Infracyanine (Indocyanine Green)

Indocyanine Green is used in diagnostic imaging to assess vascular and organ function.

• Intraoperative fluorescence angiography: enables real‑time visualization of tissue perfusion during surgery.
• Hepatic function assessment: provides quantitative measurement of liver clearance and function.
• Cardiac output measurement: supports evaluation of blood flow dynamics in cardiac studies.
• Retinal and choroidal angiography: offers near‑infrared imaging of ocular vasculature for ophthalmic diagnostics.

• Indocyanine Green binds rapidly to plasma proteins, especially albumin, forming a stable complex that remains intravascular. When excited by near‑infrared light, the complex emits fluorescence at a wavelength detectable by specialized imaging systems, allowing clinicians to track blood flow, tissue perfusion, and organ function in real time without significant tissue penetration.

Adverse reactions to Indocyanine Green are generally infrequent but may occur.

Common Side Effects

• Nausea: mild to moderate feeling of stomach upset.
• Headache: transient headache during or after injection.
• Flushing: brief skin reddening or warmth.
• Injection site pain: mild discomfort at the intravenous site.
• Mild hypotension: temporary drop in blood pressure.
• Vomiting: occasional emesis following administration.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction requiring immediate medical attention.
• Severe hypotension: marked drop in blood pressure leading to dizziness or syncope.
• Cardiac arrest: rare but life‑threatening cessation of heart activity.
• Stevens‑Johnson syndrome: severe skin and mucous membrane reaction.
• Hemolysis: destruction of red blood cells in susceptible individuals.
• Renal failure: acute kidney injury in rare cases.

When using Indocyanine Green, clinicians should observe several safety measures.

• Allergy assessment: verify patient has no known hypersensitivity to iodine or ICG.
• Vital sign monitoring: observe blood pressure and heart rate during and after injection.
• Experienced personnel: administer only by trained imaging specialists.
• Hepatic impairment: exercise caution in patients with severe liver disease.
• Renal dysfunction: consider dose adjustment or increased monitoring.
• Store at ambient temperature: keep in original packaging, protect from moisture and direct light.

Indocyanine Green may interact with other agents that affect hepatic metabolism or vascular tone.

Major Interactions (Avoid)

• Phenobarbital: enzyme induction may reduce ICG plasma levels.
• Warfarin: potential alteration of anticoagulant effect.
• High‑dose iodine contrast: may increase risk of hypersensitivity.

Moderate Interactions (Monitor Closely)

• Beta‑blockers: may blunt hemodynamic response during imaging.
• Calcium channel blockers: could affect vascular tone and fluorescence readings.