Tetracaine

Registered South African indications:

• Local surface anaesthetic

Contraindications

• Hypersensitivity to the active ingredient or any of its excipients
• Hypersensitivity to other local anaesthetics
• Application to broken skin

Cautions

• Pregnancy
• Breastfeeding
• Renal function
• Hepatic function
• Instillation into the middle ear or use in
  procedures which might involve penetration into the middle ear
• Repeated exposure
• Epilepsy

Forms avail. in SA and covered in this monograph: cre

Haemorrhoids 
Anal fissures 
Minor burns/scalds, boils, stings, certain skin infections 
Lubricant for instrumentation 

• Topical (cre): Apply small quantity to affected areas as needed

Always wash hands thoroughly after use

No information available 

Pregnancy 

• Caution
• There are no adequate data from the use of tetracaine in pregnant women. There are no animal studies to indicate direct or indirect harmful effects with respect to reproductive toxicity
• The rapid hydrolysis of tetracaine by plasma pseudocholinesterase means that it is unlikely to present a significant hazard to the foetus when used as indicated
• As a precautionary measure, it is preferable to avoid the use of tetracaine during pregnancy

Breastfeeding 

• Caution
• It is not known whether tetracaine or its metabolites are secreted in breast milk. A risk to the new-borns/ infants cannot be excluded. Therefore the product is not recommended for use on breastfeeding mothers

Fertility

• There are no clinical data regarding the potential effect of tetracaine on fertility

Renal Impairment

• Caution; no information available

Elderly 

• No dose adjustment recommended

Elderly 

• Caution; no information available 

Porphyria Information

• Not yet classified (NC)

Drugs in Sport

• Permitted - No warnings

Skin and Subcutaneous Tissue Disorders

• Application site reactions
  - Erythema
  - Oedema
  - Pruritus
  - Vesicles
  - Blistering
  - Itching

• None known

None routine 

Overdose

• Overdosage with tetracaine is unlikely to result from application to intact skin
• If accidentally ingested systemic toxicity may occur, and signs will be similar to those observed after administration of other local anaesthetics
• These signs have been described as: signs of inebriation, tingling, numbness of the tongue, tinnitus, nystagmus, nausea or vomiting, twitching and convulsions
• Oxygen is recommended as the first-line treatment for systemic toxicity

Tetracaine is a local anaesthetic and is believed to act by blocking nerve conduction mainly by inhibiting sodium ion flux across the axon membrane. Tetracaine achieves this by acting upon specific receptors that control gating mechanisms responsible for conductance changes in specialised proteinaceous sodium channels. Blocking sodium ion flux prevents the setting up of an action potential in the nerve axon, thus preventing pain receptors signalling to the central nervous system.

Cream (per 100g) 1g

• Adco-Amethocaine (Adcock Ingram)
• Anethaine cream (Sanofi)

Also available in the following forms: Ointment and eye drop.