Adult Dosing

Removal of foreign bodies, sutures, tonometry, or gonioscopy

• Instill 1-2 drops in each eye before procedure

Deep ophthalmic anesthesia

• Instill 1 drop in each eye q5-10 minutes x5-7 doses

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

[Outline]

• Adult Dosing
• Pediatric Dosing

• Removal of corneal foreign bodies and sutures and for tonometry and gonioscopy
• Short corneal or conjunctival procedures requiring deep ophthalmic anesthesia

• Hypersensitivity to any of the ingredients of the product
• Hypersensitivity to ester anesthetics
• Hypersensitivity to PABA

• N/A

Renal Dose Adjustment

• Renal impairment: Dose adjustments not defined

Hepatic Dose Adjustment

• Hepatic impairment: Dose adjustments not defined

• For ophthalmic use only; not for use in the ears or on the skin
• Use with caution in patients with known allergies, cardiac disease, cholinesterase deficiency, or hyperthyroidism
• Chronic use of therapy is not recommended because it may cause permanent corneal opacification with visual loss and delay wound healing

Pregnancy Category:C

Breastfeeding: Safety unknown. IV use in a nursing mother results in higher levels in the infant. It is unlikely that these higher levels are problematic for most infants, but exposure to intense light, such as phototherapy, should be avoided for a few days after the maternal dose. Because absorption from the eye is limited, fluorescein is not expected to cause any adverse effects in breastfed infants. Place pressure over the tear duct by the corner of the eye for 1 minute or more and remove the excess solution with an absorbent tissue for diminishing the amount of drug that reaches the breastmilk after using eye drops. This data is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 19 May 2011). Manufacturer advises caution.

• CNS: Stimulation followed by depression, seizures
• EENT: Temporary stinging, burning, conjunctival redness, immediate-type hyperallergic corneal reaction, corneal opacification (prolonged use), delayed ocular wound healing, ocular irritation, epithelial keratopathy
• DERM: Allergic contact dermatitis

Fluorescein

• Diagnostic aid; acts as an ocular disclosing agent, responds to electromagnetic radiation and light between the wavelengths of 465-490 nm and fluoresces
• Metabolized by liver; CYP450: None
• Excreted in urine
• Half-life: Unknown

Proparacaine

• Local anesthetic; exact mechanism of action unknown; inhibits sodium ion channels, stabilizing neuronal cell membranes and inhibiting nerve impulse initiation and conduction
• Metabolized by plasma; CYP450: None
• Excretion: Unknown
• Half-life: Unknown
• Onset of action with 1 gtt: 30 seconds
• Duration of action: 15 minutes

US Trade Name(s)

• Fluoracaine

US Availability

Fluoracaine

• OPTH SOLN: 0.25%/0.5%

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

[Outline]

Ophthalmic

Diagnostic Agent/Local Anesthetic Combination