Indocyanine green
Looking up MedlinePlus…
From MedlinePlus, U.S. National Library of Medicine
Diagnostic Dye
Dosing in kidney impairment
This label has no separate kidney-impairment dosing section. Check warnings and clinical pharmacology in the full label.
Dosing in liver impairment
Recommended Dose, Administration and Imaging for Visualization of Extrahepatic Biliary Ducts Dosing and Administration Administer the recommended dose of ZYOGREEN as a single intravenous injection. The initial dose and timing of administration are based on patient age as shown in Table 2 . Additional doses may be administered to obtain imaging sequences during the procedure.
The maximum total dose for any patient, including all initial and additional doses combined, must not exceed 2 mg/kg. [See table below.] Imaging Instructions Use ZYOGREEN with an FDA-authorized imaging device that is intended to be used with indocyanine green for fluorescence imaging of extrahepatic biliary ducts. For patients 6 years of age and older, fluorescence is visible in the biliary tree within 45 minutes after injection.
For patients less than 1 year of age, fluorescence is visible in the biliary tree between 12 hours and 24 hours after injection.
| *Dose based on actual body weight | ||
| Patient Age | Recommended Dose | Timing of Administration |
| Pediatric patients from birth to less than 1 year of age | 0.1 mg/kg* (Do not exceed 2.5 mg) | Administer 12 hours to 24 hours prior to surgery |
| Pediatric patients from 1 to less than 6 years of age | Not indicated | Not applicable |
| Pediatric patients 6 years of age and older | 2.5 mg | Administer at least 45 minutes prior to surgery |
| Adults | ||
Preparation and administration
Prepare this dose
Your numbers for indocyanine green. Take vial strength, diluent, and limits from the label below.
Enter a dose to see draw volume, final concentration, and rates.
Important Administration Instructions ZYOGREEN is a ready-to-use solution, provided in ampules at a concentration of 2.5 mg per mL. Use immediately after opening ampule. Withdraw the contents of the ampule through a 5 micrometer or smaller straw/filter needle to ensure that the withdrawn solution contains no particulates.
Visually inspect the withdrawn solution for particulate matter and discoloration prior to administration. Each ampule of ZYOGREEN is for a single dose. Discard any unused portion.
Recommended Dose, Administration and Imaging for Visualization of Vessels, Blood Flow and Tissue Perfusion Dosing Administer the recommended initial dose of ZYOGREEN as a single intravenous injection. The recommended initial dose is based on patient age as shown in Table 1 . Additional doses may be administered to obtain imaging sequences during the procedure.
The maximum total dose for any patient, including all initial and additional doses combined, must not exceed 2 mg/kg. [See table below.] Administration Prior to the imaging procedure, draw the desired dose of ZYOGREEN into a syringe. For adults, prepare 10 mL of 0.9% Sodium Chloride Injection in a separate syringe for flushing.
For pediatric patients, adjust the amount and type of flush for the individual patient to avoid volume and sodium overload. Administer via a central or peripheral venous line using a three-way stopcock. Inject ZYOGREEN as a tight bolus. Immediately switch the access on the stopcock and inject the prepared flush. Imaging Instructions Use ZYOGREEN with an FDA-authorized imaging device that is intended to be used with indocyanine green for fluorescence imaging of vessels, blood flow and tissue perfusion.
A fluorescence response should be visible in blood vessels within 5 seconds to 15 seconds after injection.
Recommended Dose, Administration and Imaging for Lymphatic Mapping of Cervical and Uterine Cancer Dosing and Administration The recommended dose of ZYOGREEN for lymphatic mapping of cervical and uterine cancer in adults is 5 mg. Administer this dose interstitially as four separate 1.25 mg injections into the cervix, with each injection consisting of a 0.5 mL volume of the 2.5 mg/mL solution.
The injections should be given at the 3 o'clock and the 9 o'clock positions of the cervix. At each of these two positions, one superficial injection (1 mm to 3 mm depth) and one deep injection (1 cm to 3 cm depth) are required to complete the dosing. Imaging Instructions Use ZYOGREEN with an FDA-authorized imaging device that is intended to be used with indocyanine green for fluorescence imaging of lymph nodes and delineation of lymphatic vessels during lymphatic mapping of cervical and uterine cancer.
Fluorescent lymphatic vessels and lymph nodes should begin to be visible within 1 minute after injection.
Recommended Dose and Administration for Ophthalmic Angiography Administer doses up to 40 mg of ZYOGREEN intravenously for ophthalmic angiography in adult and pediatric patients. The specific dose should be determined based on the imaging equipment and technique being used. The total dose must not exceed 2 mg/kg. For adults, administer a 5 mL bolus of 0.9% Sodium Chloride Injection immediately following the injection.
For pediatric patients, adjust the amount and type of flush solution for the individual patient to avoid volume and sodium overload. The antecubital vein can be used for ZYOGREEN administration.
Drug interactions
Check indocyanine green against a medication listLabel text (1 paragraph)
Interference with Thyroid Radioactive Iodine Uptake Studies: Do not perform radioactive iodine uptake studies for at least one week following the use of ZYOGREEN. ( 7 ) Interference with Thyroid Radioactive Iodine Uptake Studies Because ZYOGREEN contains sodium iodide, the iodine-binding capacity of thyroid tissue may be reduced for at least one week following administration. Do not perform radioactive iodine uptake studies for at least one week following administration of ZYOGREEN.
Contraindications
4 CONTRAINDICATIONS ZYOGREEN is contraindicated in patients with a history of hypersensitivity to indocyanine green. Reactions have included anaphylaxis [see Warnings and Precautions ( 5.1 )] . Hypersensitivity to indocyanine green ( 4 )
Safety data
Reported adverse events (FAERS)
Liver injury (LiverTox)
LiverTox has no chapter for indocyanine green. Check the label's hepatic warnings.
Pregnancy and lactation
Pregnancy
8.1 Pregnancy Risk Summary There are no adequate and well-controlled studies of ZYOGREEN in pregnant women. Available data from a very small number of scientific literature studies with indocyanine green use in pregnant women over several decades have not reported any drug associated risks for major birth defects, miscarriage, or adverse maternal or fetal outcomes. Data from one small study in which indocyanine green was administered intravenously to pregnant women during labor suggest there is no placental transfer of the drug. Animal reproduction studies have not been conducted with indocyanine green.
All pregnancies have a background risk of birth defects, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively.
Breastfeeding (LactMed)
Data from one patient indicates that a low subcutaneous dose of indocyanine green is not detectable in breastmilk. The manufacturer reports 17 cases of indocyanine green use in lactating women with no reported adverse effects in infants. Indocyanine green appears to be acceptable during breastfeeding, but it should be used with caution, especially while nursing a newborn or preterm infant.
Supply and cost
Drug shortage status
Recalls (last 24 months)
Therapeutic equivalence (Orange Book)
Price ladder
Not the price at the counterThese are not what a patient pays at the pharmacy counter. They are what pharmacies, health plans, and government buyers pay, before manufacturer rebates. A patient's cost depends on their insurance (copay, coinsurance, or deductible) or the pharmacy's cash price.