Fluorescein (intravenous)

Overview

Fluorescein is a solution with fluorescein sodium that is injected into patients prior to certain medical tests and procedures involving the eye, like fluorescein angiography or angioscopy. It aids in the diagnosis, monitoring, and treatment of eye conditions like macular degeneration, AMD, and diabetic retinopathy.

This solution works as a stain that make parts of the eye more visible, like the retina and iris, so the condition of the eye can be documented and (if not already done) a diagnosis can be made or course of treatment for the condition can be decided with this information.

Conditions Treated

  • Diagnosis of various eye conditions

Type Of Medication

  • Ophthalmic diagnostic agent

Brand Names:

  • AK-Fluor

Side Effects

Some of the side effects are less harmful than others, and may resolve on their own without consulting a doctor or medical professional. A list of these side effects includes:

  • Stomach or abdominal pain

If you have questions or concerns about some of the less harmful side effects, or if the effects continue for more than a few days after your procedure or are bothersome, consult with your doctor or health care provider about is going on. They should be able to answer your questions, suggest ways to reduce your discomfort, or let you know if you need to seek medical attention.

Other side effects of fluorescein are rare, but you should let your doctor or nurse know immediately if they occur. These side effects are:

  • Bluish color

Severe allergic reactions (also referred to as anaphylaxis) to the use of fluorescein are extreme rare, but can occur even after the tests it was administered for are complete. If you experience of the symptoms of a severe allergic reaction after your procedure, seek medical attention immediately. Symptoms of a severe allergic reaction include:

  • A rash or itching skin

Dosage

Fluorescein is used to help make certain parts of the eye more visible during certain procedures performed on the eye of a patient. The solution should only be given to you by a doctor, nurse or medical professional who is being supervised by your doctor. It is administered by a needle placed into one of your veins. As they administer it, they will monitor your condition to see if any side effects occur and determine whether or not they should continue administering it to you.

The manufacturer's recommendation for an adult being administered fluorescein is 500 mg intravenously, at a rate of 100 mg/second. The dosage may be reduced to 200 mg, depending on the sensitivity of the equipment used during the testing or procedure the patient will be undergoing.

When given to a child, the recommended dosage varies and is based on a calculation of 35 mg for every ten pounds of body weight up to adult dosage levels.

Actual dosages vary and are determined by a number of factors, including the ones listed above and others such as your medical history, current medical condition, and what the person administering the solution is observing about your condition at the time they administer the solution to you. The manufacturer has created general guidelines for the use of fluorescein, but the final determination always lies with the doctor or medical professional in charge of injecting the solution.

Drug Interactions:

Under ideal circumstances, and without interference, fluorescein is designed to aid in the diagnosis of certain eye conditions. However, patients undergoing the tests and procedures this solution is used in conjunction with have had other medical conditions they are undergoing treatment for. Some of the medications and supplements they are utilizing as part of that treatment can interact with fluorescein and change the effects it was intended to have on their bodies in order to complete the procedure being performed.

A list of the more common drugs and supplements that interact with fluorescein includes:

  • Antibiotics like penicillin

While the list above includes many drugs and supplements that can interact with fluorescein, it is far from exhaustive. If you are taking medications or supplements, please discuss the ones you are currently taking with your doctor before they administer fluorescein, as well as any questions or concerns you may have about the use of fluorescein. This will help your doctor to alleviate your concerns, and to determine what (if any) risk there is of a negative interaction and what other course of action might be necessary. Remember that it is always better to ask questions about what is going on beforehand if possible.

Warnings

Let your doctor know immediately if you experience redness, swelling, or skin peeling, or several hours of severe pain or loss of feeling in your arm after having received fluorescein.

Also inform your doctor if you experience nausea, vomiting, diarrhea, or stomach pain after having received this drug.

After fluorescein has been administered, you could experience a strong taste in your mouth. You might notice a yellowish discoloration in your skin for somewhere between six and twelve hours after your test have been completed. It is also possible for your urine to be a bright yellow color for as long as thirty-six hours after your test is over.

Your doctor should exercise caution in using fluorescein if you have a history of allergy or bronchial asthma.

Let your doctor know of any allergies you have as well as your history of conditions related to allergic reactions before this solution is administered to you, as there may be ingredients that trigger an allergic reaction and a skin test may need to be performed beforehand. This includes food or drug urticaria, asthma, eczema, and allergic rhinitis.

If you are pregnant or trying to become pregnant, discuss the potential risks with your doctor before having fluorescein administered. It is not currently known what effects this drug could have or if it could cause fetal harm when given to a pregnant woman.

Tell your doctor if you are nursing, as fluorescein is known to be excreted in human milk for up to four days following its initial use. Following this procedure, you will need to discontinue nursing for that four-day period. Any milk coming in should be pumped off and discarded until the fluorescein is out of your system, which is usually in that four-day time frame.

Storage And Disposal Instructions

In the medical facility where fluorescein is being administered, the drug will be stored in a space where the temperature range falls between 36-77 degrees Fahrenheit (or 2-25 degrees Celsius). Medical professionals are advised to not freeze this solution. Fluorescein is typically not available for prescription use by patients outside of medical facilities.

Once doses have expired, disposal of whatever is left of the solution will be handled by whichever local waste disposal company the medical facility has hired for that purpose.

Summary

Fluorescein is one of many diagnostic agents that assists healthcare professionals in determining what is going on inside the body of their patient. It works by highlighting what is going on in places in the body that might not show up in test results otherwise. While its intended use is as an aid in diagnosing conditions, there are risks involved that can only be assessed by a doctor who is aware of the medical history of the patient it is to be given to. These risks cannot be properly assessed unless the patient has had honest conversations with their doctor about their medical history and condition and their daily habits.

It is always in a patient's best interest to disclose their medical history, current condition and daily habits to their doctor, as well as communicating concerns they may have about the use of fluorescein during a procedure. All of this information will help medical professionals determine the best way to diagnose and then treat the medical condition that is revealed a result of testing. The right dosage of fluorescein, given in the right away, allows doctors to gather the best information possible to make that diagnosis and determine the best possible course of treatment for their patients.

Links:

  • Mayo Clinic
  • Fluorescein angiography Healthline

Fluorescein as an injection is used to help make parts of the eye, like the retina or iris, more visible while doctors are performing medical tests and procedures on the patient's eye.

    • Angioscein
    • Fluorescite
    • Diarrhea, nausea or vomiting
    • Yellow skin
    • Fluorescent yellow urine
    • Cold, clammy skin
    • Severe arm pain
    • Confusion
    • Cough
    • Difficulties with breathing or with swallowing
    • Dizziness or lightheadedness
    • Skin rash, hives, or itching
    • Swelling, pain, redness or skin peeling
    • Sweating
    • Chest tightness
    • Headaches
    • Loss of consciousness
    • Convulsions; and
    • Feeling unusually weak or tired
    • Swelling, especially in the face, tongue, or throat area
    • Trouble breathing
    • Severe dizziness
    • Anticoagulants like dextran
    • Anti-diabetic medications like glipizide
    • Corticosteroids like dexamethasone
    • Cancer medications like beacizumab (Avastin)
    • Emollients like glycerin
    • Erythropoiesis-stimulating agents (ESAs) like epoetin alfa
    • Insulin aspart
    • Medical testing contrast agents like barium sulfate
    • Over the counter medications like Maalox
    • Pain relief medications like aspirin, acetaminophen, and morphine
    • Statin medications like atorvastatin
    • Supplements like gingko biloba, arginine, and saccharomyces boulardii lyo (probiotic)
    • Drugs.com: