Fluorescein Sodium Injection for Ophthalmology | Usage, Dosage, Brands & SIde effects

Fluorescein injections are used during eye medical procedures to assist specific parts of the eye (retina & iris) become more visible. This article covers the details about Fluorescein sodium injection and other information related to it.
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What is Fluorescein Sodium Injection

Fluorescein Sodium, also known as Acid Yellow 73 is a red colour pigment used in the treatment of eyes. There are different ophthalmic solutions made from this organic compound all over the world. The most common use of this organic compound is to stain damaged cornea and the fluorescein sodium Injection solution is applied to eyes to detect corneal lesions.

Why it is used

During eye medical procedures, fluorescein sodium injections help make certain parts of the eye (e.g., retina, iris) easier to see. Your doctor must administer this medicine directly to you. A fluorescein sodium injection is a diagnostic stain containing fluorescein sodium as the active ingredient. It is used in fluorescein angiography (FNA) of the ocular fundus (part of the eye) as part of a hospital-based procedure.

A fluorescent dye is injected into the bloodstream and pictures of the back of the eye’s blood vessels are taken. A blood vessel analysis will help your provider diagnose diseases that affect them, especially in elderly or diabetic patients. Please note that this medication is only for diagnostic purposes.

How to use Fluorescein Sodium Injection

It is first necessary to saturate a fluorescein strip with sterile saline before staining the cornea. Having pulled the lower lid down and gently touched the bulbar conjunctiva with the fluorescein strip, the fluorescein is placed in the inferior cul de sac of the eyeball.

Use a 23-gauge butterfly needle for injection, after precautions are taken to prevent extravasation, administer the injection into the antecubital vein. There are usually 8 to 20 seconds before Luminescence appears in the retina or choroidal vessels.

Indications

With concentrations of 5–25%, SF is extremely safe for fundus angiography, even if the eye leaks. The hydrophilic nature of SF causes it to be absorbed quickly by the vitreous gel, and most available data indicate that intravitreal 0.20% SF dye increases fibril visibility during chromovitrectomy due to its green staining effect. Diagnostic fluorescein angiogram or angioscopy of the iris and retina is indicated with FLUORESCITE® Injection 10%.

Dosage

Fluorescite® Injection 10% (100 mg/mL), administered intravenously, is the normal adult dose of 500 mg. To administer a dose to children based on their actual body weight, it is recommended that a dose of 7.7mg per kilogram (35mg per 10lb) be administered. A maximum of 500 mg may be administered per intravenous injection.

Storage and handling

This is one-time use only. Waste materials and unused products should be disposed of according to local standards. If the tube is cracked or damaged or if there are visible particulates or discolouration, do not use Fluorescein Sodium 100mg/ml Solution for Injection.

Before administering the solution, it is important to visually inspect it again for particulates. The solution must be clear and particle-free before use. The temperature range is 2° to 25°C (36° to 77°F). Take care not to freeze.

A single-use 5 mL glass vial containing Fluorescein injection, USP 10%, is supplied with an aluminium seal and a Gray FluroTec coated chlorobutyl stopper. There is no natural rubber latex in the vial stopper. An orange-red fluorescein sodium solution is in the vial.

Some Fluorescein Sodium Injection brands

Some of the Side effects commonly and rarely seen are

  1. Yellowish discolourations of the urine and skin are the most common side effects. Yellow urine is not uncommon. In urine, discolouration usually disappears within 24 to 36 hours, and on the skin, it usually disappears in 6 to 12 hours.
  2. Common adverse effects include nausea, vomiting, and gastrointestinal distress. Injections may result in an unpleasant taste.
  3. Hypersensitivity symptoms have been experienced. The most common symptoms reported include hives, itching, bronchospasm, and anaphylaxis. There have been very few deaths conveyed.
  4. There are rare cases when cardiac arrest, basilar artery ischemia, severe shock, and death can occur. There is a possibility of a headache. Syncope and convulsions may also occur.
  5. There have been reports of thrombophilia at the injection site. An injection site that has extravasated results in intense pain and dull aching in the arm.


Converse to your doctor or pharmacologist if you experience any side/ill effects.

Some important precautions to be taken include

  1. In patients with allergies or asthma, caution should be exercised. If FLUORESCITE® Injection 10% causes a reaction, an emergency tray should be available.
  2. A potential allergy may be evaluated 30 to 60 minutes after intravenous administration with an intradermal skin test, i.e., inject 0.05 mL intradermally and observe the reaction. A negative skin test cannot prove that someone has a fluorescein allergy, given the sensitivity and specificity of skin testing.
  3. The high pH of fluorescein solution can cause severe local tissue damage during injection, so it must be taken care of to avoid extravasation during the injection.
  4. A variety of complications, including severe arm pain for several hours, shedding of the skin, superficial phlebitis, cutaneous granuloma, and toxic neuritis, have been reported to occur after fluorescein was extravasated.
  5. In the first few minutes following injections, nausea, vomiting, and gastrointestinal distress are common. This usually subsides within ten minutes.

Drug Interactions of the Fluorescein Sodium Injection

There are no specific studies on fluorescein drug interactions due to its relatively inert nature. There are few reports describing interference with certain lab tests and interactions with organic anion transporters. During the first 3 to 4 days following fluorescence measurement, blood and urine values may be affected. In certain circumstances, such as the use of digoxin or quinidine, therapeutic drug monitoring should be done with caution. A compound (e.g. Probenecid) that inhibits or competes with the active transport of organic anions may affect fluorescein’s systemic half-life. Internal document code 4 Fluo15Dec20iNZ blocking agents (including eye-drop solutions) and FluoresciteTM 100 mg/mL solution for injection may rarely provoke severe anaphylactic reactions. In the presence of cardiovascular collapse, beta-blockers may reduce the effects of adrenaline and the vascular compensation reactions.

FAQs

  • Is sodium fluorescein safe?

Despite the fact that bolus injections of fluorescein can cause serious adverse reactions, fluorescein has been used for many years for diagnostic purposes in medicine due to its widespread use and efficiency.

  • How long does fluorescein stay in your system?

The majority of fluorescein is excreted in the urine. A small amount of fluorescein remains in the urine for 24 to 36 hours following administration via IV.

  • What ingredients are in fluorescein?

Injection of Fluorescite® (fluorescein injection, USP) 10% is provided as an aqueous, pH-8.0 – 9.8, the osmolality of 572-858 mOsm/kg sterile, unpreserved solution. A sodium hydroxide solution and/or hydrochloric acid (to adjust the pH), along with water for injectable solutions, serve as inactive ingredients.

Updates from Macsen Labs on API- Macsen files a patent for Process for the preparation of crystalline Fluorescein Sodium from Diacetyl Fluorescein or Fluorescein

Disclaimer-

The information provided here is based on general knowledge, articles, research publications etc and we do not claim the authenticity of any of the information provided above. We do not claim or suggest/advise any medical, therapeutic, health or nutritional benefits of Fluorescein Sodium. We do not supply or promote our Fluorescein Sodium product for the applications which are covered by valid patents and which are not approved by the FDA.

Other articles on Fluorescein Sodium:-

Macsen Labs is a manufacturer and supplier of several grades of Fluorescein Sodium such as:-

Fluorescein Sodium USP

Fluorescein Sodium BP/ Ph Eur

Acid Yellow 73 (Fluorescein Sodium)

Solvent Yellow 94 (Fluorescein Free Acid)

Fluorescein Sodium API Manufacturer & Supplier

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