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Proparacaine and Fluorescein

Pronunciation

(proe PAR a kane & FLURE e seen)

Index Terms

  • Fluorescein and Proparacaine
  • Proparac Hcl/Fluorescein Na
  • Proparacaine/Fluorescein Sod

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product

Solution, ophthalmic: Proparacaine hydrochloride 0.5% and fluorescein sodium 0.25% (5 mL)

Flucaine: Proparacaine hydrochloride 0.5% and fluorescein sodium 0.25% (5 mL)

Brand Names: U.S.

  • Flucaine

Pharmacologic Category

  • Diagnostic Agent
  • Local Anesthetic

Pharmacology

Fluorescein is a diagnostic dye; proparacaine is a rapid acting anesthetic with short duration.

Onset of Action

Rapid

Duration of Action

Short

Use: Labeled Indications

For use in ophthalmic procedures when a topical disclosing agent is needed along with an anesthetic

Contraindications

Hypersensitivity to proparacaine, fluorescein, or any component of the formulation

Dosing: Adult

Short corneal and conjunctival surgical procedures requiring deep ophthalmic anesthesia: Ophthalmic: Instill 1 drop in each eye every 5-10 minutes for 5-7 doses

Tonometry, gonioscopy, foreign body or suture removal: Ophthalmic: Instill 1-2 drops in each eye just prior to procedure

Dosing: Geriatric

Refer to adult dosing.

Dosing: Renal Impairment

No dosage adjustment provided in manufacturer’s labeling.

Dosing: Hepatic Impairment

No dosage adjustment provided in manufacturer’s labeling.

Administration

For topical ophthalmic use only; avoid touching tip of dropper to eye, fingers, or other surfaces. Protect eye from irritation, foreign bodies, and rubbing to prevent inadvertent damage; use of an eye patch is recommended.

Storage

Store under refrigeration at 2°C to 8°C (36°F to 46°F); can be stored for up to 1 month at room temperature.

Drug Interactions

There are no known significant interactions.

Adverse Reactions

Frequency not defined.

1% to 10%: Ophthalmic: Burning sensation of eyes, stinging of eyes

<1% (Limited to important or life-threatening): Allergic contact dermatitis, corneal epithelium erosion, corneal opacity, eye irritation, hemophthalmos, hypersensitivity reaction, iritis, keratitis, ocular hyperemia

Warnings/Precautions

Disease-related concerns:

• Cardiovascular disease: Use with caution in patients with cardiovascular disease.

• Hyperthyroidism: Use with caution in patients with hyperthyroidism.

Concerns related to adverse effects:

• CNS stimulation/depression: Rarely, CNS stimulation followed by depression may occur following topical application of local anesthetics.

Other warnings/precautions:

• Appropriate use: For topical ophthalmic use only. To avoid contamination, do not touch dropper tip to eyelids or other surfaces. The anesthetized eye should be protected from irritation, foreign bodies, and rubbing to prevent inadvertent damage; use of an eye patch is recommended.

• Prolonged use: Delayed wound healing and/or permanent corneal opacification with vision loss may occur with prolonged use; not recommended.

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience burning or stinging. Have patient report immediately to prescriber vision changes, eye pain, or severe eye irritation (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.

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