Novesina (Oxybuprocaine Hydrochloride)

Novesina is a topical ophthalmic anesthetic used to numb the ocular surface for procedures involving the cornea and anterior segment.

• Tonometry: provides rapid corneal anesthesia to allow accurate intra‑ocular pressure measurement without patient discomfort.
• Slit‑lamp examination: numbs the ocular surface enabling detailed anterior segment evaluation and photography.
• Minor ophthalmic interventions: facilitates painless corneal anesthesia for procedures such as foreign‑body removal, laser treatment, or superficial debridement.

• Oxybuprocaine Hydrochloride exerts its anesthetic effect by reversibly blocking voltage‑gated sodium channels on peripheral nerve membranes in the corneal epithelium and conjunctiva. This inhibition prevents the initiation and propagation of nerve impulses, resulting in a rapid loss of sensation in the treated ocular tissues. The blockade is concentration‑dependent and reversible, allowing normal sensation to return within minutes after the drug is cleared from the ocular surface.

Oxybuprocaine Hydrochloride may cause ocular and systemic reactions, most of which are mild and transient.

Common Side Effects

• Burning sensation: transient stinging or burning upon instillation.
• Stinging or itching: mild irritation lasting a few minutes.
• Blurred vision: temporary reduction in visual acuity that resolves quickly.
• Conjunctival hyperemia: mild redness of the eye.
• Tearing: increased lacrimation after instillation.
• Photophobia: temporary sensitivity to light.
• Dryness: temporary ocular surface dryness after use.

Serious or Rare Side Effects

• Corneal epithelial toxicity: ulceration or delayed healing with prolonged use.
• Allergic reaction: swelling, rash, or severe eye irritation indicating hypersensitivity.
• Systemic toxicity: rare central nervous system or cardiovascular effects with excessive absorption.
• Infection risk: secondary bacterial keratitis if sterility compromised.

When using Novesina, clinicians should observe specific precautions to minimize adverse reactions and ensure optimal efficacy.

• Allergy assessment: verify no known hypersensitivity to ester‑type ocular anesthetics before administration.
• Contact lens use: remove lenses and wait at least 30 minutes after instillation before reinserting.
• Corneal integrity: avoid use on compromised epithelium or active corneal ulcers.
• Pregnancy and lactation: safety not established; prescribe only if potential benefit justifies risk.
• Drug interactions: do not combine with other topical ocular anesthetics to prevent additive toxicity.
• Store at room temperature: keep in original container, protect from light and moisture, and discard after expiry.

Oxybuprocaine Hydrochloride can interact with certain ophthalmic agents, affecting safety or efficacy.

Major Interactions (Avoid)

• Concurrent use with other topical ocular anesthetics: may increase risk of corneal toxicity.
• Systemic aminoglycosides: potential additive neurotoxic effects, although evidence is limited.

Moderate Interactions (Monitor Closely)

• Topical non‑steroidal anti‑inflammatory drugs (NSAIDs): may delay corneal healing when used together.
• Anticholinergic eye drops (e.g., cycloplegics): can alter pupil response and affect examination outcomes.
• Preservative‑containing eye drops: may exacerbate ocular irritation when combined with Novesina.