indigo carmine: clinical use

Prescribing considerations

• For intra-operative diagnostic use only; administer intravenously with appropriate filtration.
• Use caution with hypertension, bradycardia, rhythm or conduction disorders, coronary disease, or medicines that induce bradycardia.
• Avoid use in uncontrolled heart failure, haemodynamic instability or patients with a history of allergic reactions.
• Do not use where creatinine clearance is below 10 mL/min; renal impairment may delay urinary appearance.
• Safety and efficacy in children have not been established.

Contraindications and cautions

• Hypersensitivity to indigo carmine or any formulation excipient.

Monitoring

• Monitor arterial pressure and heart rate during administration and for several minutes afterwards.
• Stop administration for bradycardia, tachycardia, hypotension, hypertension, rash, erythema, dyspnoea or bronchospasm.
• Indigo carmine may interfere with pulse oximetry.

Clinical pharmacology

Indigo carmine is a protein-bound diagnostic dye rapidly cleared from plasma, predominantly through renal excretion. Its alpha-adrenergic activity increases peripheral vascular resistance and can cause a transient rise in blood pressure with reflex slowing of the heart rate.

Formulation and product differences

• The selected product is a blue to bluish-purple intravenous solution in brown-glass ampoules containing water for injections, citric acid monohydrate and sodium citrate.
• Do not mix with other medicines because compatibility studies are unavailable.
• Do not refrigerate or freeze; use immediately after opening.

Injection

Route: Parenteral

Strengths: 40 mg/5 mL