prior to use. Do not touch tip of container to any surface, the eyelids, or the surrounding area. Remove contact lenses prior to administering products containing benzalkonium chloride; after instilling drops, wait at least 10 minutes before inserting contact lenses. Do not insert contacts if eyes are red.

Use: Labeled Indications

Ocular decongestant: Relieves redness of the eye due to minor eye irritation and protects against further irritation; temporarily relieves burning and discomfort from dryness of the eye or exposure to wind and sun.

Medication Safety Issues
Sound-alike/look-alike issues:

Visine may be confused with Visken

Other safety concerns:

Accidental ingestion: Serious adverse reactions (eg, coma, bradycardia, respiratory depression, sedation) requiring hospitalization have been reported in children ≤5 years of age who have accidentally ingested even small amounts (eg, 1 to 2 mL) of imidazoline-derivative (ie, tetrahydrozoline, oxymetazoline, or naphazoline) eye drops or nasal sprays. Store these products out of reach of children at all times. Contact poison control or seek medical attention if accidental ingestion occurs.

Metabolism/Transport Effects

None known.

Drug Interactions

There are no known significant interactions.

Mechanism of Action

Stimulates alpha-adrenergic receptors in the arterioles of the conjunctiva to produce vasoconstriction

  1. Eye Drops (tetrahydrozoline) [prescribing information]. Livonia, MI: Rugby Laboratories; November 2018.
  2. Food and Drug Administration. FDA Drug Safety Communication: Serious adverse events from accidental ingestion by children of over-the-counter eye drops and nasal sprays. U.S. Food and Drug Administration. October 25, 2012. Available at http://www.fda.gov/Drugs/DrugSafety/ucm325257.htm. Accessed September 5, 2013.
  3. Visine Red Eye Comfort (tetrahydrozoline) [prescribing information]. Skillman, NJ: Johnson & Johnson Consumer Inc; received May 2020.
  4. Visine Red Eye Total Comfort Multi-Symptom (tetrahydrozoline) [prescribing information]. Skillman, NJ: Johnson & Johnson Consumer Inc; received May 2020.
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