Drug interactions
Methylene blue + Procarbazine
Severity: Major
Methylene blue and Procarbazine: major 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 is a potent MAO-A inhibitor, and combining it with another MAO-inhibiting drug such as procarbazine can precipitate serotonin syndrome. Features include agitation, hyperthermia, clonus, and autonomic instability.
What this interaction means in plain words
Methylene blue and Procarbazine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive MAO inhibition increases synaptic serotonin and other monoamines.
What to do
Avoid unless methylene blue is needed urgently. If given, stop procarbazine and monitor for serotonin toxicity for up to two weeks or until 24 hours after the last methylene blue dose.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Procarbazine
- Adenovirus types 4 and 7 live + Procarbazine Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amoxapine + Procarbazine Contraindicated
- Atomoxetine + Procarbazine Contraindicated
- Bcg vaccine live + Procarbazine Contraindicated
- Brimonidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Methylene blue with Procarbazine?
MediHelp rates the interaction as major. Methylene blue and Procarbazine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Methylene blue is a potent MAO-A inhibitor, and combining it with another MAO-inhibiting drug such as procarbazine can precipitate serotonin syndrome. Features include agitation, hyperthermia, clonus, and autonomic instability.
How serious is the interaction between Methylene blue and Procarbazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid unless methylene blue is needed urgently. If given, stop procarbazine and monitor for serotonin toxicity for up to two weeks or until 24 hours after the last methylene blue dose.
What other medicines interact with Procarbazine?
MediHelp also lists interactions of Procarbazine with, for example, Adenovirus types 4 and 7 live, Amitriptyline, Amoxapine. The full list is on the Procarbazine page.
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