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<h3>Background and Importance</h3> Medical dyes are widely used in surgery and diagnostics for visualisation and detection purposes. In practice, these products were often grouped and referred to by their colour, such as ‘the blues’, without clear distinction between their specific indications or regulatory status. This confusion, shared by prescribers and pharmacists, led to off-label use and avoidable costs, highlighting the need to strengthen pharmaceutical knowledge and formulary governance to ensure patient safety. <h3>Aim and Objectives</h3> The aim was to evaluate compliance and the pharmaco-economic impact of dye use, identify off-label practices, harmonise usage, optimise formulary management, and reinforce patient safety. <h3>Material and Methods</h3> Consumption data for 2024 were extracted from the PHARMA software and analysed using a pharmaco-economic approach combining cost and volume assessment with compliance mapping by indication and ward typology. This methodology enabled systematic identification of services and dyes most exposed to inappropriate use. In parallel, awareness tools were developed, including eight good-use sheets, pharmacist training, and stock reviews based on expected outcomes. <h3>Results</h3> In 2024, the 36 hospital wards using dyes consumed 8,200 units (€86,000). The audit confirmed proper use of five dyes but revealed confusion over the three blue ones, representing 1,300 units (€46,000; 53% of the annual dye budget), heterogeneous allocations, and the absence of a medical device alternative covering several indications. The critical issue concerned methylene blue (MB) antidote (70 units, €16,000), used off-label in 70% of cases, although authorised exclusively for the treatment of methemoglobinaemia. Corrective actions included introducing methylene blue as a medical device with broader indications, adding the antidote to the controlled medicines list requiring pharmacist validation, and reviewing allocations. Dissemination of good-use sheets improved awareness and consistency among clinical teams. Since March 2025, 67 pharmacist-validated dispensations have shown 100% compliance, confirming complete correction of previous off-label use. This initiative achieved an estimated 25% saving on the annual dye budget. <h3>Conclusion and Relevance</h3> This initiative corrected methylene blue misuse and confirmed other dye compliance. Patent blue is under review, and this approach now applies to controlled drugs like broad-spectrum antibiotics where misuse drives costs and resistance. <h3>Conflict of Interest</h3> No conflict of interest