Verdye

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Verdye

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Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Verdye

Quick Facts

Property Description
Active ingredient Indocyanine Green (ICG)
Form Sterile powder for injection solution
Pharmacological class Diagnostic Agent, Fluorescent Marker
General purpose Real-time visualization and function assessment
Origin Synthetic, Tricarbocyanine dye

The Core Identity: What Type of Medicine is Verdye (Indocyanine Green)?

Verdye is the commercial designation for the active pharmaceutical ingredient, Indocyanine Green (ICG), a highly pure, synthetic compound. ICG is not a therapeutic medicine intended for treatment but is officially categorized as a Diagnostic Agent and Fluorescent Marker. This classification establishes its exclusive role: to assist clinicians in obtaining visual information during procedures. ICG is designated for use in assessing cardiac output, hepatic function, and blood flow.

Composition and Preparation: The Anatomy of a Fluorescent Tracer

The active component in Verdye is Indocyanine Green, a water-soluble organic compound manufactured synthetically. Verdye is specifically distinguished by its supply as a sterile, lyophilized powder contained within a vial, designed for optimal stability and reconstitution. This agent, which falls under the tricarbocyanine dye chemical class, requires precise dissolution into an aqueous solution using a sterile solvent before use. The high-level route of administration is intravenous injection, ensuring rapid, systemic distribution essential for its function as a time-sensitive diagnostic tracer.

General Function: Why is Indocyanine Green Used?

The general purpose of ICG is to enable the real-time visualization of internal body structures that are not visible under standard lighting. The substance operates by utilizing near-infrared (NIR) fluorescence: when exposed to NIR light, it absorbs the energy and re-emits a highly distinct signal instantly captured by specialized imaging equipment. Once administered, ICG rapidly binds almost entirely to plasma proteins, ensuring it stays confined to the circulatory system. This characteristic allows clinicians to precisely map vascular integrity in a typical use scenario. This unique metabolic behavior provides an objective index of hepatic function due to its exclusive clearance by the liver.

What side effects are possible with Verdye?

Possible Side Effects and Safety Information

The safety profile of Verdye (Indocyanine Green) is officially characterized by the risk of hypersensitivity reactions, which are the most commonly reported adverse events documented in regulatory labeling. The most significant safety concern is the potential for anaphylaxis, which is listed as a serious adverse reaction. Regulatory documents acknowledge reports of anaphylactic deaths following administration, particularly during procedures such as cardiac catheterization. According to SmPC-aligned classifications, severe events like anaphylactic reactions, as well as coronary artery spasm and nausea, are considered very rare (occurring in less than 1 in 10,000 patients).

Adverse effects are documented within System-Organ Classes, primarily involving the Immune System, Skin and Subcutaneous Tissue, and the Cardiac/Vascular Systems. Symptoms associated with these reactions include a fall in blood pressure, fast heartbeat, shortness of breath, laryngospasm, itching (pruritus), hives (urticaria), and swelling of the face or lips. Skin and injection site discoloration has also been reported as an adverse reaction.

Official Safety Constraints

Official labeling mandates specific safety constraints, primarily due to the presence of sodium iodide in the active ingredient. The product is contraindicated in patients with a known history of hypersensitivity to Indocyanine Green itself or to iodine/iodides. Furthermore, due to the potential for interference, regulatory instructions state that radioactive iodine uptake studies should not be performed for at least one week after Verdye is administered.

Population-specific safety statements address the use of Verdye in specific groups. It is classified in Pregnancy Category C, advising administration only when clearly indicated. Caution is also noted for nursing mothers and for patients with terminal renal insufficiency, where the possibility of an adverse reaction may be increased.

Overdose and Emergency Response

Overdose and when to seek help

Official regulatory documentation notes that no specific data are available describing the signs, symptoms, or laboratory findings accompanying overdosage in human subjects. Therefore, the official regulatory guidance for immediate action focuses entirely on the risk of severe anaphylactic reactions, which are the most critical, life-threatening events linked to the product.


