UpToDate خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده:
4
September 2025
Blood flow, tissue perfusion, and vessel visualization (IC Green, Spy Agent Green): IV: 1.25 to 5 mg for a single image sequence or 3.75 to 10 mg for visualization of extremities through the skin; additional doses may be administered at the discretion of the imaging health care provider. Maximum cumulative dose: 2 mg/kg.
Extrahepatic biliary ducts imaging (IC Green, Spy Agent Green): IV: 2.5 mg as a single dose at least 45 minutes prior to surgery; additional doses may be administered to obtain imaging sequences. Maximum cumulative dose: 2 mg/kg.
Lymphatic mapping of breast cancer (Spy Agent Green only): Intradermal: 0.25 mg per breast (divided as 2 injections of 0.05 mL of a 2.5 mg/mL solution); an additional 0.375 mg (divided as 3 injections of 0.05 mL) is recommended if lymphatic flow towards the axillary lymph nodes is not visualized.
Lymphatic mapping of cervical and uterine cancer (IC Green, Spy Agent Green): Interstitial: 5 mg (divided as 4 injections of 1 mL of a 1.25 mg/mL solution) into cervix.
Ophthalmic angiography (IC Green only): IV: Up to 40 mg (depending on the imaging equipment and technique used).
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing.
(For additional information see "Indocyanine green: Pediatric drug information")
Dosage guidance:
Safety: Dosing varies depending upon the product and indication; use caution. Administer in a health care setting that includes cardiopulmonary monitoring and can provide resuscitation if necessary.
Blood flow, tissue perfusion, and vessel visualization: Infants ≥1 month, Children, and Adolescents: IC-Green, Spy Agent Green: IV: 1.25 to 5 mg; lower doses may be used for younger patients and/or patients with lower body weight. Additional doses may be administered as needed to obtain imaging sequences during the procedure; not to exceed a maximum total dose: 2 mg/kg.
Extrahepatic biliary ducts imaging: Children ≥12 years and Adolescents: IC-Green, Spy Agent Green: IV: 2.5 mg at least 45 minutes prior to surgery; additional doses may be administered as needed to obtain imaging during the procedure; not to exceed a maximum total dose: 2 mg/kg.
Ophthalmic angiography: Infants, Children, and Adolescents: IC-Green: IV: Dose is variable based on patient age/weight, imaging equipment, and technique used; administer once, not to exceed a maximum of 40 mg/dose (Ref).
There are no dosage adjustments provided in the manufacturer's labeling.
There are no dosage adjustments provided in the manufacturer's labeling.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Adverse reactions reported in adults.
1% to 10%: Dermatologic: Skin discoloration (1%; including skin discoloration at injection site)
Postmarketing:
Cardiovascular: Hemodynamic deterioration (decreased blood pressure, increased heart rate) (Zhai 2017)
Dermatologic: Urticaria (Higuchi 2019)
Hypersensitivity: Anaphylactic shock (Higuchi 2019), anaphylaxis (Higuchi 2019), type I hypersensitivity reaction (Meira 2020)
History of hypersensitivity (anaphylaxis) to indocyanine green or any component of the formulation.
Concerns related to adverse effects:
• Anaphylaxis: Anaphylaxis and urticaria has been reported, including anaphylactic deaths during IV administration, have been reported; cardiopulmonary resuscitation personnel and equipment should be readily available.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Solution Reconstituted, Injection:
Spy Agent Green: 25 mg (1 ea)
SPY-PHI Kit: 25 mg (1 ea)
Solution Reconstituted, Injection [preservative free]:
IC Green: 25 mg (1 ea)
Spy- MIS Kit: 25 mg (1 ea)
Solution Reconstituted, Intravenous:
IC Green: 25 mg (1 ea [DSC])
Generic: 25 mg (1 ea)
Yes
Solution (reconstituted) (IC Green Injection)
25 mg (per each): $357.29
Solution (reconstituted) (Indocyanine Green Intravenous)
25 mg (per each): $254.69
Solution (reconstituted) (Spy Agent Green Injection)
25 mg (per each): $5,459.05
Solution (reconstituted) (Spy- MIS Kit Injection)
25 mg (per each): $1,669.50
Solution (reconstituted) (SPY-PHI Kit Injection)
25 mg (per each): $883.34
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution Reconstituted, Injection:
Spy Agent Green: 25 mg (1 ea)
Spy Agent Green AIM/Pinpoint: 25 mg (1 ea)
Spy Agent Green Lymphat Pinpoi: 25 mg (1 ea)
Spy Agent Green Spy Elite: 25 mg (1 ea)
Spy Agent Green Spy Phi: 25 mg (1 ea)
Solution Reconstituted, Intravenous:
Generic: 25 mg (1 ea)
IV:
Blood flow, tissue perfusion, and vessel visualization: Administer as a bolus injection via a central or peripheral IV line using a 3-way stopcock; immediately follow with a 10 mL bolus of NS. Use with an approved imaging device that is specifically indicated for use with indocyanine green for fluorescence imaging of blood flow, tissue perfusion, and vessels. A visible fluorescence response in blood vessels may be seen within 5 to 15 seconds after administration.
