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
- herpes labialis
- local anesthesia
- mild pain
- obstetric anesthesia
- ophthalmic anesthesia
- pruritus
- regional anesthesia
- spinal anesthesia
- topical anesthesia
Side Effects
- anaphylactoid reactions
- anxiety
- arachnoiditis
- arrhythmia exacerbation
- back pain
- blurred vision
- bradycardia
- cardiac arrest
- chills
- coma
- confusion
- corneal opacification
- decreased uterine contractility
- dizziness
- drowsiness
- edema
- fecal incontinence
- fetal bradycardia
- headache
- hypotension
- injection site reaction
- iritis
- keratitis
- meningitis
- miosis
- muscle paralysis
- nausea
- ocular irritation
- ocular pain
- paresthesias
- pruritus
- respiratory arrest
- respiratory depression
- restlessness
- seizures
- shivering
- tinnitus
- tremor
- urinary incontinence
- urinary retention
- urticaria
- 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