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)
Pharmacology
Mechanism of Action
Fluorescein is a diagnostic dye; proparacaine is a rapid acting anesthetic with short duration.
Pharmacokinetics/Pharmacodynamics
Onset of Action
Rapid
Duration of Action
Short
Use: Labeled Indications
Ophthalmic procedures: 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
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.
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
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
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.
