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Tetrahydrozoline (Ophthalmic)

Generic name: tetrahydrozoline ophthalmic

Brand names: Visine Original, Eye Moisturizing Relief, Optigene 3, Clarine, Eye-Sine, Geneye Extra, Geneyes, Opti-Clear, Redness Relief, Tetrasine, Tetrasine EX, Vision Clear, Vision Eye, Visine Extra, Altazine, Visine Maximum Redness Relief, Murine Plus

Dosage Forms

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

Solution, Ophthalmic, as hydrochloride:

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

GoodSense Eye Drops: 0.05% (15 mL); Tetrahydrozoline hydrochloride 0.05%, dextran 0.1%, polyethylene glycol 1%, and povidone 1% (15 mL) [contains benzalkonium chloride, edetate disodium]

GoodSense Relief Eye Drops: Tetrahydrozoline hydrochloride 0.05% and zinc sulfate 0.25% (15 mL) [contains benzalkonium chloride, edetate disodium]

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

Visine Advanced Relief: Tetrahydrozoline hydrochloride 0.05%, dextran 0.1%, polyethylene glycol 1%, and povidone 1% (15 mL) [contains benzalkonium chloride, edetate disodium]


Mechanism of Action

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.

Dosage and Administration

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.


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 defined.

Cardiovascular: Hypertension, palpitations, tachycardia

Central nervous system: Headache, transient burning or stinging in the eyes

Neuromuscular & skeletal: Tremor

Ophthalmic: 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

What is this drug used for?

  • It is used to treat eye redness.

Frequently reported side effects of this drug

  • Burning or stinging

Other side effects of this drug: Talk with your doctor right away if you have any of these signs of:

  • Vision changes
  • Eye pain
  • Severe eye irritation
  • Signs of a significant reaction like 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. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from the healthcare provider. You must talk with the healthcare provider for complete information about the risks and benefits of using this medicine.

Source: Wolters Kluwer Health. Last updated October 26, 2019.