Drug interactions
Methylene blue + Paroxetine
Severity: Contraindicated
Methylene blue and Paroxetine: 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 antidepressants like paroxetine, can cause severe serotonin syndrome. Cases have followed intravenous methylene blue given during surgery.
What this interaction means in plain words
Methylene blue and Paroxetine 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 paroxetine.
What to do
Avoid the combination when possible; if urgent methylene blue is needed, stop paroxetine and monitor for serotonin toxicity for up to 2 weeks or until 24 hours after the last methylene blue dose.
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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
- Paroxetine + Selegiline transdermal Contraindicated
Frequently asked questions
Can I take Methylene blue with Paroxetine?
MediHelp rates the interaction as contraindicated. Methylene blue and Paroxetine 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 antidepressants like paroxetine, can cause severe serotonin syndrome. Cases have followed intravenous methylene blue given during surgery.
How serious is the interaction between Methylene blue and Paroxetine?
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 the combination when possible; if urgent methylene blue is needed, stop paroxetine and monitor for serotonin toxicity for up to 2 weeks or until 24 hours after the last methylene blue dose.
What other medicines interact with Paroxetine?
MediHelp also lists interactions of Paroxetine with, for example, Isocarboxazid, Phenelzine, Pimozide. The full list is on the Paroxetine page.
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