Dosing and uses of Lymphazurin (isosulfan blue)
Adult dosage forms and strengths
injectable solution
- 1%
Lymphography
0.5 mL (5 mg) into 3 interdigital spaces of each extremity per study (max 3 mL per study)
Pediatric dosage forms and strengths
Safety & efficacy not established
Warnings
Contraindications
Hypersensitivity to triphenylmethane or related components
Cautions
Possibility of delayed reactions - monitor patients for 30-60 min
Do NOT mix with local anesthetics in same syringe
Urine color may be blue for a period of time
Methemoglobin levels via ABG may be falsely elevated; may need to co-oximetry
Peripheral oxygenation measurements may be falsely depressed due to discoloration of serum caused by isosulfan blue; may require direct determination of arterial blood gases (ABG)
Pregnancy and lactation
Pregnancy category: C
Lactation: Excretion in milk unknown; use caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Lymphazurin (isosulfan blue)
Mechanism of action
Binds to interstitial serum albumin which is carried predominantly by lymphatics results in concentration of the dye within the lymph
Pharmacokinetics
Absorption: 34% in 30 min; 69% in 1 hr; 100% after 24 hr
Excretion: Feces 90%; urine 10%
