But methylene blue can cause toxicity in high doses. It works by converting the ferric iron (Fe+++) in hemoglobin to ferrous iron (Fe++). 2000;82:291–4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2363270/pdf/82-6690917a.pdf. Our Methylene Blue (methylene blue injection) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. Your breathing, blood pressure, oxygen levels, kidney function, and other vital signs will be watched closely while you are receiving methylene blue. Adverse Reactions Following Infusion of PROVAYBLUE® 2 mg/kg. Methylene blue reduces mortality and morbidity in vasoplegic patients after cardiac surgery. J Drugs Dermatol. 2009;78:927–32. 2005;2:26. The health care provider will perform blood tests to diagnose the condition. However recent studies has shown the efficacy of Methylene blue as an effective and cheap antimalarial agent especially in countries with increasing resistance of P. falciparum to existing 1st line antimalarial agents-chloroquine and pyrimethamine-sulfadoxine. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Based on recent pathophysiologic findings it appears that the soluble intracellular enzyme guanylate cyclase is activated to produce cyclic guanosine monophosphate (C-GMP) presumably under the influence of several mediators including nitric oxide 18). Table 1 lists the adverse reactions of any severity that occurred in at least 2% of individuals who received PROVAYBLUE®. Misra V, Misra SP, Dwivedi M, Gupta SC. What should I avoid while receiving methylene blue? See additional information. A release of nitric oxide has been incriminated in the cardiovascular alterations of septic shock. What should I discuss with my healthcare provider before receiving methylene blue? However, methemoglobin is not a type of hemoglobin that is useful in carrying oxygen. However, this effect may cause unusual results with certain urine tests. It is relatively contraindicated in G6PD deficient patients as it can cause severe hemolysis and also in patients with Heinz body anemia 11). Tell your doctor about all your current medicines and any you recently stopped using, especially: To make sure methylene blue is safe for you, tell your doctor if you have: Using methylene blue during pregnancy could harm the unborn baby. Methylene blue has been used to treat high flow priapism by intra-cavernous injection which is known to antagonize endothelial derived relaxation factor 37). See additional information. Hemoglobin is the protein in red blood cells that carries and distributes oxygen to the body. For at least 24 hours after treatment with methylene blue, avoid exposure to sunlight or tanning beds. Tell your doctor about all medicines you use, and those you have recently used before your treatment with methylene blue. Methylene blue also interacts with dapsone and forms hydroxylamine which oxidizes hemoglobin causing hemolysis 8). Since guanylate cyclase is the target enzyme in the endothelium dependent relaxation mediated by nitric oxide, Methylene blue- a potent inhibitor of guanylate cyclase has been found very effective in improving the arterial pressure and cardiac function in septic shock 24). British Journal of Anaesthesia, 106, 687–689. Call your doctor for medical advice about side effects. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors. Call your doctor for medical advice about side effects. It can also be used to treat severe vasoplegia in post operative transplant patient 22). It occurs when there is a problem with an enzyme called cytochrome b5 reductase. However, do not stop taking your medicine. It tells you about the potential risk of serotonin syndrome. People with serotonin syndrome will likely stay in the hospital for at least 24 hours for close observation. 2009;9:27. Methylene blue improves the hepatopulmonary syndrome. As no food or respiratory allergy nor skin allergy was identified in the literature search for methylene blue, and concern for anaphylactic reactions upon oral exposure is low, there are no safety concerns with respect to allergenicity of methylene blue 10). Methemoglobin is a form of hemoglobin. During septic shock, blood pressure can drop dangerously low.

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