Tetcaine®

GoodRx

Tetracaine Hydrochloride 0.5% · ophthalmic solution

Local Anesthetic

Same formulation, different label. Identical to Opticaine®. Choose on price and availability, not on the drug.

Approved uses

Topical anesthesia for ophthalmic procedures

1 drop topically in the eye(s) as needed

Corneal anesthesia is complete within 1 minute, with sensitivity back to baseline by 45 minutes.

OFF-LABELNot in the FDA label for this product

Corneal abrasion pain, short-term outpatient use

Preservative-free tetracaine 1%, up to every 30 minutes while awake for 24 hours (Waldman 2014); tetracaine every 30 minutes as needed for 24 hours (Shipman 2021)

Cochrane · very low certainty

Waldman 2014 (double-blind RCT, N=116) recorded no complications attributed to the anesthetic, no difference in persistent fluorescein uptake at 48 hours (23.9% vs 21.3%, difference 2.6%, 95% CI -14% to 20%) and no clinical difference in VAS pain, although patients rated it more effective than saline (7.7 vs 3.9 on a 0 to 10 scale). Shipman 2021 (double-blind RCT, 111 analyzed) found lower pain at the 24 to 48 hour visit (1 vs 8, 95% CI for the difference 6 to 8) and less hydrocodone use. The 2023 Cochrane review of topical ophthalmic anesthetics as a class (9 RCTs, 556 participants) graded the evidence very low certainty, concluded that it provides little or no certainty about efficacy for reducing ocular pain in the initial 24 to 72 hours and that the authors have very low confidence in it as a basis for recommending topical anesthetics for corneal abrasion pain, and found no evidence of a substantial effect on epithelial healing (unresolved defects after trauma RR 1.37, 95% CI 0.78 to 2.42, an estimate that crosses no effect) or on complications.

Waldman N, Densie IK, Herbison P. Acad Emerg Med. 2014;21(4):374-382 (double-blind RCT); Shipman S, Painter K, Keuchel M, Bogie C. Ann Emerg Med. 2021;77(3):338-344, epub 2020 Oct 27 (double-blind RCT); Sulewski M, Leslie L, Liu SH, Ifantides C, Cho K, Kuo IC. Cochrane Database Syst Rev. 2023;8(8):CD015091 (systematic review).

Contraindications

History of hypersensitivity to any component of this preparation.

Available Forms

0.5% (5 mg/mL) solution, 5 mL dropper bottle, 15 mL dropper bottle

Mechanism of Action

Ester local anesthetic that blocks sodium ion channels required for initiation and conduction of neuronal impulses, producing surface anesthesia. Cleared by plasma pseudocholinesterases and nonspecific esterases in ocular tissue.

Warnings & Precautions

Intracameral use: Not for injection or intraocular use; intracameral exposure may damage corneal endothelial cells.
Corneal toxicity: Prolonged use or abuse may cause epithelial defects that progress to permanent corneal damage, and prolonged use may produce corneal opacification and ulceration with visual loss.
Corneal injury from insensitivity: Eye stays insensitive for up to 20 minutes; accidental injury can follow touching or rubbing within 10 to 20 minutes of instillation.
Provider administration only: Indicated for use under direct supervision of a healthcare provider, not for patient self-administration.

Common Side Effects

Ocular: Transient stinging, burning, conjunctival redness, eye irritation, eye pain, ocular discomfort (postmarketing reports, frequency not estimable).

Pregnancy & Lactation

Pregnancy: No adequate and well-controlled studies in pregnant women; no animal developmental or reproductive toxicity studies reported in the published literature.

Lactation: No data on presence in human milk, effects on the breastfed child, or effects on milk production.

Pediatric Use

Safety demonstrated in pediatric clinical trials.