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Tetrahydrozoline (Ophthalmic)


(tet ra hye DROZ a leen)

Index Terms

  • Tetrahydrozoline HCl
  • Tetrahydrozoline Hydrochloride
  • Tetryzoline

Dosage Forms

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

Solution, Ophthalmic, as hydrochloride:

Altazine: 0.05% (15 mL [DSC], 30 mL [DSC])

Eye Drops: 0.05% (15 mL) [contains benzalkonium chloride, edetate disodium]

Opti-Clear: 0.05% (15 mL [DSC])

Opti-Clear: 0.05% (15 mL) [contains benzalkonium chloride, edetate disodium]

Visine: 0.05% (15 mL [DSC]) [contains benzalkonium chloride]

Generic: 0.05% (15 mL [DSC])

Brand Names: U.S.

  • Altazine [OTC] [DSC]
  • Eye Drops [OTC]
  • Opti-Clear [OTC]
  • Visine [OTC] [DSC]

Pharmacologic Category

  • Adrenergic Agonist Agent
  • Imidazoline Derivative
  • Ophthalmic Agent, Vasoconstrictor


Stimulates alpha-adrenergic receptors in the arterioles of the conjunctiva to produce vasoconstriction

Use: Labeled Indications

Ocular decongestant: Relieves redness of the eye due to minor eye irritation and protects against further irritation; temporarily relieves burning and discomfort from dryness of the eye or exposure to wind and sun.


Documentation of allergenic cross-reactivity for ophthalmic sympathomimetics is limited. However, because of similarities in chemical structure and/or pharmacologic actions, the possibility of cross-sensitivity cannot be ruled out with certainty.

Dosing: Adult

Ocular decongestant: Ophthalmic: Instill 1 to 2 drops in the affected eye(s) up to 4 times daily

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Ocular decongestant (Visine products only): Children ≥6 years, and Adolescents: Ophthalmic: Refer to adult dosing.

Dosing: Renal Impairment

There are no dosage adjustments provided in the manufacturer’s labeling.

Dosing: Hepatic Impairment

There are no dosage adjustments provided in the manufacturer’s labeling.


For ophthalmic use only; wash hands prior to use. Do not touch tip of container to any surface, the eyelids, or the surrounding area. Remove contact lenses prior to administering products containing benzalkonium chloride; after instilling drops, wait at least 10 minutes before inserting contact lenses. Do not insert contacts if eyes are red.


Store at 15ºC to 30ºC (59ºF to 86ºF). Do not use if solution changes color or becomes cloudy.

Drug Interactions

There are no known significant interactions.

Adverse Reactions

Frequency not established

Cardiovascular: Hypertension, palpitation, tachycardia

Central nervous system: Headache

Local: Transient stinging

Neuromuscular & skeletal: Tremor

Ocular: Blurred vision


Disease-related concerns:

• Cardiovascular disease: Use with caution in patients with cardiovascular disease, including hypertension and coronary artery disease.

• Diabetes: Use with caution in patients with diabetes.

• Glaucoma: Use with caution in patients with narrow-angle glaucoma.

• Hyperthyroidism: Use with caution in patients with hyperthyroidism.

Dosage form specific issues:

• Benzalkonium chloride: Some products may contain benzalkonium chloride, which may be absorbed by soft contact lenses.

Other warnings/precautions:

• Accidental ingestion: Accidental ingestion by children of over-the-counter (OTC) imidazoline-derivative eye drops and nasal sprays may result in serious harm. Serious adverse reactions (eg, coma, bradycardia, respiratory depression, sedation) requiring hospitalization have been reported in children ≤5 years of age who had ingested even small amounts (eg, 1 to 2 mL). Contact a poison control center and seek emergency medical care immediately for accidental ingestion (FDA Drug Safety Communication 2012).

• Self-medication (OTC use): For ophthalmic use only. When used for self-medication, discontinue and contact a health care provider if eye pain, vision changes, continued redness, or eye irritation occurs or if condition worsens or persists >72 hours; do not use with contacts (remove prior to use). Do not use if solution changes color or becomes cloudy. Do not touch tip of container to any surface and replace cap after use. When using this product, pupils may become temporarily enlarged; overuse may cause more eye redness.

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 tingling. 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.