tetracaine hydrochloride: clinical use

Prescribing considerations

• Use for short-term procedural ocular anaesthesia rather than ongoing pain control.
• Protect the anaesthetised eye from trauma, dust and bacterial contamination.
• Consider punctal occlusion to reduce systemic absorption, particularly in children.
• Ensure contact lenses are removed and vision and protective sensation have recovered before normal activities resume.

Contraindications and cautions

• Hypersensitivity to tetracaine, the product or similar local anaesthetics
• Concurrent treatment with sulphonamides
• Premature babies, because ester local-anaesthetic metabolism is immature

Monitoring

• Observe for persistent epithelial defects, keratitis, corneal oedema or delayed recovery of vision or sensation.
• No routine laboratory monitoring is specified for brief procedural use.

Clinical pharmacology

An ester local anaesthetic that reversibly inhibits nerve-impulse propagation by preventing the sodium permeability change needed for an action potential. Plasma pseudocholinesterases hydrolyse it to para-aminobenzoic acid; affinity for melanin may contribute to variation in effect between eyes.

Formulation and product differences

• The preparation is a sterile, clear, colourless, preservative-free single-use eye-drop unit.
• It contains hydrochloric acid for pH adjustment and purified water. Discard the opened unit after use.

Eye drops

Route: Ophthalmic

Strengths: 0.5% w/v, 1.0% w/v