Fluorescein Uses

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What is Fluorescein?

Fluorescein injection is used to help certain parts of the eye (eg, retina, iris) become more visible during eye medical procedures.

Fluorescein is to be given only by or under the direct supervision of your doctor.

Fluorescein indications

An indication is a term used for the list of condition or symptom or illness for which the medicine is prescribed or used by the patient. For example, acetaminophen or paracetamol is used for fever by the patient, or the doctor prescribes it for a headache or body pains. Now fever, headache and body pains are the indications of paracetamol. A patient should be aware of the indications of medications used for common conditions because they can be taken over the counter in the pharmacy meaning without prescription by the Physician.
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Oral

Assessment of exocrine pancreatic function

Adult: 348.5 mg Fluorescein dilaurate (equivalent to 0.5 mmol of Fluorescein), given with meal. Collect urine for the next 10 hour. A control dose of 188.14 mg Fluorescein (equivalent to 0.5 mmol of Fluorescein) is given the following day under the same conditions.

Intravenous

Angioscopy of the retinal and iris vasculature

Adult: 500 mg (as a 10% or 25% soln) over 5-10 sec into the antecubital vein. May also be given via oral admin at 25 mg/kg using Fluorescein sod.

Child: 7.5 mg/kg.

Ophthalmic

Detection of corneal lesions and foreign bodies; Aid in the fitting of hard contact lenses; Diagnostic ophthalmic procedures

Adult: Apply 1% or 2% solution as eye drops or as sterile papers impregnated with Fluorescein sodium. May also be given in combination with a local anaesthetic: as a 0.25% solution with oxybuprocaine HCl or proxymetacaine HCl.

Fluorescein description

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A phthalic indicator dye that appears yellow-green in normal tear film and bright green in a more alkaline medium, such as the aqueous humor, and is used therapeutically as a diagnostic aid in corneal injuries and corneal trauma. It has been approved by FDA for use in externally applied drugs and cosmetics. (From Merck Index, 12th ed; American Medical Association Drug Evaluations; 1995, p2275)

Fluorescein dosage

The normal adult dose of Fluorescein® (Fluorescein injection, USP) 10% is 500 mg (100 mg/mL) via intravenous administration.

For children, the dose should be calculated on the basis of 35 mg for each ten pounds of body weight (7.7 mg/kg body weight).

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. Do not mix or dilute with other solutions or drugs. Flush intravenous cannulas before and after drugs are injected to avoid physical incompatibility reactions.

Inject the dose rapidly (1 mL per second is normally recommended) into the antecubital vein, after taking precautions to avoid extravasation. A syringe, filled with Fluorescein® (Fluorescein injection, USP) 10%, may be attached to transparent tubing and a 23 gauge butterfly needle for injection. Insert the needle and draw the patient's blood to the hub of the syringe so that a small air bubble separates the patient's blood in the tubing from the Fluorescein. With the room lights on, slowly inject the blood back into the vein while watching the skin over the needle tip. If the needle has extravasated, the patient's blood will be seen to bulge the skin and the injection should be stopped before any Fluorescein is injected. When assured that extravasation has not occurred, the room light may be turned off and the Fluorescein injection completed. Luminescence usually appears in the retina and choroidal vessels in 7 to 14 seconds and can be observed by standard viewing equipment.

Reduction in dose from 5 ml to 2 ml of Fluorescein® (Fluorescein injection, USP) 10% may be appropriate in cases when a highly sensitive imaging system e.g., scanning laser ophthalmoscope is used.

How supplied

Fluorescein® (Fluorescein injection, USP) 10% is supplied in a single-use 5 mL glass vial with a gray FluroTec coated chlorobutyl (latex free) stopper and purple flip-off aluminum seal. It contains a sterile, red-orange solution of Fluorescein sodium.

NDC 0065-0092-65

Storage

Store at 2°- 25°C (36°- 77°F).

Do Not Freeze

ALCON LABORATORIES, INC. Fort Worth, Texas 76134 USA. Revised: July 2011

Fluorescein interactions

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Data is temporarily not available

Fluorescein side effects

See also:
What are the possible side effects of Fluorescein?

Skin and Urine Discoloration

The most common reaction is temporary yellowish discoloration of the skin and urine. Urine may attain a bright yellow color. Discoloration of the skin usually fades in 6 to 12 hours and usually fades in urine in 24 to 36 hours.

Gastrointestinal Reactions

Nausea, vomiting, and gastrointestinal distress are common adverse events. A strong taste may develop after injection.

Hypersensitivity Reactions

Symptoms and signs of hypersensitivity have occurred. Generalized hives and itching, bronchospasm and anaphylaxis have been reported. Rare cases of death have been reported..

Cardiopulmonary Reactions

Cardiac arrest, basilar artery ischemia, severe shock and death may occur rarely.

Neurologic Reactions

Headache may occur. Convulsions and syncope may rarely occur following injection.

Thrombophlebitis

Thrombophlebitis at the injection site has been reported. Extravasation of the solution at the injection site causes intense pain at the site and a dull aching pain in the injected arm..

Fluorescein contraindications

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Fluorescein® Injection 10% is contraindicated in patients with known hypersensitivity to Fluorescein sodium or any other ingredients in this product. Rare cases of death due to anaphylaxis have been reported..

Fluorescein sodium can induce serious intolerance reactions. These reactions of intolerance are always unpredictable but they are more frequent in patients who have previously experienced an adverse reaction after Fluorescein injection (symptoms other than nausea and vomiting) or in patients with history of allergy such as food or drug induced urticaria, asthma, eczema, allergic rhinitis.

Detailed questioning of each patient is recommended before the angiography to evaluate any prior history of allergy.

Active ingredient matches for Fluorescein:

Fluorescein


Unit description / dosage (Manufacturer)Price, USD
Injectable; Injection; Fluorescein Sodium 10%
Fluorescein 2% droptainer$ 12.00
Fluorescite 10% ampul$ 5.99
Fluorescein lite 25% vial$ 4.29
Ak-fluor 25% vial$ 3.90
Fluorescein sodium 25% vial$ 2.40
Fluorescein lite 10% vial$ 1.72
Ak-fluor 10% vial$ 1.56
Fluorescein sodium 10% vial$ 0.96
Fluorescein powder$ 0.08

List of Fluorescein substitutes (brand and generic names):

Fluorescein Novartis 100 mg/1 mL x 5 mL
Fluorescein Novartis / amp 100 mg/1 mL x 5 mL x 1's
Injectable; Injection; Fluorescein Sodium 10%
Injectable; Injection; Fluorescein Sodium 10%
Solution; Ophthalmic; Fluorescein Sodium 0.5%
Fluoresceine Faure 0.5 % x 1 Bottle
Injectable; Injection; Fluorescein Sodium 10%
Solution; Ophthalmic; Fluorescein Sodium 0.5%
Fluoresceine Faure 0.5 % x 1 Bottle

References

  1. DailyMed. "FLUORESCEIN SODIUM: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. PubChem. "fluorescein". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
  3. DrugBank. "fluorescein". http://www.drugbank.ca/drugs/DB00693 (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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