Tetrahydrozoline
Drug class: Antineoplastic Agents
Usage of Tetrahydrozoline
Conjunctival Congestion
Temporary relief of conjunctival congestion, itching, and minor irritation.
Used alone or in fixed combination with astringents (i.e., zinc sulfate).
Controls hyperemia in patients with superficial corneal vascularity.
Ineffective in the treatment of delayed hypersensitivity reactions such as contact dermatoconjunctivitis.
Used for vasoconstrictor effect during some ocular diagnostic procedures; phenylephrine may be preferred.
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How to use Tetrahydrozoline
Administration
Ophthalmic Administration
Apply ophthalmic solution topically to the conjunctiva.
Remove contact lenses before administering ophthalmic solution; wait ≥15 minutes to reinsert contact lenses.
Do not administer discolored or cloudy solution.
Avoid contamination of the dropper tip.
Dosage
Available as tetrahydrozoline hydrochloride; dosage expressed in terms of the salt.
Pediatric Patients
Conjunctival Congestion OphthalmicChildren ≥6 years of age: 1–2 drops of a 0.05% ophthalmic solution in the affected eye(s) up to 4 times daily.
Adults
Conjunctival Congestion Ophthalmic1–2 drops of a 0.05% ophthalmic solution in the affected eye(s) up to 4 times daily.
Prescribing Limits
Pediatric Patients
Conjunctival Congestion OphthalmicFor self-medication: Maximum of 4 times daily; maximum duration of 3–4 days, unless directed by a clinician.
Adults
Conjunctival Congestion OphthalmicFor self-medication: Maximum of 4 times daily; maximum duration of 3–4 days, unless directed by a clinician.
Special Populations
No special population dosage recommendations at this time.
Warnings
Contraindications
Warnings/Precautions
Warnings
GlaucomaPatients with narrow-angle glaucoma or other serious eye disease should consult a clinician before using ophthalmic solution.
General Precautions
OverusePossible irritation of conjunctiva and adverse systemic effects (particularly in children) with excessive dosage and/or prolonged or too frequent use. Possible ocular hyperemia (redness); avoid prolonged use. (See Advice to Patients.)
Overdose may produce CNS depression with drowsiness, decreased body temperature, bradycardia, shock-like hypotension, apnea, and coma.
Accidental ingestion of imidazoline derivatives (i.e., tetrahydrozoline, naphazoline, oxymetazoline) in children has resulted in serious adverse events requiring hospitalization (e.g., coma, bradycardia, decreased respiration, sedation, somnolence). (See Pediatric Use under Cautions and also see Advice to Patients.)
High concentrations of ophthalmic solution may liberate pigment granules; more common in the elderly.
Sympathomimetic EffectsPossible headache, hypertension, weakness, sweating, cardiac irregularities (e.g., palpitations), tremors, drowsiness, lightheadedness, and insomnia. Use with caution in patients with thyroid disease (e.g., hyperthyroidism), heart disease (e.g., coronary artery disease), hypertension, or diabetes mellitus.
Use of Fixed CombinationsWhen used in fixed combination with astringents (i.e., zinc sulfate), consider the cautions, precautions, and contraindications associated with the concomitant drug.
Specific Populations
PregnancyCategory C.
LactationNot known whether tetrahydrozoline is distributed into milk. Caution if used in nursing women.
Pediatric UseSafety and efficacy of ophthalmic solution not established in children <6 years of age.
Accidental ingestion of OTC ophthalmic solutions or nasal sprays containing imidazoline derivatives (i.e., tetrahydrozoline, naphazoline, oxymetazoline) in children has resulted in serious adverse events requiring hospitalization, including nausea, vomiting, lethargy, tachycardia, decreased respiration, bradycardia, hypotension, hypertension, sedation, somnolence, mydriasis, stupor, hypothermia, drooling, and coma. Respiratory depression, CNS depression, and/or lethargy reportedly occurred in infants following accidental ingestion of small amounts (≤6 mL) of 0.05% tetrahydrozoline ophthalmic solution. Keep out of reach of children. (See Advice to Patients.)
Common Adverse Effects
Ophthalmic: Blurred vision, irritation, mydriasis.
Disclaimer
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