Fluorescein sodium (Fluoresceinum natrium)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Ophthalmic products

Included in the formulation
  • Fluorescein sodium
    solution in / in 
    SSC NIOPIK, FSUE     Russia
  • Fluorescein Novartis
    solution in / in 
    Novartis Pharma AG     Switzerland
  • Fluorescence ®
    solution in / in 
    Alcon Laboratories Inc.     USA
    • Included in the list (Order of the Government of the Russian Federation No. 2782-r of 30.12.2014):

    VED

    АТХ:

    S.01.J.A.01   Fluorescein

    Pharmacodynamics:

    Dye used for diagnostic purposes. In medical practice, it is used in the form of a sterile aqueous solution for intravenous administration or in the form of eye test strips (the latter are not registered in the Russian Federation).

    When injected into the ulnar vein after 9-14 seconds, the glowing vessels of the retina and choroidal vessels are illuminated, due to which they differ from neighboring sites. Stains green ulcers, affected and deprived epithelium of the cornea; foreign bodies are detected due to the surrounding green ring.

    The injection solution is used in ophthalmology to determine the occlusion or obliteration of the retinal vessels, vascular malformation, neovascularization, changes in vascular permeability, ocular tumors, and retinal pigment epithelial defects.

    The indicator strips are used for dyeing the anterior segment of the eye, if necessary visualization of the lesions of the cornea,herpetic lesions or detection of a foreign body; for the localization of intraocular lesions, for fitting contact lenses, for carrying out a fluorescein test for postoperative healing of corneoscleral wounds during interventions on the anterior chamber of the eye, as well as for carrying out the lacrimation test.

    Pharmacokinetics:Not studied. It is excreted by the kidneys within 3 days.
    Indications:Fluorescent angiography of retinal vessels, angioscopy of the vascular network of the fundus and iris.
    ICD-10

    XXI.Z00-Z13.Z01.0   Examination of eyes and eyesight

    Contraindications:Hypersensitivitykidney disease, pregnancy (especially the first trimester).
    Carefully:Children's age (safety and effectiveness of use in children are not defined), polyvalent allergy (in the anamnesis), bronchial asthma, breast-feeding.
    Pregnancy and lactation:

    It should be refrained from conducting angiography in pregnancy (especially in the first trimester).

    Action category for the fetus by FDA - C.

    If it is necessary to use during the period of breastfeeding, it is necessary to take into account that sodium fluorescein penetrates into breast milk.

    Dosing and Administration:

    Angiography of the retinal vessels

    Enter the elbow vein quickly (within 2-3 seconds). Adults - 5 ml of 10% solution (fluorescence in the retinal vessels appears after 12-30 seconds) and according to the standard method (serial images), carry out a diagnostic study. Repeated administration (if necessary) is performed no earlier than 3 days later. Before the injection, the patient's sensitivity to the drug is checked: 0.1 ml of a 1% solution is injected intradermally. In the absence of a local reaction, angiography is performed after 30 minutes. Children - 35 mg / 4.5 kg.

    Angiography or angioscopy of the vascular fundus of the fundus and iris

    Quickly injected into the ulnar vein. A syringe filled with an injection solution is connected to a transparent tube or a 25-gauge venous needle with a screening screen. Enter the needle, draw the patient's blood into the syringe in such a way that a small air bubble separates the patient's blood in the syringe cylinder from fluorescein. With the light on, slowly inject blood back into the vein, carefully following the skin above the tip of the needle. If the tip of the needle is exactly in the vein, turn off the light and inject the drug. Fluorescence in retinal vessels and choroidal vessels, which is seen with standard equipment, appears after 9-14 seconds.Before the introduction, the sample is tested for an allergic reaction: 0.05 ml is injected intradermally, the reaction is followed for 30-60 minutes.

    Side effects:

    From the side cardiovascular system and blood (hematopoiesis, hemostasis): hypotension, cardiac arrest, basilar arterial ischemia.

    On the part of organs GIT: gastrointestinal discomfort, nausea, vomiting, diarrhea, or constipation.

    Allergic reactions: rash, itching, bronchospasm, anaphylaxis, shock.

    Other: headache, convulsions, thrombophlebitis at the injection site, fainting. With systemic absorption, it can cause transient fluorescence of the skin and urine. If you get under the skin - skin rejection, superficial phlebitis, subcutaneous granuloma, toxic neuritis along the ulnar vein. Complications of extravasation can cause severe pain, lasting for several hours.

    Overdose:

    Not described.

    Treatment symptomatic

    Interaction:Not described.
    Special instructions:

    When administered, avoid the formation of extravasate, since a high pH of the solution can lead to severe damage to nearby tissues. When a large extravasate is formed, the infusion is immediately stopped, conservative treatment of damaged tissues and anesthesia are carried out.

    Use with caution in patients with an allergy or bronchial asthma in an anamnesis. When there are allergic reactions as an urgent measure introduce epinephrine (0.1%) intravenously or intramuscularly, antihistamines, soluble steroids and aminophylline intravenously. If the reaction to injection of fluorescein is likely, it should be possible to carry out oxygenation.

    May cause transient staining of the skin and urine in a yellowish color. Skin coloring is carried out within 6-12 hours, urine - 24-36 hours.

    Do not use with contact lenses due to their possible staining. After the procedure, the patient wearing contact lenses can use them not earlier than 1 hour, after washing the eyes with a sterile normal saline solution.

    If intravenous administration is not possible, if there is no need to obtain early angiogram phases (for example, in the diagnosis of cystoid macular edema), sodium fluorescein can be applied orally at a dose of 1 g. Usually it takes 10 to 15 minutes until the dye appears in the fundus.

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