Fluorescite Information
Fluorescite (Fluorescein sodium) Description
FLUORESCITE® (fluorescein injection, USP) 10% is supplied as a sterile, unpreserved, single-use aqueous solution, that has a pH of 8.0 - 9.8 and an osmolality of 572-858 mOsm/kg.
Active ingredient: fluorescein sodium
Inactive Ingredients
Sodium hydroxide and/or hydrochloric acid (to adjust pH), and water for injection.
Fluorescite (Fluorescein sodium) Clinical Pharmacology
Distribution:
Within 7 to 14 seconds after IV administration into antecubital vein, fluorescein usually appears in the central artery of the eye. Within a few minutes of IV administration of fluorescein sodium, a yellowish discoloration of the skin occurs, which begins to fade after 6 to 12 hours of dosing. Various estimates of volume of distribution indicate that fluorescein distributes well into interstitial space (0.5 L/kg).
Metabolism:
Fluorescein undergoes rapid metabolism to fluorescein monoglucuronide. After IV administration of fluorescein sodium (14 mg/kg) to 7 healthy subjects, approximately 80% of fluorescein in plasma was converted to glucuronide conjugate after a period of 1 hour post dose, indicating relatively rapid conjugation.
Excretion:
Fluorescein and its metabolites are mainly eliminated via renal excretion. After IV administration, the urine remains slightly fluorescent for 24 to 36 hours. A renal clearance of 1.75 mL/min/kg and a hepatic clearance (due to conjugation) of 1.50 mL/min/kg have been estimated. The systemic clearance of fluorescein was essentially complete by 48 to 72 hours after administration of 500 mg fluorescein.
Fluorescite (Fluorescein sodium) Indications And Usage:
Fluorescite (Fluorescein sodium) Contraindications
Fluorescite (Fluorescein sodium) Warnings
FOR INTRAVENOUS USE
Care must be taken to avoid extravasation during injection as the high pH of fluorescein solution can result in severe local tissue damage. The following complications resulting from extravasation of fluorescein have been noted to occur: Sloughing of the skin, superficial phlebitis, subcutaneous granuloma, and toxic neuritis along the median curve in the antecubital area. Complications resulting from extravasation can cause severe pain in the arm for up to several hours. When significant extravasation occurs, the injection should be discontinued and conservative measures to treat damaged tissue and to relieve pain should be implemented. Rare cases of death due to anaphylaxis have been reported (See ).
Fluorescite (Fluorescein sodium) Precautions
Teratogenic Effects: Pregnancy Category C
Adequate animal reproduction studies have not been conducted with fluorescein sodium. It is also not known whether fluorescein sodium can cause fetal harm when administered to a pregnant woman. Fluorescein sodium should be given to a pregnant woman only if clearly needed.
Fluorescite (Fluorescein sodium) Pediatric Use
Safety and effectiveness in pediatric patients have been established.
Fluorescite (Fluorescein sodium) Geriatric Use
No overall differences in safety or effectiveness have been observed between elderly and other adult patients.
Fluorescite (Fluorescein sodium) Adverse Reactions (see Warnings And Precautions)
Nausea, vomiting, gastrointestinal distress, headache, syncope, hypotension, and symptoms and signs of hypersensitivity have occurred. Cardiac arrest, basilar artery ischemia, severe shock, convulsions, thrombophlebitis at the injection site, and rare cases of death have been reported. Extravasation of the solution at the injection site causes intense pain at the site and a dull aching pain in the injected arm (see ). Generalized hives and itching, bronchospasm and anaphylaxis have been reported. A strong taste may develop after injection.
Fluorescite (Fluorescein sodium) Dosage And Administration
The normal adult dose of (fluorescein injection, USP) 10% is 500 mg (100 mg/mL) via intravenous administration.
For children, the dose should be calculated on the basis of 35 mg for each ten pounds of body weight (7.7 mg/kg body weight).
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. Do not mix or dilute with other solutions or drugs. Flush intravenous cannulas before and after drugs are injected to avoid physical incompatibility reactions.
Inject the dose rapidly (1 mL per second is normally recommended) into the antecubital vein, after taking precautions to avoid extravasation. A syringe, filled with (fluorescein injection, USP) 10%, may be attached to transparent tubing and a 23 gauge butterfly needle for injection. Insert the needle and draw the patient's blood to the hub of the syringe so that a small air bubble separates the patient's blood in the tubing from the fluorescein. With the room lights on, slowly inject the blood back into the vein while watching the skin over the needle tip. If the needle has extravasated, the patient's blood will be seen to bulge the skin and the injection should be stopped before any fluorescein is injected. When assured that extravasation has not occurred, the room light may be turned off and the fluorescein injection completed. Luminescence usually appears in the retina and choroidal vessels in 7 to 14 seconds and can be observed by standard viewing equipment.
Reduction in dose from 5 ml to 2 ml of (fluorescein injection, USP) 10% may be appropriate in cases when a highly sensitive imaging system e.g., scanning laser ophthalmoscope is used.
Fluorescite (Fluorescein sodium) How Supplied
NDC 0065-0092-65
Store at 2°- 25°C (36°- 77°F).
Do Not Freeze
Rx Only
Fort Worth, Texas 76134 USA
Printed in USA
© 2006, 2009 Alcon, Inc.
Fluorescite (Fluorescein sodium) Principal Display Panel
NDC 0065-0092-65 1 Dozen 5 mL Vials
(fluorescein injection, USP) 10%
STERILE
100 mg/ml Fluorescein
FOR INTRAVENOUS USE
Store at 2° - 25° C (36° - 77°F)
Do Not Freeze
Fort Worth, Texas 76134 USA
©2000-2009 Alcon, Inc. H11427-1009
