Tetracaine

Tetracaine is a prescription medication used for spinal and ophthalmic anesthesia.

• Tetracaine is available under the following different brand names: Tetcaine, tetracaine ophthalmic

Common side effects of Tetracaine include:

• runny nose,
• nasal congestion,
• watery eyes,
• nasal discomfort,
• sore or numb throat,
• a temporary rise in blood pressure,
• nasal pain,
• sneezing,
• nosebleed,
• nasal dryness,
• headache,
• changes in taste,
• dizziness,
• sensory disturbance,
• oral discomfort,
• slow heart rate, and
• high blood pressure

Serious side effects of Tetracaine include:

• hives,
• difficulty breathing,
• swelling of the face, lips, tongue, or throat,
• nose bleeds,
• blurred vision,
• chest pain or pressure,
• trouble swallowing,
• dizziness,
• headache,
• light-headedness,
• fainting,
• nervousness,
• pounding in the ears,
• slow, fast, or irregular heartbeat,
• ulcers in the nose,
• unusual tiredness,
• bluish-coloreded lips, fingernails, or palms,
• cough,
• dark urine,
• fever,
• itching,
• skin rash,
• pale skin,
• redness of the skin,
• sore throat,
• tightness in the chest,
• unusual bleeding,
• easy bruising,
• confusion,
• difficulty speaking,
• loss of color perception,
• double vision,
• seeing halos around lights,
• inability to move the arms, legs, or facial muscles,
• inability to speak,
• loss of consciousness,
• nausea,
• nervousness,
• night blindness,
• loss of blood pressure or pulse,
• overbright appearance of lights,
• pain or discomfort in the arms, jaw, back, or neck,
• pounding in the ears,
• slow speech,
• stuffy nose,
• sweating,
• tunnel vision,
• unusual tiredness or weakness, and
• vomiting

Rare side effects of Tetracaine include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheartedness, or passing out.

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult and pediatric dosage

Injectable solution

• 1 %

Powder for injection

• 20 mg

Ophthalmic solution

• 0.5 %

Spinal Anesthesia

Adult dosage

• High, medium, low & saddle: 0.2 %-0.3 % solution
• For perineum: 5 mg/dose
• For lower extremities: 10 mg/dose
• For saddle block: 2-5 mg/dose
• Prolonged (2-3 hours): 1 % solution
• For spinal: 1 % solution diluted 1:1 in CSF, administered at 1 mL per 5 seconds
• Doses of above 15 mg are rarely required, and should only be used in exceptional cases

Ophthalmic

Adult dosage

• Short-term anesthesia: 1-2 drops into the affected eye just before evaluation
• Minor surgical procedure: 1-2 drops into the affected eye every 5-10 mins
• Prolonged surgical procedure: 1-2 drops into the affected eye every 5-10 mins; not to exceed 5 doses

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Tetracaine has severe interactions with no other drugs.
• Tetracaine has serious interactions with the following drugs
  • bupivacaine implant
• Tetracaine has moderate interactions with at least 24 other drugs.
• Tetracaine has minor interactions with no other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity to aminobenzoic acid, sulfates, parabens, or any components of the preparation
• Spinal anesthesia 

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Tetracaine?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Tetracaine?”

Cautions

• Use preservative-free preparations for spinal or epidural anesthesia
• Some formulations may contain sulfites
• Use caution in decreased levels of plasma esterase, hyperthyroidism, cardiovascular disease (heart block, rhythm disturbances, shock)
• Use caution in the elderly, debilitated patients, obstetrics, or patients with intraabdominal pressure
• DO NOT use solutions with epinephrine in distal areas of the body (.g, digit, nose, ear, etc.)
• Addition of vasoconstrictor, epinephrine, will promote local hemostasis, decrease systemic absorption, and increase the duration of action
• Ophthalmic solution
  • Indicated for administration under the direct supervision of a healthcare provider; the ophthalmic solution is not intended for patient self-administration
  • Not for injection or intraocular use, do not use intracamerally as it may lead to damage to the corneal endothelial cells
  • Prolonged use or abuse may lead to corneal epithelial toxicity and may manifest as epithelial defects which may progress to permanent corneal damage
  • Patients should not touch the eye for at least 10-20 minutes after using an anesthetic as accidental injuries can occur due to insensitivity of the eye

Pregnancy and Lactation

• There are no adequate and well-controlled studies on pregnant women; animal developmental and reproductive toxicity studies with tetracaine hydrochloride have not been reported in the published literature
• No human data on the effect of the drug on fertility is available
• Lactation
  • There are no data to assess whether the drug is excreted in human milk or to assess its effects on milk production/excretion; developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on the breastfed child from therapy or the underlying maternal condition