It is helpful to keep a list of all your current medications in your wallet or another location where it is easily retrieved.
Make sure your healthcare professional knows about all the medications you are taking. Do not stop taking your serotonergic psychiatric medicine without first talking to a healthcare professional. Your healthcare provider will tell you when to start methylene blue after stopping your serotonergic psychiatric medication. You may need to temporarily stop taking your serotonergic psychiatric medication if it becomes necessary for you to take methylene blue in certain situations. Health Canada issued a NOTICE TO HOSPITALS on the association of serotonin toxicity with methylene blue in combination with serotonin reuptake inhibitors on February 16, 2011. (See Additional Information for Healthcare Professionals)Ī separate Drug Safety Communication (DSC) is being released today for linezolid (Zyvox) due to similar potential drug interactions with serotonergic psychiatric medications and includes drug usage recommendations. Safety information about these potential drug interactions and important drug usage recommendations for emergency and non-emergency situations are being added to the drug labels for serotonergic psychiatric medications. However, there are some conditions that may be life-threatening or require urgent treatment with methylene blue such as when it is used in the emergency treatment of: 
Methylene blue should generally not be given to patients taking serotonergic drugs. Healthcare professionals and patients may not realize that methylene blue has monoamine oxidase inhibitor (MAOI) properties. Signs and symptoms of Serotonin Syndrome include mental changes (confusion, hyperactivity, memory problems), muscle twitching, excessive sweating, shivering or shaking, diarrhea, trouble with coordination, and/or fever. This is referred to as Serotonin Syndrome. It is believed that when methylene blue is given to patients taking serotonergic psychiatric medications, high levels of serotonin can build up in the brain, causing toxicity. Is a potent, reversible monoamine oxidase inhibitor (MAOI).Īlthough the exact mechanism of this drug interaction is unknown, methylene blue inhibits the action of monoamine oxidase A-an enzyme responsible for breaking down serotonin in the brain.Used as a dye in therapeutic and diagnostic applications.Used to treat methemoglobinemia, vasoplegic syndrome, ifosfamide-induced encephalopathy, cyanide poisoning.
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