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Tetracaine

Local Anesthetic · Ophthalmic Anesthetic

Also known as Amethocaine, Tetracaine hydrochloride

Local AnestheticOphthalmic Anesthetic
CDSCO approved
EXCRETION
not curated
INTERACTIONS
2 major
SEVERE in our sources
PREGNANCY
not curated
Top interactions
  • Nitrous AcidSevereDatabaseDDInter
  • PrilocaineSevereDatabaseDDInter

Mechanism

Tetracaine functions as a topical local anaesthetic. It is known to produce a profound anaesthesia, making it suitable for minor surgical procedures.

Indications

Local anaesthesia to the eyeAnaesthesia before minor surgical procedures, such as the removal of corneal suturespain (nociception)Spinal anesthesia (when long duration is needed)Topical anesthetic preparationsOphthalmic usetopical ophthalmic anesthesiaTopical application to the eyeTopical application to the noseTopical application to the throatTopical application to the tracheobronchial treeSpinal anaesthesia (rarely for long duration)Caudal anaesthesia (rarely for long duration)

Dosing

Adult
Apply as required to the eye

Pharmacokinetics

Onset
Slow
Peak effect
Peak anesthetic effect following topical application occurs within 3 to 8 minutes.
Duration
Long (400- to 450-min) duration of action for nerve blocks; 210- to 240-min duration for spinal anesthesia
Protein binding
Bound to α1 acid glycoprotein in plasma.
Metabolism
Slowly hydrolysed by plasma pseudocholinesterase.

Contraindications

  • Should not be used for the management of ocular symptoms

Side effects

Common
DermatitisEye disordersEye inflammationParaesthesiaTemporary disruptive effect on the corneal epithelium
Serious
  • Increased systemic toxicity (due to slower metabolism compared to other common ester local anesthetics)
  • allergic reactions
  • More toxic than other LAs (due to slow hydrolysis)

Drug interactions

Nitrous Acid
Severe
Database

Clinical effect not specified

Source: DDInter

Prilocaine
Severe
Database

Clinical effect not specified

Source: DDInter

10 additional low-confidence interactions hidden — those rows lack a documented mechanism or management plan in our sources.

Related guidelines

Other Local Anesthetic drugs

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Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-10 · House clinical team