Extrahepatic biliary ducts: Administer at least 45 minutes prior to surgery. Use with an approved imaging device that is specifically indicated for use with indocyanine green for fluorescence imaging of extrahepatic biliary ducts. A visible fluorescence response in the biliary tree may be seen within 45 minutes after administration.
Hepatic function or visualization diagnostics (off-label use): Optimal timing has not been established and may vary based on patient-specific factors, clinical requirements, and institutional protocols (Ref).
Ophthalmic angiography studies: Administer as a bolus injection into the antecubital vein; immediately follow with a 5 mL bolus of normal saline.
Intradermal: Lymphatic mapping of breast cancer: Administer into the peri-areolar area at the 12 and 9 o'clock positions for the right breast or at the 12 and 3 o'clock positions for the left breast; if an additional dose is necessary, administer at the 12, 3, and 9 o'clock positions. Use with an approved imaging device that is specifically indicated for use with indocyanine green for fluorescence imaging of lymph nodes and delineation of lymphatic vessels during lymphatic mapping of breast cancer. A visible fluorescence response in lymph nodes and lymphatic vessels may be seen within 1 minute after administration.
Interstitial: Lymphatic mapping of cervical and uterine cancer: Administer into the cervix at the 3 and 9 o'clock positions with a superficial (1 to 3 mm) and deep (1 to 3 cm) injection at each position for a total of 4 injections. Use with an approved imaging device that is specifically indicated for use with indocyanine green for fluorescence imaging of lymph nodes and delineation of lymphatic vessels during lymphatic mapping of cervical and uterine cancer. A visible fluorescence response in lymph nodes and lymphatic vessels may be seen within 1 minute after administration.
Parenteral: IV:
Blood flow, tissue perfusion, and vessel visualization: IC-Green, Spy Agent Green: Infants, Children, and Adolescents: Administer via central or peripheral vein by rapid bolus; follow immediately with NS flush (eg, 10 mL in adults). Note: The use of 2 syringes (one with indocyanine green and the other with NS flush) connected to three-way stopcock is recommended.
Extrahepatic biliary ducts imaging: IC-Green, Spy Agent Green: Children ≥12 years and Adolescents: Inject dose at least 45 minutes prior to surgery.
Ophthalmic angiography: IC-Green: Infants, Children, and Adolescents: Administer by IV injection; may use peripheral site (antecubital vein may be used); follow dose immediately with 5 mL NS flush.
Blood flow, tissue perfusion, and vessel visualization (IC Green, Spy Agent Green): Fluorescence imaging of blood flow, tissue perfusion, and vessels (eg, micro- and macro-vasculature) before, during, and after GI, organ transplant, plastic, micro and reconstructive, and vascular surgeries, (including minimally invasive surgical procedures) in adults and pediatric patients ≥1 month of age.
Extrahepatic biliary ducts imaging (IC Green, Spy Agent Green): Fluorescence imaging of extrahepatic biliary ducts in adults and pediatric patients ≥12 years of age.
Lymphatic mapping (IC Green, Spy Agent Green): Fluorescence imaging of lymph nodes and delineation of lymphatic vessels during lymphatic mapping in adults with breast (Spy Agent Green), cervical (IC Green, Spy Agent Green), or uterine cancer (IC Green, Spy Agent Green) for which this procedure is a component of intraoperative management.
Ophthalmic angiography (IC Green only): For ophthalmic angiography in adult and pediatric patients.
Hepatic function or visualization diagnostics
None known.
There are no known significant interactions.
Studies evaluating use of indocyanine green during pregnancy are limited (Ireland 2017; Nöschel 1980; Papadia 2015; Robson 1990; Wang 2022).
It is not known if indocyanine green is present in human milk.
Studies evaluating the presence of indocyanine green in breast milk are limited (Sakai 2021).
According to the manufacturer, the decision to breastfeed should consider the risk of infant exposure, the benefits of breastfeeding to the infant, and the benefits of treatment to the mother.
Signs and symptoms of hypersensitivity.
Indocyanine dye is a tricarbocyanine dye that permits recording of the indicator-dilution curves for both diagnostic and research purposes independently of fluctuations in oxygen saturation.
Protein binding: 95% to 98% to albumin.
Half-life elimination: 2.5 to 3 minutes.
Excretion: Bile.
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
