Fluorescein is a diagnostic dye used primarily in ophthalmology for angiography and as a vital stain. The 600mg dose is formulated for intravenous administration in fluorescein angiography (FA). It is a water-soluble, orange-red crystalline powder that fluoresces bright yellow-green under blue light (wavelength 465-490 nm). In India, it is a critical tool for diagnosing and managing retinal vascular disorders.
Adult: 500 mg (5 mL of 10% solution) to 600 mg (3 mL of 20% solution) administered as a rapid intravenous bolus into a large antecubital vein. The 600mg dose is typically given as 3mL of a 20% concentration. Dose is not weight-based for standard angiography.
Note: 1. Use a sterile, single-use vial/syringe. 2. Draw up dose using aseptic technique. 3. Administer as a rapid IV bolus (over 2-5 seconds) via a secure, large-bore intravenous line (preferably antecubital). 4. Flush line with 5-10 mL of Normal Saline immediately after injection. 5. Begin photographic sequence within 5-10 seconds of injection. 6. Monitor patient closely for at least 30 minutes post-injection for adverse reactions.
Fluorescein sodium is a fluorescent tracer. When injected intravenously, it circulates with the blood. As it passes through the choroidal and retinal vasculature, it is excited by blue light (465-490 nm) from a fundus camera, emitting yellow-green fluorescence (520-530 nm). This allows real-time visualization of blood flow, detection of leaks from vessels (as in diabetic retinopathy, macular edema), identification of non-perfused areas (ischemia), and delineation of abnormal vasculature (neovascularization). It does not cross the intact blood-retinal barrier.
Pregnancy: Pregnancy Category C (US FDA). Animal reproduction studies have not been conducted. It is not known whether fluorescein can cause fetal harm when administered to a pregnant woman. Use only if clearly needed and the potential benefit justifies the potential risk to the fetus. Elective procedures should be postponed until after delivery.
Driving: Patients should be advised NOT to drive immediately after the procedure due to potential for transient blurred vision from pupil dilation (often done concurrently), dizziness, syncope, or nausea. They may resume driving once these effects have completely resolved, typically after a few hours.
| Probenecid | May competitively inhibit renal tubular secretion of fluorescein, potentially prolonging its half-life and increasing systemic exposure. | Moderate |
| Other diagnostic dyes (e.g., Indocyanine Green - ICG) | If administered concurrently or in close succession, may interfere with fluorescence imaging. A gap of 24 hours is recommended between FA and ICG angiography. | Moderate |
| Photosensitizing drugs (e.g., Tetracyclines, Phenothiazines) | Theoretical increased risk of phototoxic reactions due to temporary fluorescein presence in skin. Avoid intense sun exposure post-procedure. | Low |
Same composition (Fluorescein (600mg)), different brands: