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Alcaine

Alcaine

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Tomasz Grzelewski

Dermatology20 years of experience

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults.

In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

Patients commonly seek his care for:

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns
Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.
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This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use Alcaine

Patient Information Leaflet: Patient Information

Warning! Keep the leaflet! Information on the immediate packaging in a foreign language.

Alcaine, 5 mg/ml, eye drops, solution

Proxymetacaine hydrochloride

Read the leaflet carefully before using the medicine, as it contains important information for the patient.

  • Keep this leaflet, so you can read it again if you need to.
  • If you have any doubts, consult your doctor or pharmacist.
  • This medicine has been prescribed specifically for you. Do not pass it on to others. The medicine may harm another person, even if their symptoms are the same.
  • If the patient experiences any side effects, including any side effects not listed in this leaflet, they should tell their doctor or pharmacist. See section 4.

Table of Contents of the Leaflet

  • 1. What is Alcaine and what is it used for
  • 2. Important information before using Alcaine
  • 3. How to use Alcaine
  • 4. Possible side effects
  • 5. How to store Alcaine
  • 6. Contents of the pack and other information

1. What is Alcaine and what is it used for

Alcaine contains the active substance proxymetacaine hydrochloride, which has a local anesthetic effect.
Alcaine is used for surface anesthesia before ophthalmic procedures that require rapid and short-term anesthesia, such as: preparation for cataract surgery, removal of corneal sutures, tonometric measurement of intraocular pressure,
gonioscopic examination, removal of foreign bodies, scraping of the conjunctiva for diagnostic purposes, and other procedures if surface anesthesia is necessary.

2. Important information before using Alcaine

When not to use Alcaine

  • if the patient is allergic to proxymetacaine hydrochloride or any of the other ingredients of this medicine (listed in section 6),
  • without medical supervision,
  • for a long time, as this may cause corneal damage, vision loss, and prolonged healing time,
  • while wearing contact lenses, as Alcaine contains benzalkonium chloride.

Warnings and precautions

Before starting to use Alcaine, discuss it with your doctor or pharmacist.

  • Alcaine is intended for local administration to the eye only by a doctor. It must not be injected.
  • The medicine should only be used for eye drops (eyes).
  • Repeated use or abuse of this medicine may lead to infections and corneal damage.
  • Due to the anesthetic effect, the eyes will lose sensation, so caution should be exercised to avoid accidental eye injury. Do not touch or rub your eyes and take precautions to protect them from everyday contaminants (such as dust, dirt, etc.).
  • Repeated use of this medicine may lead to a shortened anesthetic effect.
  • Proxymetacaine hydrochloride may cause allergic contact dermatitis. Avoid contact between Alcaine and the skin.
  • If other medicines are being used, also read the section Alcaine and other medicines.
  • Caution should be exercised when using the medicine in patients:
  • with epilepsy, heart disease, hyperthyroidism, or respiratory disorders,
  • with myasthenia, as they are particularly sensitive to the effects of local anesthetics,
  • with low acetylcholinesterase enzyme activity in blood serum and in patients treated with cholinesterase inhibitors, as there is an increased risk of systemic side effects after local use of local anesthetics from the ester group. Patients should avoid touching or rubbing their eyes until the local anesthetic effect has worn off.

If symptoms of hypersensitivity or irritation occur or worsen, consult a doctor immediately.

Alcaine and other medicines

Tell your doctor or pharmacist about all medicines you are taking or have recently taken, as well as any medicines you plan to take.

Pregnancy, breastfeeding, and fertility

If you are pregnant or breastfeeding, think you may be pregnant, or plan to have a child, consult your doctor before using this medicine.
Using Alcaine during pregnancy and breastfeeding is not recommended.

Driving and using machines

After using Alcaine, temporary blurred vision may occur. Do not drive or operate machines until this symptom has resolved.

Alcaine contains benzalkonium chloride

The medicine contains 0.0035 mg of benzalkonium chloride per drop, which corresponds to 0.1 mg/ml.
Benzalkonium chloride may be absorbed by soft contact lenses and change their color. Remove contact lenses before instillation and wait at least 15 minutes before reinserting. Benzalkonium chloride may also cause eye irritation, especially in people with dry eye syndrome or corneal disorders (the transparent layer at the front of the eye). If abnormal sensations, stinging, or eye pain occur after using the medicine, consult a doctor.

3. How to use Alcaine

Alcaine is intended for use by a doctor only.
Recommended dose
When preparing a patient for a simple examination, e.g., tonometric examination or other short-term procedures, usually one to two drops are instilled directly before the procedure.
Before minor surgical procedures, such as removal of a foreign body or sutures, instill one to two drops every five to ten minutes, one to three times.
To achieve long-term anesthesia, e.g., during cataract surgery, instill one to two drops of the medicine into the eye (eyes) every five to ten minutes, three to five times.
Remember that the local anesthetic effect occurs within 30 seconds and may last up to 15 minutes.
Method of administration
Alcaine should only be instilled into the eye (eyes).
Remove the cap. If the protective collar is loose after removing the cap, discard it before using the medicine.
To prevent infection of the dropper tip or solution, be careful not to touch the dropper tip to the eyelids or surrounding tissues. Keep the bottle tightly closed when not in use.
Systemic absorption of the medicine can be reduced by using the following methods after instillation:

  • close your eyes for 2 minutes;
  • press the nasolacrimal duct with your finger for 2 minutes.

Do not use the solution if it is cloudy or has changed color.
Note: Since there is no blinking reflex after using the medicine, it is recommended to apply an eye patch after the procedure.
If the patient is using other eye drops or ointments at the same time,wait at least 5 minutes between administrations of the next medicines. Apply eye ointments last.

