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Methemoglobin is a form of hemoglobin (HEEM o glo bin). Hemoglobin is a substance in blood that carries oxygen and distributes it to your tissues and organs. However, methemoglobin is not a type of hemoglobin that is useful in carrying oxygen.
Methemoglobin normally exists in small amounts in the blood. However, when methemoglobin levels increase, the blood is less efficient in circulating oxygen. The resulting lack of oxygen throughout the body can cause symptoms such as pale or blue-colored skin.
Methemoglobinemia is a condition in which methemoglobin is present in high levels in the blood. Methemoglobinemia can occur when a person is exposed to certain drugs or chemicals such as nitrites.
Methylene blue injection is used to treat methemoglobinemia. methylene blue works by converting methemoglobin to a more efficient type of hemoglobin to better carry oxygen throughout the body.
Methylene blue may also be used for purposes not listed in this medication guide.
You should not be treated with methylene blue if you have glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Many drugs can interact with methylene blue. Tell your doctor about all your current medicines and any you recently stopped using, especially an antidepressant.
You should not be treated with methylene blue if you are allergic to it, or if you have:
a genetic enzyme deficiency called glucose-6-phosphate dehydrogenase (G6PD) deficiency.
Many drugs can interact with methylene blue. Tell your doctor about all your current medicines and any you recently stopped using, especially:
alfentanil, fentanyl;
buspirone;
digoxin, digitalis;
dihydroergotamine, ergotamine;
phenytoin;
pimozide;
quinidine;
warfarin (Coumadin, Jantoven);
an MAO inhibitor--isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine, and others;
an "SSRI" antidepressant--citalopram, escitalopram, fluoxetine, paroxetine, sertraline, Prozac, Paxil, Zoloft, and others;
an "SNRI" antidepressant--desvenlafaxine, duloxetine, levomilnacipran, milnacipran, venlafaxine, Effexor, Cymbalta, Pristiq, and others;
other antidepressants--bupropion, clomipramine, mirtazapine; or
medicine to prevent organ transplant rejection--cyclosporine, sirolimus, tacrolimus.
To make sure methylene blue is safe for you, tell your doctor if you have:
liver disease; or
kidney disease.
Using methylene blue during pregnancy could harm the unborn baby. Tell your doctor if you are pregnant.
Do not breast-feed within 8 days after you received methylene blue. If you use a breast pump during this time, throw out any milk you collect. Do not feed it to your baby.
Methylene blue is injected into a vein through an IV. A healthcare provider will give you this injection. The IV infusion can take up to 30 minutes to complete.
Your breathing, blood pressure, oxygen levels, kidney function, and other vital signs will be watched closely while you are receiving methylene blue. Your blood will also need to be tested to help your doctor determine that the medicine is working.
You may only need to receive one dose of methylene blue. If you do need a second dose, it can be given 1 hour after your first dose.
Methylene blue will most likely cause your urine or stools to appear blue or green in color. This is a normal side effect of the medication and will not cause any harm. However, this effect may cause unusual results with certain urine tests.
Because you will receive methylene blue in a clinical setting, you are not likely to miss a dose.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include vomiting, stomach pain, chest pain or tightness, wheezing, trouble breathing, feeling like you might pass out, fast heart rate, anxiety, confusion, tremor, dilated pupils, blue-colored skin or lips, numbness, or tingling.
methylene blue may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.
For at least 24 hours after treatment with methylene blue, avoid exposure to sunlight or tanning beds. This medicine can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Tell your caregivers right away if you have:
confusion or weakness;
pale or yellowed skin;
dark colored urine;
fever; or
high levels of serotonin in the body--agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting.
Common side effects may include:
pain in your arms or legs;
blue or green urine;
altered sense of taste;
headache, dizziness;
sweating, skin discoloration;
nausea; or
feeling hot.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Many drugs can interact with methylene blue, and some drugs should not be used together. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide. Tell your doctor about all medicines you use, and those you have recently used before your treatment with methylene blue.
Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Methylene Blue (www.drugs.com/mtm/methylene-blue-injection.html).
Applies to methylene blue: intravenous solution
Intravenous route (Solution)
Methylene blue may cause serious or fatal serotonergic syndrome when used in combination with serotonergic drugs. Avoid concomitant use of methylene blue with selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors.
Along with its needed effects, methylene blue may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor or nurse immediately if any of the following side effects occur while taking methylene blue:
Incidence not known
Get emergency help immediately if any of the following symptoms of overdose occur while taking methylene blue:
Symptoms of overdose
Some side effects of methylene blue may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Less common
Applies to methylene blue: compounding powder, injectable solution, intravenous solution, oral tablet
Common (1% to 10%): Chest pain, chest discomfort, presyncope, syncope
Frequency not reported: Cardiac arrhythmia, tachycardia, hypertension, hypotension, palpitations
Common (1% to 10%): Ecchymosis
Frequency not reported: Hemolytic anemia, hemolysis, methemoglobinemia, hemoglobin decreased, hyperbilirubinemia (in infants only)
Frequency not reported: Anaphylaxis
Common (1% to 10%): Influenza-like illness
Common (1% to 10%): Injection site pain, injection site discomfort
Frequency not reported: Infusion site extravasation, infusion site induration, infusion site pruritus, infusion site swelling, infusion site urticaria, peripheral swelling
Very common (10% or more): Pain in extremity (84%)
Common (1% to 10%): Musculoskeletal pain, back pain, muscle spasms, chills, arthralgia
Frequency not reported: Serotonin syndrome, myalgia
Frequency not reported: Mydriasis, eye pruritus, ocular hyperemia, vision blurred
Common (1% to 10%): Decreased appetite, limb discomfort
Frequency not reported: Local tissue necrosis at the injection site
Common (1% to 10%): Anxiety
Frequency not reported: Confusional state, agitation
Very common (10% or more): Chromaturia (blue-green) (74%)
Frequency not reported: Dysuria
Frequency not reported: Elevated liver enzymes
Common (1% to 10%): Dyspnea
Frequency not reported: Dyspnea, tachypnea, hypoxia, nasal congestion, rhinorrhea, sneezing
Very common (10% or more): Feeling hot (17%), fever
Common (1% to 10%): Feeling cold, discomfort, catheter site pain
Frequency not reported: Genotoxicity, fever, lack of effectiveness, interference with in-vivo monitoring devices, interference with laboratory tests
Very common (10% or more): Dysgeusia (20%), dizziness (16%), headache (10%), paresthesia
Common (1% to 10%): Headache, paresthesia oral, dizziness postural
Frequency not reported: Serotonin syndrome (with concomitant use of serotonergic drugs), tremor, aphasia, tremor, aphasia
Very common (10% or more): Skin discoloration (blue) (13%), hyperhidrosis (13%), sweating
Common (1% to 10%): Pallor, contact dermatitis, pruritus, cold sweat, erythema
Frequency not reported: Urticaria, necrotic ulcer, papule, phototoxicity, rash (blue macules, severe burning pain)
Very common (10% or more): Nausea (13%)
Common (1% to 10%): Vomiting, abdominal pain, diarrhea, hypoesthesia oral, oral discomfort
Frequency not reported: Feces discoloration (blue-green), dry mouth, flatulence, glossodynia, tongue eruption, thirst, oropharyngeal pain, blue colored saliva
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Methylene Blue (www.drugs.com/mtm/methylene-blue-injection.html).
March 27, 2020
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