Benoxinate/fluorescein ophthalmic (Fluress, Fluorox)
Dosing and uses of Fluress, Fluorox (Benoxinate/fluorescein ophthalmic)
Adult dosage forms and strengths
benoxinate/fluorescein ophthalmic
ophthalmic solution
- 0.4%/0.25%
Removal of Foreign Bodies, Sutures, or Tonometry
Provides topical ophthalmic anesthesia with a disclosing agent for short corneal and conjunctival procedures
1-2 gtt into each eye before procedure
Deep Ophthalmic Anesthesia
2 gtt in each eye q90seconds x 3 doses
Pediatric dosage forms and strengths
Safety and efficacy not established
Fluress, Fluorox (Benoxinate/fluorescein ophthalmic) adverse (side) effects
Frequency not defined
Transient local stinging
Transient local burning
Acute, intense and diffuse epithelial keratitis
Conjunctival redness
Gray ground glass appearance
Sloughing of epithelium
Iritis with descemetitis
Dying/fissuring of fingertips
Severe, immediate allergic corneal reaction (rare)
Allergic contact dermatitis (rare)
Conjunctival congestion (rare)
Conjunctival hemorrhage (rare)
Warnings
Contraindications
Hypersensitivity to either component or to similar drugs
Cautions
Prolonged use not recommended as may diminish duration of anesthesia, retard wound healing, and cause corneal infection and/or opacification with accompanying permanent visual loss or corneal perforation
Systemic toxicity (CNS stimulation followed by CNS and cardiovascular depression) possible but rare
Protection of the eye from other irritating chemicals, foreign bodies, and rubbing during the period of anesthesia is very important
CNS stimulation followed by depression may occur with topical application of local anesthetics
Use cautiously and sparingly in patients with known allergies, cardiac disease, or hyperthyroidism
Pregnancy and lactation
Pregnancy category: C
Lactation: Unknown whether distributed in breast milk, caution advised
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Fluress, Fluorox (Benoxinate/fluorescein ophthalmic)
Mechanism of action
Benoxinate hydrochloride: Topical anesthetics stabilize neuronal membrane so neuron is less permeable to ions, preventing initiation and transmission of nerve impulses, producing local anesthetic action
Fluorescein sodium: Contact with aqueous humor increases intensity of green fluorescence
