Bludigo® Demonstrated Fast and Striking Visualization of Ureter Flow1

Using a five-point ordinal urine jet conspicuity score, indigo carmine was found to be significantly superior to saline in its capacity to aid visualization.1

Bludigo® is the first and only FDA-approved injectable indigo carmine diagnostic dye.2
Bludigo® demonstrated fast and striking visualization of ureter flow.1

85.4% of ureter patency assessments reported color contrasts in jet stream ranging from significant to striking 1

67.5% of physicians scored the color contrast at or 1


Within 4-9 minutes
post-IV injection2

Urine jet conspicuity score by the blinded central review process was assessed using the following 5-point ordinal scale: 1 = No jet observed; 2 = Weak jet, little color contrast; 3 = Color contrast or significant jet flow; 4 = Strong jet flow with good color contrast; 5 = Strong jet flow with striking contrast in color.1

Summary of proportion of responders* by ureter and reviewer or surgeon in patients receiving Bludigo® 5 mL2

% Responders
95% CL
Left Ureter
Right Ureter
Reviewer 1
% responder
95% CL
(48%, 77%)
(61%, 87%)
Reviewer 2
% responder
95% CL
(63%, 88%)
(68%, 91%)
% responder
95% CL
(57%, 83%)
(68%, 91%)

*A subject was a responder when there was ≥1-point improvement in the conspicuity scores following the indigo carmine vs saline treatment (indigo carmine – saline ≥1) and the conspicuity score following the indigo carmine treatment was 3, 4, or 5. The responder criteria were assessed separately for each ureter for each subject based on the blinded central reviewer’s conspicuity score.1

Two-sided 95% confidence limits for the proportion of responders, calculated using the Clopper-Pearson (exact) method.1

Study design: Bludigo® was studied in a phase 3, open-label, randomized, multicenter, parallel-group study of 121 patients. The study was composed of 3 periods: Screening (up to 30 days prior to surgery), Randomization/Dosing (Day 1), and a 30-day Safety Follow-up Period. Patients served as their own control by receiving a dose of normal saline prior to randomization, at which point patients were randomized 1:1 to receive 2.5 mL or 5 mL indigo carmine. The primary endpoint was efficacy based on a visualization conspicuity score. Efficacy was assessed using a 5-point ordinal scale measuring contrast flow. Secondary endpoints were physician satisfaction, time to visualization, and proportion of responders.1

CL=confidence level; IV=intravenous.

BLUDIGO® (indigotindisulfonate sodium injection, USP)


BLUDIGO® is a diagnostic dye indicated for use as a visualization aid in the cystoscopic assessment of the integrity of the ureters in adults following urological and gynecological open, robotic, or endoscopic surgical procedures.



BLUDIGO® is contraindicated in patients with known hypersensitivity to indigotindisulfonate or any of its components.


Cardiovascular Reactions: Severe or life-threatening cardiovascular reactions including cardiac arrest, arrhythmia, asystole, atrioventricular block second degree, hypotension, elevation in blood pressure, bradycardia, and tachycardia have been reported. Closely monitor blood pressure and cardiac rhythm during and following the BLUDIGO® injection. Interrupt administration if reactions are observed.

Hypersensitivity Reactions: Serious anaphylactic reactions with hypotension, dyspnea, bronchospasm, urticaria, or erythema have been reported. Monitor patients for anaphylactic reactions and have emergency equipment and trained personnel readily available.

Interference with Oximetry Measurements: Anesthesiologists should be aware of the potential for artifactual reduction in SpO2 when anesthetized patients are administered BLUDIGO®.


Renal Impairment: BLUDIGO® is not recommended for use in patients with eGFR<30 mL/min.

Pediatric Use: The safety and effectiveness of BLUDIGO® have not been established in pediatric patients.

Pregnancy and Lactation: Please consult the Full Prescribing Information before using BLUDIGO® in a patient that is lactating, pregnant, or may be pregnant.


The recommended dose for BLUDIGO® is 5 mL given intravenously over 1 minute.


  • Monitor blood pressure and cardiac rhythm during and following the injection.
  • Use immediately after opening ampule.
  • Withdraw the contents of the ampule through a 5 micron or smaller filter straw/filter needle to ensure that the withdrawn solution contains no particulates. The withdrawn solution should be inspected visually for particulate matter and discoloration prior to administration.
  • Do not administer with infusion assemblies used with other diluents or drugs.
  • Discard any unused portion.


Clinical Trial Experience: The most common adverse reactions (1%) associated with BLUDIGO® in clinical trials were: constipation, nausea, vomiting, abdominal pain, pyrexia, ALT increase, and dysuria.

Postmarketing Experience: The following adverse reactions have been identified following the use of indigotindisulfonate sodium injection products:

  • Cardiovascular disorders: cardiac arrest, arrhythmia, asystole, atrioventricular block second degree, hypotension, elevation in blood pressure, bradycardia, tachycardia
  • General disorders and administration site conditions: injection site discoloration
  • Immune system disorders: anaphylactic reactions with hypotension, dyspnea, bronchospasm, urticaria, erythema

Please see the full Prescribing Information for additional Important Safety Information.

To report SUSPECTED ADVERSE REACTIONS, contact PROVEPHARM Inc at 1–833-727-6556 or FDA at 1-800-FDA-1088 or

References: 1. Data on file. PVP-10ICO1 clinical study report. Newark, NJ: Provepharm, Inc.; 2024. 2. Bludigo. Prescribing Information. Provepharm, Inc.; 2024.