Isosulfan Blue

Isosulfan blue is a contrast agent used to delineate lymphatic vessels draining in the region of injection. It is an adjunct to lymphography 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.

• Isosulfan blue is available under the following different brand names: Lymphazurin

Common side effects of isosulfan blue include:

• hypersensitivity near the injection site
• a temporary blue coloring to the skin
• minor allergic reactions such as itching and hives
• serious allergic reactions including respiratory distress and shock

Serious side effects of isosulfan blue include:

• cold, clammy skin
• confusion
• cough
• difficulty with swallowing
• dizziness
• fast heartbeat
• fast, weak pulse
• hives or welts
• itching
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
• lightheadedness
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• redness of the skin
• shortness of breath
• skin rash
• sweating
• tightness in the chest
• troubled breathing
• unusual tiredness or weakness
• wheezing

Rare side effects of isosulfan blue include:

• none

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, coordination loss, unsteady, very stiff muscles, high fever, profuse sweating, or tremors
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Injectable solution

• 1%

Lymphography

Adult dosage

• 0.5 mL (5 mg) into three interdigital spaces of each extremity per study (max 3 mL per study)

Dosage Considerations – Should be Given as Follows:

• See "Dosages"

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, healthcare provider, or pharmacist first.

• Isosulfan blue has no noted severe interactions with any other drugs
• Isosulfan blue has no noted serious interactions with any other drugs
• Isosulfan blue has no noted moderate interactions with any other drugs
• Isosulfan blue has no noted minor interactions with any other drugs

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, health questions, or concerns.

Contraindications

• Hypersensitivity to triphenylmethane or related components

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Isosulfan blue?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Isosulfan blue?”

Cautions

• Possibility of delayed reactions — monitor patients for 30-60 min
• Do not mix with local anesthetics in the same syringe
• Urine color may be blue for some time
• Methemoglobin levels via arterial blood gases (ABG) may be falsely elevated; may need co-oximetry
• Peripheral oxygenation measurements may be falsely depressed owing to discoloration of serum caused by isosulfan blue; may require direct determination of ABG

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risks during pregnancy
• Lactation
  • Excretion in milk unknown; use caution