Yes

Local Anesthetic

Dental: Ester-type local anesthetic topically applied to nose and throat for various diagnostic procedures

Medical: Spinal anesthesia; local anesthesia in the eye for various diagnostic and examination purposes; topically applied to nose and throat for various diagnostic procedures; approximately 10 times more potent than procaine

C

Hypersensitivity to tetracaine or any component; ophthalmic secondary bacterial infection, patients with liver disease, CNS disease, meningitis (if used for epidural or spinal anesthesia), myasthenia gravis

No pediatric dosage recommendations; ophthalmic preparations may delay wound healing; use with caution in patients with cardiac disease and hyperthyroidism

1% to 10%: Dermatologic: Contact dermatitis, burning, stinging, angioedema

<1%: Tenderness, urticaria, urethritis, methemoglobinemia in infants

Maximum dose is 50 mg

Decreased effect: Aminosalicylic acid, sulfonamides effects may be antagonized

Store solution in the refrigerator

Ester local anesthetic blocks both the initiation and conduction of nerve impulses by decreasing the neuronal membrane's permeability to sodium ions, which results in inhibition of depolarization with resultant blockade of conduction

Onset of anesthetic effect:

Ophthalmic instillation: Within 60 seconds

Topical or spinal injection: Within 3-8 minutes after applied to mucous membranes or when saddle block administered for spinal anesthesia

Duration of action: Topical: 1.5-3 hours

Metabolism: By the liver

Elimination: Renal

Maximum adult dose: 50 mg

Adults:

Ophthalmic (not for prolonged use):

Ointment: Apply 1/2 " to 1" to lower conjunctival fornix

Solution: Instill 1-2 drops

Spinal anesthesia:

High, medium, low, and saddle blocks: 0.2% to 0.3% solution

Prolonged (2-3 hours): 1% solution

Subarachnoid injection: 5-20 mg

Saddle block: 2-5 mg; a 1% solution should be diluted with equal volume of CSF before administration

Topical mucous membranes (2% solution): Apply as needed; dose should not exceed 20 mg

Topical for skin: Ointment/cream: Apply to affected areas as needed

Before injection, withdraw syringe plunger to make sure injection is not into vein or artery

None reported

None reported

No information available to require special precautions

No effects or complications reported

Topical or ophthalmic anesthesia effects may last for some time following use; you will need to observe appropriate safety precautions to prevent injury (eg, do not rub or touch your eye, scratch your nose, or eat or drink (depending on use) until all sensation returns).

Store the solutions in the refrigerator; before injection, withdraw syringe plunger to make sure injection is not into vein or artery

Cream, as hydrochloride: 1% (28 g)

Injection, as hydrochloride: 1% [10 mg/mL] (2 mL)

Injection, as hydrochloride, with dextrose 6%: 0.2% [2 mg/mL] (2 mL); 0.3% [3 mg/mL] (5 mL)

Ointment, as hydrochloride:

Ophthalmic: 0.5% [5 mg/mL] (3.75 g)

Topical: 0.5% [5 mg/mL] (28 g)

Powder for injection, as hydrochloride: 20 mg

Solution, as hydrochloride:

Ophthalmic: 0.5% [5 mg/mL] (1 mL, 2 mL, 15 mL, 59 mL)

Topical: 2% [20 mg/mL] (30 mL, 118 mL)

Bartfield JM, Lee FS, Raccio-Robak N, et al, "Topical Tetracaine Attenuates the Pain of Infiltration of Buffered Lidocaine," Acad Emerg Med, 1996, 3(11):1001-5.

Bonadio WA, "Safe and Effective Method for Application of Tetracaine, Adrenaline, and Cocaine to Oral Lacerations," Ann Emerg Med, 1996, 28(4):396-8.

Duffin RM and Olson RJ, "Tetracaine Toxicity," Ann Ophthalmol, 1984, 16(9):836, 838.

Garfield JM, Andriole GL, Vetto JL, et al, "Prolonged Diabetes Insipidus Subsequent to an Episode of Chemical Meningitis," Anesthesiology, 1986, 64(2):253-4.

Grant SA and Hoffman RS, "Use of Tetracain, Epinephrine, and Cocaine as a Topical Anesthetic in the Emergency Department," Ann Emerg Med, 1992, 21(8):987-97.

Kintner JC, Grossniklaus HE, Lass JH, et al, "Infectious Crystalline Keratopathy Associated With Topical Anesthetic Abuse," Cornea, 1990, 9(1):77-80.

Skidmore RA, Patterson JD, and Tomsick RS, "Local Anesthetics," Dermatol Surg, 1996, 22(6):511-22.

van Kan JH, Egberts AC, Rijnvos WP, et al, "Tetracaine Versus Lidocaine-Prilocaine for Preventing Venipuncture-Induced Pain in Children," Am J Health Syst Pharm, 1997, 54(4):388-92.