Methylene Blue

Methylene Blue Brand Names- PROVAYBLUE | Urolene Blue

What is Methylene Blue

Methylene blue is a water-soluble thiazine dye for acquired methemoglobinemia.

Other uses include bacteriological staining, as an indicator dye, and as a tracer in the evaluation of gastrointestinal fistulas.

Methylene blue carries a black box warning for the risk of serotonin syndrome with concomitant use of serotonergic medications; concurrent use of serotonergic medications should be avoided

Indications

  1. gastrointestinal fistula diagnosis
  2. hypotension
  3. lymphography
  4. methemoglobinemia
  5. neurotoxicity prophylaxis
  6. parathyroid gland localization
  7. sentinel lymph node mapping
  8. septic shock

For use as a diagnostic aid to determine the presence of a gastrointestinal fistula (e.g., gastrointestinal fistula diagnosis)

Side Effects

  1. abdominal pain
  2. anaphylactoid reactions
  3. anemia
  4. anorexia
  5. anxiety
  6. arthralgia
  7. arthralgia
  8. back pain
  9. blurred vision
  10. chest pain (unspecified)
  11. chills
  12. contact dermatitis
  13. diarrhea
  14. dizziness
  15. dizziness
  16. dysgeusia
  17. dysgeusia
  18. dyspnea
  19. dysuria
  20. ecchymosis
  21. edema
  22. elevated hepatic enzymes
  23. erythema
  24. flatulence
  25. headache
  26. headache
  27. hemolysis
  28. hot flashes
  29. hot flashes
  30. hyperbilirubinemia
  31. hyperhidrosis
  32. hyperhidrosis
  33. hypertension
  34. hypoesthesia
  35. influenza
  36. influenza
  37. infusion-related reactions
  38. methemoglobinemia
  39. muscle cramps
  40. muscle cramps
  41. musculoskeletal pain
  42. myalgia
  43. nasal congestion
  44. nausea
  45. nausea
  46. pallor
  47. palpitations
  48. paresthesias
  49. peripheral edema
  50. photosensitivity
  51. pruritus
  52. pruritus
  53. rhinorrhea
  54. serotonin syndrome
  55. sinus tachycardia
  56. skin discoloration
  57. sneezing
  58. syncope
  59. urine discoloration
  60. urticaria
  61. vomiting
  62. vomiting
  63. xerostomia

Monitoring Parameters

  • ECG
  • methemoglobin

Contraindications

  • anemia
  • breast-feeding
  • driving or operating machinery
  • G6PD deficiency
  • geriatric
  • hepatic disease
  • intrathecal administration
  • MAOI therapy
  • pregnancy
  • renal failure
  • renal impairment
  • subcutaneous administration

Interactions

  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Tramadol
  • Alfentanil
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amoxapine
  • Amphetamine
  • Amphetamine; Dextroamphetamine
  • Amphetamines
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Benzhydrocodone; Acetaminophen
  • Benzphetamine
  • Bromocriptine
  • Brompheniramine; Dextromethorphan; Guaifenesin
  • Brompheniramine; Dextromethorphan; Phenylephrine
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Buprenorphine
  • Buprenorphine; Naloxone
  • Bupropion
  • Bupropion; Naltrexone
  • Buspirone
  • Caffeine; Ergotamine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Codeine
  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Citalopram
  • Clomipramine
  • Cocaine
  • Codeine
  • Codeine; Guaifenesin
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Desipramine
  • Desvenlafaxine
  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmethylphenidate
  • Dextroamphetamine
  • Dextromethorphan
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dextromethorphan; Guaifenesin; Potassium Guaiacolsulfonate
  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Promethazine
  • Dextromethorphan; Quinidine
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Dihydroergotamine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Dolasetron
  • Doxepin
  • Duloxetine
  • Ergoloid Mesylates
  • Ergonovine
  • Ergot alkaloids
  • Ergotamine
  • Escitalopram
  • Fenfluramine
  • Fentanyl
  • Fluoxetine
  • Fluoxetine; Olanzapine
  • Fluvoxamine
  • Granisetron
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Homatropine; Hydrocodone
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Ibuprofen; Oxycodone
  • Imipramine
  • Isocarboxazid
  • Isoniazid, INH
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Lasmiditan
  • Levomilnacipran
  • Levorphanol
  • Linezolid
  • Lisdexamfetamine
  • Lithium
  • Lorcaserin
  • Maprotiline
  • Meperidine
  • Meperidine; Promethazine
  • Methadone
  • Methamphetamine
  • Methoxsalen
  • Methylergonovine
  • Methylphenidate
  • Methysergide
  • Milnacipran
  • Mirtazapine
  • Monoamine oxidase inhibitors
  • Morphine
  • Morphine; Naltrexone
  • Nalbuphine
  • Nefazodone
  • Netupitant, Fosnetupitant; Palonosetron
  • Nortriptyline
  • Ondansetron
  • Oxycodone
  • Oxymorphone
  • Ozanimod
  • Palonosetron
  • Paroxetine
  • Pentazocine
  • Pentazocine; Naloxone
  • Pergolide
  • Perphenazine; Amitriptyline
  • Phenelzine
  • Porfimer
  • Procarbazine
  • Protriptyline
  • Rasagiline
  • Remifentanil
  • Safinamide
  • Selegiline
  • Serotonin norepinephrine reuptake inhibitors
  • Serotonin-Receptor Agonists
  • Sertraline
  • Sibutramine
  • St. John’s Wort, Hypericum perforatum
  • Sufentanil
  • Tapentadol
  • Tramadol
  • Tranylcypromine
  • Trazodone
  • Trimipramine
  • Venlafaxine
  • Verteporfin
  • Vilazodone
  • Vortioxetine