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Topical ester local anaesthetic

Tetracaine

Brand names: Ametop, Minims tetracaine

Tetracaine (amethocaine) is an ester-type local anaesthetic, used topically including as a gel to provide skin anaesthesia before cannulation or venepuncture and in ophthalmic preparations.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It reversibly blocks voltage-gated sodium channels in nerve membranes, preventing the initiation and conduction of pain impulses.

Prescribing in practice

  • Systemic absorption can cause local anaesthetic toxicity, so it must not be applied to large areas, broken or inflamed skin, or mucous membranes beyond its licensed use, and total exposure should be limited.
  • Local erythema, oedema and pruritus at the application site are common and usually transient.
  • Hypersensitivity to ester-type local anaesthetics is a contraindication; cross-reactivity within the ester class can occur.

Monitoring

Observe the application site for local reactions and remain alert for systemic features of local anaesthetic toxicity if large amounts are absorbed.

Counselling the patient

  • Numbing gel applied to the skin before a needle to reduce the pain of cannulation.
  • Mild redness or itching where it is applied is common and settles.
  • Remove the dressing and gel as directed and do not apply to broken skin.

Evidence & guidelines

Topical tetracaine is well established for reducing pain of venepuncture and cannulation, with its use and precautions described in the SPC.

Reference: AAGBI; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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