Version May 2024
Lymphatic vessel delineation: SubQ: Inject 0.5 mL into 3 interdigital spaces of each extremity per study; maximum dose: 3 mL (30 mg)
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.
1% to 10%:
Dermatologic: Pruritus (2%; affecting abdomen, hands, and neck)
Hypersensitivity: Hypersensitivity reaction (2%)
Local: Local swelling (2%)
<1%, postmarketing, and/or case reports: Anaphylaxis; skin discoloration (including blue urticaria)
Known hypersensitivity to isosulfan blue, triphenylmethane (or related compounds), or any component of the formulation.
Concerns related to adverse events:
• Discoloration: May cause blue discoloration of urine for 24 hours following administration. May also result in tattoo-like blue coloration of the skin at the injection site (transient or long term).
• Hypersensitivity: Hypersensitivity reactions, including life-threatening anaphylactic reactions (respiratory distress, shock, angioedema), have occurred. Monitor patients closely for ≥60 minutes following administration. Patients with a history of bronchial asthma, allergies, drug reactions, or prior reactions to triphenylmethane dyes are at higher risk for reactions. Competent personnel should be available to administer emergency care (including resuscitation). For breast cancer sentinel lymph node biopsy, prophylaxis with an IV corticosteroid (hydrocortisone 100 mg, methylprednisolone 20 mg, dexamethasone 4 mg) or diphenhydramine (50 mg IV) or famotidine (20 mg IV) has been used to decrease the severity of hypersensitivity reactions to blue dyes, although the incidence was not decreased (James 2016).
Other warnings/precautions:
• Methemoglobin: Methemoglobin levels via arterial blood gases (ABG) may be falsely elevated; co-oximetry may be required to accurately assess methemoglobin level.
• Oxygen saturation: Peripheral oxygenation measurements by pulsoximetry may be falsely low due to isosulfan blue interference (peak interference is 30 minutes after administration; minimal effect by ~4 hours postdose); may require direct determination by ABG analysis.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Subcutaneous:
Generic: 1% (5 mL)
Solution, Subcutaneous [preservative free]:
Generic: 1% (5 mL)
Yes
Solution (Isosulfan Blue Subcutaneous)
1% (per mL): $245.00 - $254.61
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.
SubQ: Single patient use only. Due to precipitation, do not mix with local anesthetics (eg, lidocaine) in same syringe (use separate syringes). Monitor closely for hypersensitivity for ≥60 minutes following administration.
Lymphatic vessel delineation: Adjunct to lymphography to delineate lymphatic vessels draining the region of injection in primary and secondary lymphedema of the extremities; chyluria, chylous ascites, or chylothorax; lymph node involvement by primary or secondary neoplasm; and lymph node response to therapeutic modalities.
None known.
There are no known significant interactions.
Animal reproduction studies have not been conducted. Isosulfan blue 1% injection should be given to a pregnant woman only if clearly needed.
It is not known if isosulfan blue is excreted in breast milk. The manufacturer recommends that caution be exercised when administering isosulfan blue to nursing women.
Monitor for hypersensitivity reactions for at least 60 minutes following administration. Due to interference with pulse oximetry, monitor arterial blood gases for at least 30 to 240 minutes following administration if need to evaluate oxygenation.
Isosulfan blue binds to serum proteins and is then drained by the regional lymphatic system; blue coloration imparted by the dye permits delineation of the vessels against the surrounding tissue.
Excretion: Urine (up to 10%; as unchanged drug within 24 hours of administration)
آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
