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Drug overview for ALCAINE (proparacaine hcl):
Generic name: proparacaine HCl
Drug class: Ophthalmic Local Anesthetics
Therapeutic class: Ophthalmic Agents
Proparacaine hydrochloride is a rapidly-acting local anesthetic.
No enhanced Uses information available for this drug.
Generic name: proparacaine HCl
Drug class: Ophthalmic Local Anesthetics
Therapeutic class: Ophthalmic Agents
Proparacaine hydrochloride is a rapidly-acting local anesthetic.
No enhanced Uses information available for this drug.
DRUG IMAGES
ALCAINE 0.5% EYE DROPS
The following indications for ALCAINE (proparacaine hcl) have been approved by the FDA:
Indications:
Administration of corneal anesthesia
Local anesthesia for ophthalmologic procedure
Professional Synonyms:
None.
Indications:
Administration of corneal anesthesia
Local anesthesia for ophthalmologic procedure
Professional Synonyms:
None.
The following dosing information is available for ALCAINE (proparacaine hcl):
It isessential that the manufacturer's labeling be consulted for more detailed information on dosage and administration of this drug. Dosage summary:
Usual dosage in adults and pediatric patients: for removal of foreign bodies and sutures and for tonometry, apply 1 to 2 drops (in single instillations) in each eye before operating.
Short corneal and conjunctival procedures in adults and pediatric patients: apply 1 drop in each eye every 5 to 10 minutes for 5 to 7 doses.
Usual dosage in adults and pediatric patients: for removal of foreign bodies and sutures and for tonometry, apply 1 to 2 drops (in single instillations) in each eye before operating.
Short corneal and conjunctival procedures in adults and pediatric patients: apply 1 drop in each eye every 5 to 10 minutes for 5 to 7 doses.
FOR TOPICAL OPHTHALMIC USE ONLY. NOT FOR INJECTION. Apply topically to the eye in the form of a 0.5%
solution. Administer under the direct supervision of a healthcare provider; not intended for patient self-administration. Store bottles under refrigeration at 2degreesC to 8degreesC in unit carton to protect contents from light.
After opening, proparacaine can be used until the expiration date on the bottle. The ophthalmic solution should be clear to straw-color. If the solution becomes darker, discard the solution.
solution. Administer under the direct supervision of a healthcare provider; not intended for patient self-administration. Store bottles under refrigeration at 2degreesC to 8degreesC in unit carton to protect contents from light.
After opening, proparacaine can be used until the expiration date on the bottle. The ophthalmic solution should be clear to straw-color. If the solution becomes darker, discard the solution.
No dosing information available.
No generic dosing information available.
The following drug interaction information is available for ALCAINE (proparacaine hcl):
There are 0 contraindications.
There are 1 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Long-acting Bupivacaine/Local Anesthetics SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Concurrent use of other local anesthetics or use of other local anesthetics within 96 hours following long-acting bupivacaine may result in additive neurologic and cardiovascular effects. Use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine may also increase the risk of methemoglobinemia.(1,2) Non-liposomal bupivacaine may impact the pharmacokinetic and/or physicochemical properties of the liposomal formulation when administered in the same syringe or used simultaneously unless the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Local anesthetics other than bupivacaine may trigger the immediate release of bupivacaine from the liposomal formulation when administered together locally.(1) CLINICAL EFFECTS: Concurrent or use of local anesthetics with 96 hours of use of long-acting bupivacaine may result in neurologic and cardiovascular toxicity. Use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine may also result in methemoglobinemia.(1,2) Non-liposomal bupivacaine may impact the pharmacokinetic and/or physicochemical properties of the liposomal formulation when administered in the same syringe or used simultaneously unless the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Local anesthetics other than bupivacaine may trigger the immediate release of bupivacaine from the liposomal formulation when administered together locally.(1) PREDISPOSING FACTORS: Use of additional agents that are associated with methemoglobinemia may further increase the risk of methemoglobinemia.(1) Patients who are at increased risk of developing methemoglobinemia include those with glucose-6-phosphate dehydrogenase deficiency, congenital or idiopathic methemoglobinemia, cardiac or pulmonary compromise, infants under 6 months of age, and concurrent exposure to oxidizing agents or their metabolites are more susceptible to developing clinical manifestations of the condition. If local anesthetics must be used in these patients, close monitoring for symptoms and signs of methemoglobinemia is recommended.