Drug reference
fluorescein
Diagnostic ophthalmic/angiographic dye · Diagnostic agent
START
Topical strip/drop as needed; IV 500 mg for angiography
TYPICAL MAX
500 mg IV per session
STOP IF
Anaphylaxis or severe vasovagal/extravasation
WATCH
Resuscitation readiness for IV; warn about temporary discolouration
CDSCO approvedATC S01JA01
KDIGO 2024 + manufacturer label
- ONSET
- 36s · IV fluorescence
- PEAK
- 3min · arterial phase
- t½
- 4h · t½
- DURATION
- 1d · skin colour
EXCRETION
Renal — fluorescein and glucuronide
route + CYP
INTERACTIONS
—
none in our sources
PREGNANCY
Use only if benefit outweighs risk (IV).
FDA category + note
Mechanism
Hydrophilic xanthene dye fluoresces under blue light (~490 nm excitation, ~525 nm emission), permitting visualisation of corneal/conjunctival epithelial defects (topical) or retinal/choroidal vasculature (IV angiography).
Indications
Topical: detection of corneal abrasion / foreign body / contact-lens fit / tonometryIV: fluorescein angiography of retinal/choroidal vasculature
Dosing
- Adult
- Topical: instill a strip / drop of 0.25–2% solution as needed. IV angiography: 500 mg (5 mL of 10%) IV bolus.
- Pediatric
- Topical as adult; IV weight-based (~7.7 mg/kg) — specialist.
- Renal adjustment
- No adjustment.
- Hepatic adjustment
- No adjustment.
- Geriatric
- Standard; monitor for vasovagal/hypersensitivity.
- Max dose
- 500 mg IV per angiography session
Pharmacokinetics
Onset
Topical staining within seconds; IV fluorescence within seconds
Peak effect
IV ~10–60 s (arterial phase imaging)
Duration
Tissue clearance over hours
Half-life
~4 h (terminal)
Bioavailability
IV 100% (topical local)
Protein binding
~50–80%
Metabolism
Glucuronidation
Excretion
Renal (fluorescein and fluorescein-glucuronide; urine discolouration)
Contraindications
- Severe hypersensitivity to fluorescein (rare anaphylaxis)
- Caution: prior anaphylactoid reaction, asthma
Side effects
Common
Yellow-green discolouration of skin/urine (24 h)Transient nausea (IV)Sneezing/itching (mild)
Serious
- Anaphylaxis (IV — rare but reported)
- Extravasation injury (IV)
- Severe vasovagal reactions
Pregnancy & lactation
Pregnancy
Use only if benefit outweighs risk (IV).
Lactation
Interrupt breastfeeding ~24–48 h after IV dose.
Related guidelines
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Sources: Goodman & Gilman 14e·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20