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Proparacaine and Fluorescein

Generic name: fluorescein/proparacaine ophthalmic

Brand names: Fluoracaine, Flucaine

Dosage Forms

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

Solution, ophthalmic:

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

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


Mechanism of Action

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


Onset of Action


Duration of Action


Use: Labeled Indications

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


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

Dosage and Administration

Dosing: Adult

Ophthalmic procedures:

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

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

Dosing: Geriatric

Refer to adult dosing.


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.


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

Methemoglobinemia Associated Agents: May enhance the adverse/toxic effect of Local Anesthetics. Specifically, the risk for methemoglobinemia may be increased. Monitor therapy

Adverse Reactions

Frequency not defined.

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

<1%, postmarketing, and/or case reports: Allergic contact dermatitis, corneal opacity, epithelial keratopathy (sloughing of necrotic epithelium), eye irritation, hemophthalmos, hypersensitivity reaction, iritis, keratitis, ocular hyperemia


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.

Source: Wolters Kluwer Health. Last updated January 2, 2019.