Required Emergency Actions

The need to seek urgent medical help is dictated by the potential for a rapid, acute hypersensitivity response. Regulatory documents require that emergency resuscitation facilities should be available for immediate use during administration.

Action Trigger Mandated Response (Official Labeling)
Onset of anaphylactic symptoms Immediate measures must be taken to provide basic life support and administer treatments such as epinephrine, glucocorticoids, and antihistamines to manage circulatory and respiratory compromise.

Monitoring and Special Considerations

Patients must be monitored for at least one hour following administration to detect severe adverse reactions. The official label notes a higher incidence of severe adverse reactions in patients with severe renal insufficiency, which requires increased clinical caution.

Therapeutic Uses of Verdye

What Verdye Treats: Main Uses and Benefits

Verdye (Indocyanine Green/ICG) is a specialized diagnostic agent generally used in clinical settings. It is not intended to cure disease directly, but to provide essential, real-time visual information that supports improved procedural results and is used to assist with risk management during the procedure. Its primary benefit is turning unseen physiological risks into objective data, which helps clinicians make supportive decisions that may assist in reducing the likelihood of severe complications. The compound is formally indicated for various types of functional assessment and imaging.


Enhancing Surgical Precision and Anatomy Mapping

This domain covers the use of Verdye during various surgical procedures to address the clinical challenge of anatomical ambiguity and uncertain tissue viability. The agent is applied in contexts where failure to visualize critical structures—such as bile ducts, sentinel lymph nodes, or small blood vessels supplying vital tissue flaps—is associated with the potential for serious complications. By providing visual information on these elements, Verdye supports precise delineation, which supports the goal of more focused resections and assists in maintaining functional stability by reducing the potential for injury.


Specialized Diagnostics for Circulation and Organ Function

Verdye is crucial in clinical situations demanding the quantitative assessment of organ functional capacity and detailed microcirculation patterns. This is relevant for conditions where patient management relies on accurately assessing organ reserve, notably in evaluating liver function before a major resection (hepatectomy) in assessing capacity relative to the risk of post-operative failure. Additionally, it is used in ophthalmic angiography to map subtle circulatory abnormalities in the eye, assisting in the diagnosis and supportive management of retinochoroidal vascular disorders.


QuickFact Block

Quick Fact: Support in Specialized Procedures Description
Symptom Domain Addresses symptoms linked to organ-specific functional stress and heightened physiological activity during high-stakes surgery.
Key Benefit Provides support that helps ease the overall symptom burden of surgical risk by facilitating safer decisions and contributing to faster recovery.
Common Scenario Applied in clinical settings that involve acute or unstable symptom patterns, such as intraoperative imaging during complex oncologic resections.

Regulatory References

  1. U.S. National Library of Medicine’s DailyMed

Eligibility and Restrictions for Use

Who Can and Cannot Use Verdye? (Official Regulatory Information)

Verdye (Indocyanine Green) eligibility is strictly defined by regulatory documents, focusing on patient status and specific medical conditions.

Contraindications (Must Not Be Used)

Contraindicated Group Restriction Basis
Allergy/Hypersensitivity Known allergy to indocyanine green, sodium iodide, or iodine.
Thyroid Conditions Manifest hyperthyroidism or autonomic thyroid adenomas.
Neonates Premature babies or newborns suffering from hyperbilirubinaemia.

Restricted or Cautionary Use

  • Severe Renal Impairment: The medicine must only be applied after a careful benefit/risk assessment due to a reported increased incidence of adverse reactions in patients with severe kidney failure.
  • Pregnancy: Use requires caution and is only recommended if clearly indicated, as the potential risk to the human fetus is officially unknown.
  • Lactation: Use requires caution since it is not known whether the medicine is excreted into human milk.
  • Children and Adolescents: All age groups are generally eligible, but the total daily dose is strictly limited by body weight and age. Use for the specific purpose of sentinel lymph node identification is not recommended due to insufficient safety and efficacy data.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The official regulatory profile for Verdye (Indocyanine Green) defines interactions primarily as constraints on diagnostic co-administration and subsequent laboratory testing, rather than conventional drug-drug metabolic effects.

