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All about: Anesthetics Ophthalmic

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Some commonly used brand names are:

In the U.S.—

  • Ak-Taine 1
  • Ak-T-Caine 2
  • Alcaine 1
  • Ocu-Caine 1
  • Ophthaine 1
  • Ophthetic 1
  • Opticaine 2
  • Pontocaine 2
  • Spectro-Caine 1

In Canada—

  • Alcaine 1
  • Diocaine 1
  • Minims Tetracaine 2
  • Ophthetic 1
  • Pontocaine 2

Other commonly used names are: Amethocaine Proxymetacaine

Note:

For quick reference, the following anesthetics are numbered to match the corresponding brand names.

This information applies to the following medicines:
1. Proparacaine (proe-PARE-a-kane)
2. Tetracaine (TET-ra-kane)§
‡ Generic name product may be available in the U.S.
§ Generic name product may be available in Canada

Category

  • Anesthetic, local, ophthalmic—Proparacaine; Tetracaine

Description

Proparacaine and tetracaine are local anesthetics that are used in the eye to cause numbness or loss of feeling. They are used before certain procedures such as measuring of eye pressure, removing foreign objects or sutures (stitches) from the eye, and performing certain eye examinations.

These medicines are to be administered only by or under the immediate supervision of your doctor. They are available in the following dosage forms:

  • Ophthalmic
  • Proparacaine
    • Ophthalmic solution (U.S. and Canada)
  • Tetracaine
    • Ophthalmic ointment (U.S.)
    • Ophthalmic solution (U.S. and Canada)

Before Receiving This Medicine

In deciding to use a medicine, the risks of using the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For local anesthetics used in the eye, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction after use of a local anesthetic in the eye. Such a reaction may include severe itching, pain, redness, or swelling of the eye or eyelid, or severe and continuing watering of the eyes.

Also, tell your doctor if you have ever had any unusual or allergic reaction to tetracaine or other local anesthetics, such as benzocaine, butacaine, butamben, chloroprocaine, procaine, or propoxycaine, when given by injection or applied to the skin.

In addition, tell your doctor if you have ever had an allergic reaction to aminobenzoic acid (also called para-aminobenzoic acid [PABA]), or if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Although studies on effects in pregnancy have not been done in either humans or animals, proparacaine and tetracaine have not been reported to cause birth defects or other problems in humans.

Breast-feeding—It is not known whether proparacaine or tetracaine passes into breast milk. Although most medicines pass into breast milk in small amounts, many of them may be used safely while breast-feeding. Mothers who receive this medicine and who wish to breast-feed should discuss this with their doctor.

Children—Although there is no specific information comparing use of ophthalmic anesthetics in children with use in other age groups, these medicines are not expected to cause different side effects or problems in children than they do in adults.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults. Although there is no specific information comparing use of ophthalmic anesthetics in the elderly with use in other age groups, these medicines are not expected to cause different side effects or problems in older people than they do in younger adults.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Before receiving a local anesthetic in the eye, tell your doctor if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Other medical problems—The presence of other medical problems may affect the use of local anesthetics in the eye. Make sure you tell your doctor if you have any other medical problems, especially:

  • Allergies—The risk of unwanted effects may be increased

Proper Use of This Medicine

Dosing—The dose of proparacaine or tetracaine will be different for different people. It will depend on the reason the anesthetic is being used. Your health care professional will apply the medicine.

  • For proparacaine or tetracaine
  • For ophthalmic drops dosage form (eye drops):
    • For causing loss of feeling in the eye:
      • Adults and teenagers—For most procedures, one or two drops will be all that is needed. However, for some other procedures, several applications of the medicine may be needed, usually five or ten minutes apart.
      • Children—Use and dose must be determined by the doctor.
  • For tetracaine
  • For ophthalmic ointment dosage form (eye ointment):
    • For causing loss of feeling in the eye:
      • Adults and teenagers—Your health care professional will apply a small amount of the ointment to the lower eyelid.
      • Children—Use and dose must be determined by the doctor.

Precautions After Receiving This Medicine

After a local anesthetic is applied to the eye, do not rub or wipe the eye until the anesthetic has worn off and feeling in the eye returns . To do so may cause injury or damage to the eye. The effects of these medicines usually last for about 20 minutes. However, if more than one dose is applied, the effects may last longer.

If you get one of these medicines on your fingers, it may cause a rash with dryness and cracking of the skin. If you touch your eye after this medicine has been applied, wash your hands as soon as possible.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Tell your doctor immediately if any of the following side effects occur shortly after this medicine has been applied:

Symptoms of too much medicine being absorbed into the body—very rare

Dizziness or drowsiness; increased sweating; irregular heartbeat; muscle twitching or trembling; nausea or vomiting; shortness of breath or troubled breathing; unusual excitement, nervousness, or restlessness; unusual tiredness or weakness

Other side effects may occur that usually do not need medical attention. Mild stinging or eye irritation may occur as soon as tetracaine is applied or up to several hours after proparacaine is applied. Although these side effects usually are not serious, check with your doctor as soon as possible if any of the following side effects are severe , because you may be having an allergic reaction to the medicine. Also, check with your doctor if any of these effects continue or are bothersome:

Less common

Burning, stinging, redness, or other irritation of eye

Rare

Itching, pain, redness, or swelling of the eye or eyelid; watering of eyes

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 08/25/94

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