(1) PATIENT MANAGEMENT: Avoid the use of other local anesthetics within 96 hours following the administration of long-acting bupivacaine. In patients for whom use is required, monitor for neurologic and cardiovascular effects. Also monitor for methemoglobinemia with use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine.(1,2) Non-liposomal bupivacaine may be administered in the same syringe as bupivacaine liposomal or injected immediately before bupivacaine liposomal as long as the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Lidocaine may be administered 20 minutes or more prior to bupivacaine. It is unknown if other local anesthetics may be used without compromising the release characteristic of bupivacaine liposomal.(1) DISCUSSION: Concurrent use of other local anesthetics or use of other local anesthetics within 96 hours following long-acting bupivacaine may result in additive neurologic and cardiovascular effects. Use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine may also increase the risk of methemoglobinemia.(1,2) Non-liposome bupivacaine may impact the pharmacokinetic and/or physicochemical properties of the liposomal formulation when administered in the same syringe or used simultaneously unless the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Local anesthetics other than bupivacaine may trigger the immediate release of bupivacaine from the liposomal formulation when administered together locally. Lidocaine may be administered 20 minutes or more prior to bupivacaine. It is unknown if other local anesthetics may be used without compromising the release characteristic of bupivacaine liposomal.(1) |
BUPIVACAINE LIPOSOME, EXPAREL, XARACOLL, ZYNRELEF |
There are 0 moderate interactions.
The following contraindication information is available for ALCAINE (proparacaine hcl):
Drug contraindication overview.
Known hypersensitivity to any of the ingredients of this preparation.
Known hypersensitivity to any of the ingredients of this preparation.
There are 0 contraindications.
There are 0 severe contraindications.
There are 3 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Hyperthyroidism |
| Ocular infection |
| Ocular inflammation |
The following adverse reaction information is available for ALCAINE (proparacaine hcl):
Adverse reaction overview.
Occasional temporary stinging, burning and conjunctival redness may occur with the use of proparacaine. A rare, severe, immediate-type, apparently hyperallergic corneal reaction characterized by acute, intense and diffuse epithelial keratitis, a gray, ground glass appearance, sloughing of large areas of necrotic epithelium, corneal filaments and, sometimes, iritis with descemetitis has been reported. Allergic contact dermatitis with drying and fissuring of the fingertips has also been reported.
Occasional temporary stinging, burning and conjunctival redness may occur with the use of proparacaine. A rare, severe, immediate-type, apparently hyperallergic corneal reaction characterized by acute, intense and diffuse epithelial keratitis, a gray, ground glass appearance, sloughing of large areas of necrotic epithelium, corneal filaments and, sometimes, iritis with descemetitis has been reported. Allergic contact dermatitis with drying and fissuring of the fingertips has also been reported.
There are 6 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. | None. |
| Rare/Very Rare |
|---|
|
Cardiac arrhythmia Corneal opacity Excitement Fatigue Hyperhidrosis Pallor |
There are 7 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Conjunctival hyperemia Ocular irritation Ocular pain |
Ocular redness |
| Rare/Very Rare |
|---|
|
Allergic conjunctivitis Eyelid dermatitis Ocular itching |
The following precautions are available for ALCAINE (proparacaine hcl):
Safety and effectiveness of proparacaine hydrochloride ophthalmic solution in pediatric patients have been established. Use of proparacaine hydrochloride is supported by evidence from adequate and well-controlled studies in adults and children older than 12 years of age, and safety information in neonates and other pediatric patients.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
Animal reproduction studies have not been conducted with proparacaine hydrochloride ophthalmic solution. It is also not known whether the drug can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Proparacaine should be administered to a pregnant woman only if clearly needed.
It is not known whether proparacaine is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when proparacaine is administered to a nursing woman.
No overall clinical differences in safety or effectiveness have been observed between the elderly and other adult patients.
The following prioritized warning is available for ALCAINE (proparacaine hcl):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for ALCAINE (proparacaine hcl)'s list of indications:
No ICD codes found for this drug.
No ICD codes found for this drug.
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