Interaction Scope

Category Official Regulatory Statement
Medicinal product categories with documented interactions Preparations containing sodium bisulfite (e.g., certain Heparin products).
Timing-based interaction rules One week separation is required for subsequent radioactive iodine uptake studies.
Population-specific interaction notes No population-specific interaction considerations are explicitly stated in the official interaction section.
Interaction-related restrictions Do not use sodium bisulfite-containing preparations as an anticoagulant for blood sample collection for Indocyanine Green analysis.

Resulting Interaction Structure

Official interaction statements:

  • Procedural Constraint: Co-use of preparations containing sodium bisulfite as an anticoagulant for blood sample analysis is restricted because the bisulfite chemically reduces the absorption peak of Indocyanine Green in the blood.
  • Timing Constraint: Because the drug contains iodine, which can interfere with testing, radioactive iodine uptake studies must not be performed for at least one week following the administration of Verdye.

Connection to the overall interaction profile (2–4 sentences): The regulatory documents define the product's interaction structure primarily through two specific constraints: a procedural restriction that prohibits co-use with bisulfite-containing anticoagulants during sample collection and a timing-based restriction that requires mandatory separation before performing radioactive iodine uptake studies. This specialized interaction profile reflects the role of the product as a time-sensitive diagnostic agent.

Mechanism of Action

How Verdye Works: Mechanism of Action

Verdye functions by targeting and modulating key molecular signaling pathways to achieve specific alterations in physiological output. It is relevant in systems where distinct transmitters or mediators dominate, engaging mechanisms that influence dysregulated processes and resulting in defined alterations to the system's physiological output.


Receptor-Mediated Signaling and Attenuation

Verdye acts within domains involving receptor- or enzyme-mediated signaling by initiating or suppressing specific signaling sequences. This interaction modifies early molecular steps that shape systemic physiological outcomes, attenuating the signaling output resulting from elevated mediator activity within targeted biological systems.


Modulation of Pathway Responses

The compound modulates key pathways associated with heightened physiological responses by engaging mechanisms that influence feedback regulation. This action influences the regulatory components of processes driven by distinct signaling patterns and modulates signaling sequences to dampen overactive physiological processes, promoting pathway dynamics consistent with basal or non-stimulated activity within affected tissues.


Intracellular Cascade Regulation

Verdye engages mechanisms that influence processes relevant in cascades where multiple layers of pathway activation occur. Its molecular action specifically targets intermediary signaling components, thereby re-tuning the overall dose-response characteristics of the signaling pathway and altering cellular activity that may elevate under specific conditions.

Dosage and Administration Information

How to Use Verdye: Official Administration Guidelines

Verdye (Indocyanine Green) is administered exclusively as an acute diagnostic agent; it is not a long-term therapeutic medicine. The usage protocol is highly standardized and dependent on the specific assessment being conducted.


Administration Scope

The medicine is supplied as a lyophilized powder and requires reconstitution using Sterile Water for Injection, USP, immediately prior to the procedure. The reconstituted solution has a limited use window and must be utilized within 6 hours of preparation.

Element Official Guideline
Route of administration Primarily administered via Intravenous (IV) Injection for systemic function assessment. Localized procedures, such as lymphatic mapping, may use interstitial, intradermal, or subcutaneous injection.
Dosing schedule Dosage is specific to the diagnostic purpose. For example, the dose for Cardiac Output in adults is typically 5 mg, while Hepatic Function Studies require 0.5 mg/kg. The maximum total cumulative dose for all uses must not exceed 2 mg/kg.
Administration Timing The IV injection must be delivered as a rapid bolus immediately followed by a saline flush. For biliary imaging, the dose may be administered at least 45 minutes prior to the required visualization time.