Using a higher dose of Alcaine than recommended

If a higher dose than recommended is used, flush the eye with lukewarm water.
In case of overdose or accidental ingestion, consult a doctor, pharmacist, or poison control center immediately, as severe reactions from the nervous or respiratory system may occur.

Missing a dose of Alcaine

Do not double the dose to make up for a missed dose.
If you have any further doubts about using this medicine, consult your doctor or pharmacist.

4. Possible side effects

Like all medicines, Alcaine can cause side effects, although not everybody gets them.
The following side effects have been observed with the use of Alcaine, but their frequency cannot be estimated from the available data:

  • Eye-related effects: corneal damage, clouding of the eye surface, swelling of the eye surface, inflammation of the eye surface, blurred vision, photophobia, pupil dilation, eye pain, eye irritation, eye swelling, discomfort in the eye, redness of the eye, increased tear production.
  • General side effects: hypersensitivity (allergy), fainting, dizziness. Transient symptoms, such as a feeling of stinging, burning, or redness of the conjunctiva, may occur. In rare cases, an allergic reaction of the cornea (in which acute, diffuse corneal epithelial inflammation with the formation of fibers and (or) separation of large areas of necrosis, diffuse edema of the substrate, inflammation of the posterior limiting layer, and inflammation of the iris) may occur.

In very rare cases, after local use in the eye, systemic toxic effects may occur, manifested by central nervous system stimulation, followed by its depression.
Additionally, uncontrolled use or abuse of Alcaine may lead to permanent corneal disorders and (or) eye damage.

Reporting side effects

If you experience any side effects, including any side effects not listed in this leaflet, tell your doctor or pharmacist. Side effects can be reported directly to the Department of Monitoring of Adverse Reactions to Medicinal Products, Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products, Al. Jerozolimskie 181C, 02-222 Warsaw, tel.: 22 49 21 301, fax: 22 49 21 309, website: https://smz.ezdrowie.gov.pl.
Reporting side effects will help gather more information on the safety of the medicine.

5. How to store Alcaine

Keep the medicine out of sight and reach of children.
Protect from light.
Store in a refrigerator at a temperature between 2°C and 8°C.
Shelf life after first opening the bottle: 4 weeks.
After each use, close the bottle tightly.
Do not use this medicine after the expiry date stated on the packaging.
The expiry date refers to the last day of the specified month.
Do not use the solution if it is cloudy or has changed color.
Medicines should not be disposed of via wastewater or household waste containers. Ask your pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.

6. Contents of the pack and other information

What Alcaine contains

  • The active substance of Alcaine is proxymetacaine hydrochloride. 1 ml of solution contains 5 mg of proxymetacaine hydrochloride.
  • The other ingredients (excipients) are: glycerol, hydrochloric acid, and/or sodium hydroxide, benzalkonium chloride, purified water.

What Alcaine looks like and contents of the pack

Alcaine is available as a sterile, isotonic aqueous solution.
A white, opaque bottle (DROP-TAINER) made of low-density polyethylene (LDPE), with a dropper and a white polypropylene cap, contains 15 ml of solution.
For more detailed information, contact the marketing authorization holder or parallel importer.

Marketing authorization holder in Bulgaria, the country of export:

Alcon Farmaceutika d.o.o.
Avenija Dubrovnik 16
10160 Zagreb, Croatia

Manufacturer:

S.A. ALCON-COUVREUR N.V.
Rijksweg 14
2870 Puurs
Belgium
Alcon Laboratories Belgium
Lichterveld 3
2870 Puurs-Sint-Amands
Belgium

Parallel importer:

InPharm Sp. z o.o.
ul. Strumykowa 28/11
03-138 Warsaw

Repackaged by:

InPharm Sp. z o.o. Services sp. k.
ul. Chełmżyńska 249
04-458 Warsaw
Marketing authorization number in Bulgaria, the country of export:20000223
Parallel import authorization number:153/23

Date of approval of the leaflet: 30.07.2024

[Information about the trademark]

  • Country of registration
  • Active substance
  • Prescription required
    Yes
  • Marketing authorisation holder (MAH)
    Alcon Farmaceutika d.o.o.
  • Alternatives to Alcaine
    Dosage form: Drops, 5 mg/ml
    Active substance: proxymetacaine
    Prescription required
    Dosage form: Drops, 5 mg/ml
    Active substance: proxymetacaine
    Prescription required
    Dosage form: Drops, 5 mg/ml
    Active substance: proxymetacaine
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Alternatives to Alcaine in other countries

The best alternatives with the same active ingredient and therapeutic effect.

Alternative to Alcaine in Spain

Dosage form: OPHTHALMIC GEL, 20 mg/g
Active substance: lidocaine
Prescription required
Dosage form: EYEDROP, 5 mg tetracaine HCl; 0.5 mg naphazoline HCl
Active substance: combinations
Manufacturer: Alcon Healthcare S.A.
Prescription required
Dosage form: EYE DROP, 4 mg/ml + 1 mg/ml
Active substance: combinations
Manufacturer: Alcon Healthcare S.A.
Prescription required

Online doctors for Alcaine

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for Alcaine – subject to medical assessment and local rules.

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Doctor

Tomasz Grzelewski

Dermatology20 years of experience

Dr Tomasz Grzelewski is an MD, PhD specialist in allergy, paediatrics, general practice and sports medicine, with a clinical focus on dermatology, endocrinology, allergology and sports-related health. He has more than 20 years of clinical experience and completed his medical training at the Medical University of Łódź, where he defended his PhD thesis with distinction. His doctoral research was recognised by the Polish Society of Allergology for its innovative contribution to the field. Throughout his career, he has gained extensive expertise in diagnosing and managing a wide range of allergic and paediatric conditions, including modern allergen desensitisation techniques.

For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults.

In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

Patients commonly seek his care for:

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns
Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.
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