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Topical ocular anaesthetic Pregnancy: Compatible — single topical application; systemic absorption negligible.

Proxymetacaine 0.5% Eye Drops (Minims Proxymetacaine)

Brand names: Minims Proxymetacaine

Adult dose

Dose: 1–2 drops in affected eye(s)
Route: Ophthalmic
Frequency: Single application (for procedures); may repeat once after 90 seconds if needed
Max: Clinical effect usually achieved with 1–2 drops; additional drops for longer procedures
Topical anaesthesia for: tonometry, foreign body removal, suture removal, minor surgical procedures, corneal scraping. Onset: approximately 30 seconds. Duration: 15–20 minutes. Single-use Minims only — do NOT give patient a bottle to take home (masking pain → missed diagnosis and corneal damage).

Paediatric dose

Route: Ophthalmic
Frequency: Single application
Max: 1–2 drops per eye
Used in children for ophthalmic procedures. Same dosing as adults. Neonates: use under specialist supervision.

Dose adjustments

Renal

No adjustment required.

Hepatic

No adjustment required.

Clinical pearls

  • Preferred topical anaesthetic in UK eye casualty — causes less stinging than amethocaine (tetracaine)
  • NEVER send patient home with bottle — prolonged use inhibits corneal healing and masks worsening injury
  • Duration ~15–20 minutes — sufficient for most minor ophthalmic procedures
  • Warn patient not to touch or rub anaesthetised eye until sensation fully returns
  • Single-use Minims only — multi-dose bottles carry contamination risk

Contraindications

  • Hypersensitivity to proxymetacaine or ester-type local anaesthetics
  • Do NOT prescribe for home use (masks pain masking injury/infection)

Side effects

  • Transient stinging (less than tetracaine/amethocaine)
  • Conjunctival hyperaemia
  • Corneal epithelial damage (with repeated or prolonged use)
  • Allergic contact dermatitis
  • Corneal anaesthesia — risk of injury while anaesthetised

Interactions

  • No significant interactions at topical ophthalmic doses

Monitoring

  • Corneal integrity post-procedure (slit lamp / fluorescein)

Reference: BNFc; BNF; RCOphth Ophthalmic Trauma Guidelines; Minims Proxymetacaine SPC. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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