Procedural Context and Special Populations

Administration is confined to a controlled medical setting under the supervision of a physician. Usage protocols for specific populations are detailed: Pediatric dosing for cardiac assessments is generally lower, with distinct doses specified for infants (e.g., 1.25 mg) and children (e.g., 2.5 mg).

The required preparation steps, precise injection technique, and dose calculations are designed to ensure administration occurs for obtaining accurate diagnostic data.

Recent Clinical Evidence

Research evidence / Overview of studies for Verdye

Evidence for use in Detecting Eye Vessel Damage

Verdye was studied for its role in helping healthcare providers visualize problems with blood vessels in the eye, particularly in conditions characterized by fluctuating or episodic manifestations such as diabetic retinopathy or blockages. Research often involves imaging studies where the dye is used to highlight the blood flow patterns in the retina and choroid. These studies were observed in clinical settings to see how using Verdye compares to standard imaging techniques.

The findings describe patterns observed in the studies where research highlights changes measured during the study period, related to the visualization of specific areas of vessel leakage or poor circulation. These outcomes reflecting daily functioning or activity level were not the primary focus, but research examined the visualization achieved and monitored structural changes in the eye. Research involves Verdye in studies examining the integrity of the ocular vasculature.

However, the follow-up durations were limited in many of these studies. Comparative evidence is lacking to fully understand how Verdye-assisted imaging compares to newer or developing techniques over the long term. Evidence is limited for repeated use over many years, and research exploring short-term symptom changes did not provide detailed information on the stability of vessel damage over extended periods.


Evidence for use in Assessing Tumors and Abnormal Growths

Verdye was evaluated in research settings involving the visualization of various tumors and abnormal growths in different parts of the body. Research examined how the dye is absorbed by and flows through the blood vessels supplying these growths, as tumors often have a unique blood supply pattern. These studies monitored the dye's presence using specialized cameras to create detailed images.

The data show patterns related to the visualization of the edges of some tumors and the distinction between tissues. Research describes studies monitoring visualization during surgical planning or biopsies, especially for conditions associated with acute or disruptive episodes of cell proliferation.

Sample sizes were modest in some of the studies focused on rare tumor types. Data are still emerging regarding the observations of Verdye across the full spectrum of tumor types, and evidence quality varies across studies based on the location and stage of the growths being studied. Subgroup findings are uncertain for specific genetic or aggressive tumor variants.


Evidence for use in Guiding Surgical Procedures

Studies explored the use of Verdye as a visualization tool to assist surgeons, which is particularly relevant in complex operations. Research examined how the dye could help highlight specific structures like small blood vessels or lymph nodes that need to be preserved or removed during a procedure. This is often relevant in trials assessing short-term or episodic symptom patterns by focusing on the immediate technical aspects of the surgery.

The research highlights changes measured during the study period, related to the identification of intended structures. Research examined this visual guidance in relation to the technical aspects of the procedure. These patterns were observed in studies conducted during periods of increased symptom activity where surgical intervention was studied.

Data for certain groups remain insufficient, especially when looking at the use of Verdye in very specialized or newly developed surgical techniques. Comparative evidence is lacking for certain types of operations, making it difficult to fully assess its impact versus older visualization methods. The results apply only to the populations studied and the specific surgical environments where the research was conducted.


Long-term Studies and Follow-up

This section will outline what is known about outcomes over a longer period following the use of Verdye. Research describes the need for studies that track patients well beyond the initial procedure or imaging session. Studies monitored the time intervals over which the initial observations were followed, which is sometimes studied as durability of response.

Long-term effects are not fully established because many studies have limited follow-up durations. Research is ongoing to understand the long-term clinical significance of findings and how the patterns observed in the studies were monitored over defined time intervals. Certainty remains low about the extended impact on outcomes reflecting daily functioning or activity level over decades.


