Topical Cocaine Solution in Rhinoplasty and Plastic Surgery

Clinical Reference for Prescribers: Not Intended for Patient Use

Town & Country Compounding can prepare Cocaine HCl-Tetracaine HCl (Benzalkonium) Rhinoplasty Solution, a patient-specific compounded nasal anesthetic commonly used by surgical teams performing rhinoplasty, septoplasty, and other sinonasal procedures. It is a combination formulation rather than a single-agent cocaine solution, and it is available with or without a visualization dye, under an individual prescription, so your practice can specify what your protocol calls for.

Why Compound a Combination Instead of Cocaine Alone

Both agents anesthetize the nasal mucosa, and cocaine also provides the vasoconstriction that tetracaine lacks. Compounding the two together combines both in a single application, with each component’s strength specified by the prescriber.

Combining the two means the formulation pairs cocaine’s anesthetic and vasoconstrictive effects with tetracaine’s additional anesthetic effect in a single application. That is the clinical rationale for building a combination formulation rather than defaulting to a single-agent cocaine solution.

Why a Dye Makes a Difference in the Field

Town & Country Compounding can compound this solution with a pharmaceutical-grade dye added, giving the surgical team a clear visual marker of where it has been placed:

• Faster visual confirmation that both nasal cavities received even, complete coverage
• May help the team account for pledgets at the end of the case
• A clear visual distinction from other clear solutions on the surgical tray
• Easier coordination between surgeon and staff when multiple pledgets are placed and repositioned during a procedure

A Compounding Partner That Gets You What the Case Requires

This is the role a compounding pharmacy is built for: preparing what a specific patient and a specific procedure call for, on a prescription-by-prescription basis, built around the pharmacology the case actually needs rather than a single off-the-shelf agent.

Town & Country Compounding works directly with surgeons and surgical centers to prepare Cocaine HCl-Tetracaine HCl (Benzalkonium) Rhinoplasty Solution to the specific volume and formulation your protocol calls for, patient by patient, with or without dye, so the solution you want is the one you get.

Frequently Asked Questions

Why combine cocaine and tetracaine instead of using a single-agent cocaine solution?

Cocaine and tetracaine each anesthetize nasal mucosa through a different mechanism, and cocaine alone also provides the vasoconstriction that tetracaine lacks. Compounding the two together carries both anesthetic mechanisms plus cocaine’s vasoconstrictive effect in a single application, rather than relying on one agent to do everything.

What does adding a visualization dye do during surgery?

A pharmaceutical-grade dye gives the surgical team a clear visual marker of where the solution has been placed, helping confirm even coverage of both nasal cavities and distinguishing the solution from other clear liquids on the surgical tray.

Is this compounded solution legal to prescribe?

Yes, by licensed practitioners with appropriate DEA registration. Cocaine HCl-Tetracaine HCl (Benzalkonium) Rhinoplasty Solution requires a valid, patient-specific prescription and is dispensed for use by licensed practitioners in a clinical or surgical setting in accordance with applicable state and federal law.

Is this a controlled substance?

Yes. This formulation contains cocaine hydrochloride, a Schedule II controlled substance, and is prepared and dispensed accordingly.