Drug interactions
Meperidine + Methylene blue
Severity: Contraindicated
Meperidine 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 MAO-A and, with serotonergic meperidine, can precipitate serotonin syndrome. Severe reactions with confusion, hyperthermia and seizures have been described.
What this interaction means in plain words
Meperidine 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
MAO-A inhibition by methylene blue combined with serotonin reuptake inhibition by meperidine increases synaptic serotonin.
What to do
Avoid; if methylene blue is urgently required, stop meperidine and monitor for CNS toxicity, delaying resumption for 24 hours after the last methylene blue dose, or until 2 weeks have passed if monitoring continues.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
- Meperidine + Rasagiline Contraindicated
Frequently asked questions
Can I take Meperidine with Methylene blue?
MediHelp rates the interaction as contraindicated. Meperidine 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 MAO-A and, with serotonergic meperidine, can precipitate serotonin syndrome. Severe reactions with confusion, hyperthermia and seizures have been described.
How serious is the interaction between Meperidine 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; if methylene blue is urgently required, stop meperidine and monitor for CNS toxicity, delaying resumption for 24 hours after the last methylene blue dose, or until 2 weeks have passed if monitoring continues.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Meperidine page.
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