Chloroprocaine (EENT) (Monograph)

Brand name: Iheezo
Drug class: Local Anesthetics

Medically reviewed by Drugs.com on Apr 10, 2024. Written by ASHP.

Introduction

Chloroprocaine hydrochloride is a local anesthetic.

Uses for Chloroprocaine (EENT)

Chloroprocaine hydrochloride has the following uses:

Chloroprocaine hydrochloride ophthalmic gel is indicated for ocular surface anesthesia.

Chloroprocaine (EENT) Dosage and Administration

General

Chloroprocaine hydrochloride is available in the following dosage form(s) and strength(s):

3% chloroprocaine hydrochloride ophthalmic gel in single-patient-use vials. Each single-patient-use vial contains 24 mg chloroprocaine in 800 mg of gel.

Dosage

It is essential that the manufacturer's labeling be consulted for more detailed information on dosage and administration of this drug. Dosage summary:

Adults

Dosage and Administration

The recommended dose of chloroprocaine hydrochloride ophthalmic gel is 3 drops applied topically to the ocular surface in the area of the planned procedure.
May be reapplied as needed to maintain anesthetic effect.

Cautions for Chloroprocaine (EENT)

Contraindications

Patients with a history of hypersensitivity to any component of this preparation.

Warnings/Precautions

Administration Warning

Chloroprocaine hydrochloride should not be injected or intraocularly administered.

Corneal Injury due to Insensitivity

Patients should not touch the eye for at least 10 to 20 minutes after using anesthetic as accidental injuries can occur due to insensitivity of the eye.

Corneal Opacification

Prolonged use of a topical ocular anesthetic may produce permanent corneal opacification and ulceration with accompanying visual loss.

Risk of Contamination

Do not touch the dropper tip to any surface as this may contaminate the gel.

Administration by Healthcare Provider

Chloroprocaine hydrochloride is indicated for administration under the direct supervision of a healthcare provider. The drug is not intended for patient self-administration.

Specific Populations

Pregnancy

There are no adequate and well-controlled studies of chloroprocaine hydrochloride use in pregnant women to inform a drug associated risk. There are no animal reproduction studies for chloroprocaine.

Lactation

There are no data on the presence of chloroprocaine in human milk, the effects on the breastfed infant, or the effects on milk production. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for chloroprocaine hydrochloride and any potential adverse effects on the breastfed infant from chloroprocaine hydrochloride.

Pediatric Use

The safety and effectiveness of chloroprocaine hydrochloride have not been established in pediatric patients.

Geriatric Use

No overall differences in safety or effectiveness of chloroprocaine hydrochloride have been observed between elderly and younger patients.

Common Adverse Effects

Most common adverse reaction is mydriasis (approximately 25%).

Drug Interactions

Specific Drugs

It is essential that the manufacturer's labeling be consulted for more detailed information on interactions with this drug, including possible dosage adjustments. Interaction highlights:

Please see product labeling for drug interaction information.

Actions

Mechanism of Action

Chloroprocaine, like other local anesthetics, blocks the generation and the conduction of nerve impulses, presumably by increasing the threshold for electrical excitation in the nerve, by slowing the propagation of the nerve impulse, and by reducing the rate of rise of the action potential. In general, the progression of anesthesia is related to the diameter, myelination, and conduction velocity of affected nerve fibers. Clinically, the order of loss of nerve function is as follows: (1) pain, (2) temperature, (3) touch, (4) proprioception, and (5) skeletal muscle tone.

Additional Information

AHFSfirstRelease^™. For additional information until a more detailed monograph is developed and published, the manufacturer's labeling should be consulted. It is essential that the manufacturer's labeling be consulted for more detailed information on usual uses, dosage and administration, cautions, precautions, contraindications, potential drug interactions, laboratory test interferences, and acute toxicity.

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.