Anesthesia, ocular: Ophthalmic: Apply 3 drops to ocular surface in area where procedure will occur; may reapply as needed to maintain effect.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Injection, as hydrochloride [preservative free]:
Nesacaine-MPF: 3% (20 mL) [methylparaben free]
Generic: 3% (20 mL)
Yes
Iheezo: FDA approved September 2022; anticipated availability currently unknown.
Ophthalmic: For topical ophthalmic use only; not for injection or intraocular use. Administer under direct supervision of a health care provider; not for patient self-administration. To avoid contamination, do not touch dropper tip to any surface. Instruct patient to avoid touching eye for 10 to 20 minutes following administration.
Anesthesia, ocular: Local anesthesia for ophthalmic procedures.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Adverse reactions reported in adults.
>10%: Ophthalmic: Mydriasis (26%)
1% to 10%: Ophthalmic: Eye irritation (6%)
Hypersensitivity to chloroprocaine or any component of the formulation.
Concerns related to adverse effects:
• Corneal ulceration: Prolonged use may cause permanent corneal ulceration and/or opacification with loss of vision.
Other warnings/precautions:
• Appropriate use: For ophthalmic use only; not for injection or intraocular use. Administer under direct supervision of a health care provider; not for patient self-administration. To avoid contamination, do not touch dropper tip to any surface.
None known.
Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.
Methemoglobinemia Associated Agents: May enhance the adverse/toxic effect of Local Anesthetics. Specifically, the risk for methemoglobinemia may be increased. Risk C: Monitor therapy
Animal reproduction studies have not been conducted with ophthalmic chloroprocaine.
It is not known if chloroprocaine is present in breast milk following ophthalmic application.
According to the manufacturer, the decision to breastfeed following application should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother.
Local anesthetics block both the initiation and conduction of nerve impulses by increasing electrical excitation in the nerve, slowing propagation of the nerve impulse, and decreasing the rate of rise of the action potential.
Metabolism: Rapidly hydrolyzed by plasma enzymes to 2-chloro-4-aminobenzoic acid and beta-diethylaminoethanol.
Half-life elimination: In vitro, plasma: Neonates: ~43 seconds; Adults: ~25 seconds.
Excretion: Primarily urine.
