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General Precautions: ICG may rarely produce shock. It should be selected with prudence, taking into consideration the conditions of patients. For diagnosis, the following points should be noted with care.
1) Patient's condition should be sufficiently inquired to predict whether shock-like reactions will occur.
2) ICG should be dissolved completely in the attached solvent. No other solvent (physiological saline, etc.) should be used.
When incompletely dissolved ICG is injected, it may cause nausea, fever and shock like reactions. For good dissolution, the vial should be turned upside down several times and, in addition, it should be slightly shaked so that even a small portion of the agent adhering to the inner side of rubber stopper can be dissolved completely. Then, keep the vial horizontal and rotate it to observe the inner side of the vial and to confirm that no portions remain undissolved.
3) Prepare drugs and utensils for emergency use beforehand. (See Side Effects.)
4) Throughout the whole process of test, patients should be kept quiet, leaving them lying on his back so as to observe them sufficiently.
ICG should not be administered in the following patients: 1) Patients having antecedents of hypersensitivity to ICG.
2) Patients having iodine-hypersensitivity to iodine (As ICG contains iodine, it may produce iodine-hypersensitivity).
ICG should be administered prudently in the following patients: Patients having allergy-tendency.
Diagnostic interference: ICG may affect radioiodine uptake test of the thyroid.
Therefore, there should be, at least, over one week washout period between the two respective tests.
the ampoule with disinfectant cotton impregnated with ethanol and cut.
Cautions for diagnosis: There may be some errors in measured values in the following cases: 1) Effects of the physical condition of the patient.
Patients of chylous serum, or extremely turbid or hemolytic serum.
Edematous, emaciated or obese patients or patients who lost blood heavily [In these cases, it is advisable to perform measurement by means of methods permitting determination of disappearance rate (ex. K-method)].
2) Effects of the concomitant use of other drugs: Gall bladder contrast media (iopanoic acid, etc.), cholagogues, rifampicin, drugs against gout.
3) Effects of substances other than drugs: Effects of diet (lipemia, increased hepatic circulation, etc.)
Administration to pregnant women or nursing mothers: Since the safety of this drug for pregnant women or nursing mothers has not been established, administer to pregnant women , women who might be pregnant or nursing mothers only when the therapeutic benefits are considered to outweigh the risks.
