What Is Tetracaine? Uses, Dosage, and What You Need to Know in 2026

Tetracaine is a prescription local anesthetic that has been in clinical use since 1941. It is one of the most widely used anesthetics in ophthalmology, and it is also used for spinal anesthesia during surgeries and to relieve minor skin pain. Listed by the World Health Organization as an Essential Medicine, tetracaine is valued for its effectiveness, low cost, and rapid onset of action.

What Is Tetracaine?

Tetracaine (also known as amethocaine) is an ester-class local anesthetic. It works by blocking nerve signals at the site of application, preventing the area from feeling pain. Unlike general anesthesia — which affects the entire body and causes unconsciousness — local anesthetics like tetracaine are applied or injected only where numbness is needed.

The drug is available under several brand names including Altacaine (ophthalmic), Tetcane, and previously Pontocaine HCl (injection, now discontinued). Generic versions are manufactured by multiple companies including Bausch + Lomb, Somerset Therapeutics, and Paragon BioTeck.

What Is Tetracaine Used For?

Tetracaine has three primary FDA-approved uses:

Ophthalmic anesthesia (0.5% eye drops): One drop is applied to the eye before a procedure such as tonometry (measuring eye pressure for glaucoma), removal of foreign bodies, contact lens fitting, or minor eye surgeries. Numbness begins within 30 seconds and lasts 10–15 minutes.

Spinal anesthesia (injection): Administered by anesthesiologists into the spinal space for procedures requiring 2–3 hours of regional (lower body) anesthesia. This is a hospital or surgery center use only.

Topical skin anesthesia (2% solution): Applied to the skin to relieve pain from minor irritations such as sunburn, minor rashes, or surface skin conditions. Applied in thin layers up to 4 times daily.

Off-label, tetracaine is also used as part of the TAC mixture (tetracaine, adrenaline, cocaine) for emergency wound care and pediatric surface anesthesia.

Tetracaine Dosage and Administration

Tetracaine dosage depends on the formulation and use:

Ophthalmic: 1 drop (0.5% solution) in the affected eye(s) as needed during the procedure. Administered only by a healthcare provider.

Spinal injection: Dosage is determined by the anesthesiologist based on patient weight, age, physical status, and procedure. Reduced doses are used in elderly, debilitated, and obstetric patients.

Topical skin: A thin layer of 2% solution applied to affected skin up to 4 times daily. Use the smallest amount necessary. Do not apply to large areas or cover with occlusive wrapping without medical guidance.

Is Tetracaine a Controlled Substance?

No. Tetracaine is not a controlled substance and is not assigned a DEA schedule. It does require a prescription from a licensed healthcare provider, but there are no special handling, reporting, or refill restrictions beyond standard prescription drug regulations.

What Are the Side Effects of Tetracaine?

Common side effects include temporary stinging, burning, redness, or watering of the eye. These typically resolve within a few minutes. Serious but rare reactions include allergic reactions and methemoglobinemia (especially when combined with oxidizing drugs). Long-term self-use of tetracaine eye drops is dangerous and can cause corneal damage.

How Does Tetracaine Compare to Other Local Anesthetics?

Tetracaine is one of several local anesthetics used in ophthalmology and anesthesia. Compared to the most common alternative, proparacaine:

Both have similar onset (within 30 seconds to 1 minute)

Proparacaine lasts slightly longer (~15 minutes vs. 10 minutes for tetracaine)

Proparacaine causes less stinging on instillation

Tetracaine may be slightly more potent and is a WHO Essential Medicine; proparacaine is not

Both are ester anesthetics and contraindicated in pseudocholinesterase deficiency

Want to understand the science? See: How Does Tetracaine Work? Mechanism of Action Explained in Plain English.

How to Get Tetracaine

Tetracaine requires a prescription and is most commonly administered in clinical settings. If you've been prescribed it for outpatient use, compounding pharmacies and independent pharmacies are your most reliable options. medfinder can help you locate which pharmacies near you have tetracaine available without calling each one yourself.