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Isosulfan Blue or Blue Dye
Blue Dye, manufactured name Lymphazurin™, is also known chemically as sulphan blue, Patent Blue or Isosulfan Blue. It is a contrast agent for the delineation of lymphatic vessels and is used in a procedure called “mapping of the sentinel lymph nodes”. It’s an adjunct to lymphography for visualization of the lymphatic system draining the region of injection. This procedure is done in certain types of cancer, including breast cancer and melanoma. One example of such a use is to identify the sentinel lymph node in breast cancer surgeries. Often used in the hospital setting. Isosulfan Blue Backorder Information Manufacturer Drug Shortage Notification Information from the American Society of Health-System Pharmacists regarding Isosulfan Blue Compounded Preparation Information for Isosulfan Blue
Lymphazurin™ 1% vs. sulfa drug allergic reactions The chemical structure of a sulfa drug is distinct from that of Lymphazurin™ which contains SO3. The functional group specific to sulfa drugs is the sulfonamide which is SO2NH attached to an aromatic ring. Allergenicity to sulfa drugs is generally due to the formation of a toxic hydroxlamine metabolite which is then not sufficiently metabolized. Since this metabolic pathway is specific to sulfonamides, there is no risk of cross-sensitivity with SO3. In summary, the allergy associated with sulfa drugs is not a sulfur allergy, but a sulfonamide allergy. Therefore, drugs that simply contain a sulfur moiety and lack the distinct sulfonamide structure (such as Lymphazurin™) are not considered to be contraindicated in sulfa drug allergy. Reference: http://www.mc.uky.edu/pharmacy/dic/currenttopics/issues/topics0900.pdf (page 3)
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