Tetracaine

What is Tetracaine

Tetracaine is an ester-type local anesthetic with an intermediate to long duration of action.

Relative to other local anesthetics, tetracaine in considered the most toxic.

Tetracaine is available in various injectable forms for spinal anesthesia, as well as preparations for topical use.

These preparations are typically used prior to examination of the larynx, trachea, or esophagus, to abolish laryngeal and esophageal reflexes and provide local analgesia.

Topical nonprescription products are also available for the temporary relief of pain associated with herpes labialis. Tetracaine received FDA approval in 1965.

Indications & Dosage

  1. herpes labialis
  2. local anesthesia
  3. mild pain
  4. obstetric anesthesia
  5. ophthalmic anesthesia
  6. pruritus
  7. regional anesthesia
  8. spinal anesthesia
  9. topical anesthesia

Side Effects

  1. anaphylactoid reactions
  2. anxiety
  3. arachnoiditis
  4. arrhythmia exacerbation
  5. back pain
  6. blurred vision
  7. bradycardia
  8. cardiac arrest
  9. chills
  10. coma
  11. confusion
  12. corneal opacification
  13. decreased uterine contractility
  14. dizziness
  15. drowsiness
  16. edema
  17. fecal incontinence
  18. fetal bradycardia
  19. headache
  20. hypotension
  21. injection site reaction
  22. iritis
  23. keratitis
  24. meningitis
  25. miosis
  26. muscle paralysis
  27. nausea
  28. ocular irritation
  29. ocular pain
  30. paresthesias
  31. pruritus
  32. respiratory arrest
  33. respiratory depression
  34. restlessness
  35. seizures
  36. shivering
  37. tinnitus
  38. tremor
  39. urinary incontinence
  40. urinary retention
  41. urticaria
  42. vomiting

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • anticoagulant therapy
  • AV block
  • breast-feeding
  • burns
  • cardiac disease
  • coagulopathy
  • contact lenses
  • dehydration
  • eczema
  • ester local anesthetic hypersensitivity
  • geriatric
  • hypotension
  • hypovolemia
  • infection
  • intraarterial administration
  • intravenous administration
  • labor
  • myasthenia gravis
  • obstetric delivery
  • occlusive dressing
  • para-aminobenzoic acid, PABA hypersensitivity
  • pregnancy
  • pseudocholinesterase deficiency
  • QT prolongation
  • shock
  • skin abrasion
  • spinal anesthesia
  • sulfite hypersensitivity
  • thrombocytopenia

Interactions

  • Acetaminophen
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Adapalene; Benzoyl Peroxide
  • Alfentanil
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Ambenonium Chloride
  • Aminosalicylate sodium, Aminosalicylic acid
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Angiotensin II receptor antagonists
  • Angiotensin-converting enzyme inhibitors
  • Articaine; Epinephrine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Atracurium
  • Atropine; Edrophonium
  • Atropine; Hyoscyamine; Phenobarbital; Scopolamine
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benzhydrocodone; Acetaminophen
  • Benzocaine
  • Benzocaine; Butamben; Tetracaine
  • Benzonatate
  • Benzoyl Peroxide
  • Benzoyl Peroxide; Clindamycin
  • Benzoyl Peroxide; Erythromycin
  • Benzoyl Peroxide; Sulfur
  • Bepridil
  • Beta-adrenergic blockers
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Bupivacaine
  • Bupivacaine Liposomal
  • Bupivacaine; Lidocaine
  • Calcium-channel blockers
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Central-acting adrenergic agents
  • Chloroprocaine
  • Chloroquine
  • Chloroxylenol; Hydrocortisone; Pramoxine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Cholinesterase inhibitors
  • Cisatracurium
  • Clevidipine
  • Clomipramine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Cyclophosphamide
  • Dapsone
  • Daratumumab; Hyaluronidase
  • Desipramine
  • Dibucaine
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diltiazem
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Donepezil
  • Donepezil; Memantine
  • Doxacurium
  • Doxazosin
  • Doxepin
  • Edrophonium
  • Enalapril; Felodipine
  • Encainide
  • Enflurane
  • Eplerenone
  • Epoprostenol
  • Erythromycin; Sulfisoxazole
  • Ethyl Chloride
  • Etomidate
  • Felodipine
  • Fentanyl
  • Flutamide
  • Fosphenytoin
  • Fospropofol
  • Galantamine
  • General anesthetics
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Halothane
  • Homatropine; Hydrocodone
  • Hyaluronidase
  • Hyaluronidase, Recombinant; Immune Globulin
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydrocortisone; Pramoxine
  • Hydromorphone
  • Hydroxyurea
  • Ibuprofen; Oxycodone
  • Ifosfamide
  • Iloprost
  • Imipramine
  • Isoflurane
  • Isradipine
  • Ketamine
  • Lidocaine
  • Lidocaine; Prilocaine
  • Loop diuretics
  • Mecamylamine
  • Meperidine
  • Meperidine; Promethazine
  • Mepivacaine
  • Mepivacaine; Levonordefrin
  • Metoclopramide
  • Minocycline
  • Mivacurium
  • Monoamine oxidase inhibitors
  • Moricizine
  • Neostigmine
  • Neuromuscular blockers
  • Nicardipine
  • Nifedipine
  • Nimodipine
  • Nisoldipine
  • Nitrates
  • Nitrofurantoin
  • Nortriptyline
  • Oxycodone
  • Oxymorphone
  • Pancuronium
  • Penicillin G Benzathine; Penicillin G Procaine
  • Penicillin G Procaine
  • Perindopril; Amlodipine
  • Perphenazine; Amitriptyline
  • Phenobarbital
  • Phenoxybenzamine
  • Phentolamine
  • Phenytoin
  • Physostigmine
  • Potassium-sparing diuretics
  • Pramoxine
  • Prazosin
  • Prilocaine
  • Prilocaine; Epinephrine
  • Primaquine
  • Primidone
  • Procarbazine
  • Propofol
  • Propoxyphene
  • Protriptyline
  • Pyridostigmine
  • Pyrimethamine; Sulfadoxine
  • Quinine
  • Rapacuronium
  • Rasburicase
  • Remifentanil
  • Reserpine
  • Rituximab; Hyaluronidase
  • Rivastigmine
  • Rocuronium
  • Ropivacaine
  • Sevoflurane
  • Sparfloxacin
  • Succinylcholine
  • Sufentanil
  • Sulfadiazine
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfasalazine
  • Sulfisoxazole
  • Sulfonamides
  • Tacrine
  • Terazosin
  • Thiazide diuretics
  • Trandolapril; Verapamil
  • Trastuzumab; Hyaluronidase
  • Treprostinil
  • Tricyclic antidepressants
  • Trimipramine
  • Tubocurarine
  • Valproic Acid, Divalproex Sodium
  • Vasodilators
  • Vecuronium
  • Verapamil
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