Evidence in Special Populations

Studies explored the use of Verdye across different groups, focusing on patients who may have different physiological responses or where standard evidence is limited. Research examined individuals with comorbid conditions, meaning existing health issues alongside the primary condition, and how this can influence the procedure.

Data for certain groups remain insufficient, especially for children and specific older adults populations. Evidence is limited regarding the use of Verdye in pregnancy-related populations. Findings were mixed or very limited for individuals with complex, pre-existing systemic or functional imbalance issues.


What is Still Uncertain about Verdye

Verdye has been studied for a variety of imaging and guidance applications. However, there are still areas where more information is needed. Evidence quality varies across studies, and there are often inconsistent findings when comparing results from different research centers.

Comparative evidence is lacking against the latest alternative imaging agents or diagnostic tools in many of its studied uses. Data are still emerging on how best to integrate Verdye imaging into long-term management protocols, especially for conditions involving periods of heightened symptoms. Findings describe group patterns, not personal outcomes.

Frequently Asked Questions (FAQ)

Common questions about Verdye (FAQ)

Q: Where is the dye injected?

Verdye is primarily administered as an intravenous (IV) injection directly into a vein. For specific diagnostic or surgical procedures, official product information indicates the medicine may also be administered via injection into the skin (intradermally or subcutaneously) or into other specific tissues, as determined by the healthcare provider.

Q: What does Verdye actually do in the body?

According to the official product information, Verdye acts as a fluorescent tracer. Once injected, the dye rapidly binds to plasma proteins in the blood, allowing it to stay confined within the circulatory system. When exposed to near-infrared light from specialized equipment, it fluoresces (grows), which enables visualization of structures like blood vessels in real-time by specialized imaging equipment. It is then removed from the body entirely by the liver.

Q: Is this dye safe to use?

Verdye is a diagnostic agent that must only be administered by a physician in a controlled medical setting. Safety information emphasizes that it is generally administered without issue when used under physician supervision. However, official reports acknowledge very rare serious adverse events, such as anaphylaxis and coronary artery spasm. The dye must not be used if you have a known allergy to indocyanine green itself or to iodine/iodides.

Q: How long does the dye stay visible under the camera?

The duration of visibility depends on the diagnostic application. In the blood vessels, the dye typically begins to fluoresce (become visible) within 5 to 15 seconds after injection. For procedures involving the biliary ducts (bile vessels), the fluorescence response may remain visible for up to 120 minutes (two hours) after the dye is administered, according to official product information.

Q: Does Verdye make my urine or skin change color?

The official product information states that Verdye is taken up exclusively by the liver and excreted through the bile. This suggests the dye does not rely on the kidneys for excretion. However, skin discoloration near the site of injection has been reported as an adverse reaction.

Q: Is it used for anything besides heart and liver checks?

Yes, while it is used to assess cardiac output (heart) and hepatic function (liver), regulatory documents list other indications. This includes ophthalmic angiography to visualize eye blood vessels and providing real-time guidance for surgeons by highlighting vessels, blood flow, and tissue perfusion during various surgical procedures.

How should Verdye be stored and disposed of?

How to Store and Dispose of Verdye

Official regulatory requirements define specific storage and disposal rules to maintain the stability of Verdye (Indocyanine Green) powder.


Unreconstituted Powder Storage

  • The dry powder must be kept in its original container and outer carton to protect from light.
  • Store the vial at controlled room temperatures, typically not above 30 C.
  • This medicinal product must be stored out of the sight and reach of children.

Solution Stability and Disposal

Verdye is for single use only. Once the powder has been dissolved into a solution, it is considered chemically unstable in aqueous solution and must be used within 6 hours of preparation. If the solution appears unclear or contains a precipitate, it must be discarded. Any unused medicinal product or waste material must be disposed of in accordance with local requirements.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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