tetrahydrozoline/zinc sulfate/hypromellose ophthalmic

Medically Reviewed on 4/20/2023

Generic Name: tetrahydrozoline/zinc sulfate/hypromellose ophthalmic 

Brand Names: Rohto Ice, Rohto Relief

Drug Class: Ophthalmic Lubricants

What is tetrahydrozoline/zinc sulfate/hypromellose ophthalmic, and what is it used for?

Tetrahydrozoline/zinc sulfate/hypromellose ophthalmic is a combination medication used for the temporary relief of redness and discomfort in the eyes caused by dry eyes or minor irritations such as swimming, dust, smoke or smog. Each drug in the combination works in a unique way to provide relief to irritated red eyes. Tetrahydrozoline/zinc sulfate/hypromellose ophthalmic is a solution topically applied to the eye and is available over the counter (OTC).

  • Tetrahydrozoline: Tetrahydrozoline reduces the redness of the eye by constricting the small blood vessels and reducing blood flow in the membrane (conjunctiva) that covers the eye whites. Naphazoline is an alpha adrenergic agonist that works by stimulating alpha receptors, protein molecules that are stimulated by norepinephrine, a chemical messenger (neurotransmitter). Alpha receptors make smooth muscles around blood vessels contract, causing vasoconstriction and reduction in blood flow.
  • Zinc sulfate: Zinc sulfate is a combination of zinc, a naturally occurring mineral, and sulfate, a form of sulfur, a chemical element abundant in nature. Zinc sulfate is an astringent that decongests the eye by shrinking the tissue.
  • Hypromellose: Hypromellose is a gelatinous substance that lubricates the eye. Hypromellose itself is inert and has no medicinal effect, but because of its viscosity, prevents loss of moisture on the eye surface and allows for controlled release of the other drugs in the combination.


  • Do not use tetrahydrozoline/zinc sulfate/hypromellose ophthalmic if you are hypersensitive to any of the components in the formulation.
  • Discontinue tetrahydrozoline/zinc sulfate/hypromellose ophthalmic and consult with your physician if:
    • Your condition worsens or persists for longer than 72 hours
    • You have continued irritation or redness of the eye
    • You develop eye pain or vision changes
  • Use tetrahydrozoline with caution in patients with:
  • Use with caution in patients with narrow angle glaucoma, a condition with high intraocular pressure that can progressively damage the optic nerve.
  • Overuse of tetrahydrozoline/zinc sulfate/hypromellose ophthalmic may increase redness and cause temporary dilation of the pupils (mydriasis).


Pink Eye (Conjunctivitis) Symptoms, Causes, Treatments See Slideshow

What are the side effects of tetrahydrozoline/zinc sulfate/hypromellose ophthalmic?

Common side effects of tetrahydrozoline/zinc sulfate/hypromellose ophthalmic include:

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

What are the dosages of tetrahydrozoline/zinc sulfate/hypromellose ophthalmic?

Ophthalmic solution

  • 0.05%/0.25%/0.2%

Adult and Pediatric

Ocular Redness and Irritation

  • Indicated to temporarily relieve discomfort due to minor ophthalmic irritations and redness
  • 1-2 drops in each eye as needed; not to exceed 4 doses/day


  • Do not touch tip of container to any surface to avoid contamination
  • Replace cap after each use
  • Do not use if solution changes color or becomes cloudy
  • Remove contact lenses before use


Ophthalmic use of tetrahydrozoline/zinc sulfate/hypromellose is unlikely to cause sufficient systemic absorption to result in overdose. Excessive use can have a rebound effect and increase the redness. Oral overdose can cause symptoms including drowsiness, severe sweating, decreased body temperature, slow/shallow breathing. Overdose may be treated with supportive and symptomatic care.

What drugs interact with tetrahydrozoline/zinc sulfate/hypromellose ophthalmic?

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

  • Tetrahydrozoline/zinc sulfate/hypromellose, ophthalmic has no listed severe, serious, moderate, or mild interactions with other drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

Pregnancy and breastfeeding

Tetrahydrozoline/zinc sulfate/hypromellose ophthalmic should be used with caution during pregnancy only if clearly needed.

It is not known if ophthalmic application results in sufficient systemic absorption for the drug to be present in breastmilk.

Do not use any OTC drugs, including tetrahydrozoline/zinc sulfate/hypromellose ophthalmic, without checking with your physician if you are pregnant or breastfeeding.

What else should I know about tetrahydrozoline/zinc sulfate/hypromellose ophthalmic?

  • Use tetrahydrozoline/zinc sulfate/hypromellose ophthalmic exactly as directed.
  • Tetrahydrozoline/zinc sulfate/hypromellose ophthalmic solution is only for external topical use in the eyes.
  • Store safely out of reach of children.
  • In case of oral ingestion and overdose, seek immediate medical help or contact Poison Control.

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Tetrahydrozoline/zinc sulfate/hypromellose ophthalmic is a combination medication used for the temporary relief of redness and discomfort in the eyes caused by dry eyes or minor irritations such as swimming, dust, smoke or smog. Common side effects of tetrahydrozoline/zinc sulfate/hypromellose ophthalmic include transient burning and stinging in the eyes, temporary dilation of pupils, temporary blurred vision, transient dryness of the eyes, rebound redness of the eyes, and increased pressure inside the eye (intraocular). Consult your doctor if pregnant or breastfeeding.

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Medically Reviewed on 4/20/2023