Indigokarmin Serb (Indigo Carmine)

Indigokarmin Serb is used as a diagnostic dye to enhance visualisation in urological and imaging procedures.

• Urological procedures: Improves identification of urinary tract structures during cystoscopy and pyelography.
• Visualization of urinary tract: Highlights the ureters and bladder for clearer imaging.
• Diagnostic imaging: Provides contrast for intra‑operative assessment and radiographic studies.

• Indigo Carmine acts as a water‑soluble anionic dye that binds to plasma proteins and is rapidly excreted by the kidneys. After intravenous injection, the dye circulates and imparts a deep blue colour to urine and extracellular fluids, thereby delineating anatomical structures and allowing clinicians to visualise the urinary tract and related tissues during diagnostic and therapeutic procedures.

Indigokarmin Serb may cause a range of adverse reactions, from mild to severe.

Common Side Effects

• Transient hypotension: temporary drop in blood pressure.
• Nausea: feeling of sickness.
• Vomiting: expulsion of stomach contents.
• Flushing: reddening of skin.
• Urinary discoloration: blue‑tinted urine.
• Headache: mild to moderate head pain.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction with airway compromise.
• Methemoglobinemia: elevated methemoglobin causing cyanosis.
• Hemolysis: destruction of red blood cells.
• Severe bronchospasm: acute airway narrowing.
• Cardiac arrhythmia: irregular heart rhythm.

Before using Indigokarmin Serb, consider the following precautions to minimise risk.

• Allergy assessment: verify no known hypersensitivity to indigo carmine or other azo dyes.
• Renal function: evaluate kidney function as the dye is renally excreted.
• Cardiovascular status: monitor patients with unstable blood pressure or heart disease.
• Concomitant medications: exercise caution when used with other vasodilators or antihistamines.
• Pregnancy and lactation: avoid use unless benefits outweigh potential unknown risks.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Indigokarmin Serb can interact with certain drugs; awareness of these interactions helps ensure safe administration.

Major Interactions (Avoid)

• MAO inhibitors: may potentiate hypertensive episodes when combined with vasoconstrictive agents.
• Other contrast agents: concurrent use can increase risk of renal toxicity and allergic reactions.

Moderate Interactions (Monitor Closely)

• Antihistamines: may mask early signs of an allergic response.
• Beta‑blockers: can blunt compensatory tachycardia in case of hypotension.
• Diuretics: may alter dye clearance and affect imaging quality.