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patent blue

V04CX09

Forms & Strengths

2.5% solution (25 mg/mL) for IV injection
0.5% solution for subcutaneous use
Sterile ampoules for single‑use

Adult Dosing

IV bolus 0.5–1 mg/kg (≈0.02–0.04 mL/kg of 2.5% solution) for sentinel‑node mapping
Maximum single dose 5 mg
Inject slowly over 1–2 min
Optional repeat dose after 30 min if mapping incomplete

Pediatric Dosing

IV 0.5 mg/kg (max 5 mg) for lymphatic mapping
0.1–0.2 mg/kg for ureter visualization in infants
Dilute to 1 mg/mL for neonates
Weight‑based; avoid >0.5 mg/kg

Indications

Sentinel lymph‑node identification in breast cancer
Sentinel node detection in cutaneous melanoma
Intraoperative lymphatic mapping
Ureter visualization during pelvic surgery
Detection of chylous leaks
Corneal staining in ophthalmic procedures

Mechanism of Action

Triphenylmethane dye binds plasma proteins and remains intravascular
Uptake by lymphatic channels stains nodes blue
Absorbs light at 630 nm producing visible blue color
Transiently increases vascular permeability facilitating lymphatic uptake

Contraindications

Known hypersensitivity to patent blue or related dyes
Previous severe anaphylactic reaction to the dye
Severe cardiovascular instability (risk of hypotension)
Use only if essential in pregnancy

Adverse Reactions

Anaphylactoid reaction: urticaria, bronchospasm, hypotension
Transient blue discoloration of skin, mucosa, urine
Methemoglobinemia
Nausea, vomiting, abdominal pain
Injection‑site pain or phlebitis
Transient hypertension or tachycardia
Rare serotonin syndrome when combined with serotonergic agents

Drug Interactions

May cause falsely low SpO₂ readings on pulse oximetry
Interferes with colorimetric lab assays (bilirubin, glucose, etc.)
Additive hypotensive effect with other vasodilators
Concurrent methylene blue may increase risk of serotonin syndrome
May potentiate antihistamine effects during anaphylaxis management

Curated Content: Needs Vetting Before Put to Clinical Use