Drug interactions
Duloxetine + Methylene blue
Severity: Contraindicated
Duloxetine and Methylene blue: contraindicated interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Methylene blue inhibits monoamine oxidase A and, together with duloxetine, can cause serious serotonin syndrome. Cases with intravenous methylene blue and serotonergic antidepressants have included severe neurological toxicity.
What this interaction means in plain words
Duloxetine and Methylene blue are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Reversible MAO-A inhibition by methylene blue combined with serotonin reuptake inhibition by duloxetine.
What to do
Avoid in non-emergency settings. If methylene blue is urgently needed, stop duloxetine and monitor for serotonin toxicity, resuming duloxetine 24 hours after the last methylene blue dose or after the monitoring period per labeling.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Duloxetine
- Duloxetine + Isocarboxazid Contraindicated
- Duloxetine + Linezolid Contraindicated
- Duloxetine + Phenelzine Contraindicated
- Duloxetine + Procarbazine Contraindicated
- Duloxetine + Rasagiline Contraindicated
- Duloxetine + Safinamide Contraindicated
Frequently asked questions
Can I take Duloxetine with Methylene blue?
MediHelp rates the interaction as contraindicated. Duloxetine and Methylene blue are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Methylene blue inhibits monoamine oxidase A and, together with duloxetine, can cause serious serotonin syndrome. Cases with intravenous methylene blue and serotonergic antidepressants have included severe neurological toxicity.
How serious is the interaction between Duloxetine and Methylene blue?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid in non-emergency settings. If methylene blue is urgently needed, stop duloxetine and monitor for serotonin toxicity, resuming duloxetine 24 hours after the last methylene blue dose or after the monitoring period per labeling.
What other medicines interact with Duloxetine?
MediHelp also lists interactions of Duloxetine with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Duloxetine page.
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