Drug interactions
Methylene blue + Rasagiline
Severity: Major
Methylene blue and Rasagiline: 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 inhibits MAO-A and, with serotonergic drugs, has caused serotonin syndrome. Rasagiline is an MAO-B inhibitor with serotonergic concern, so the combination may increase toxicity.
What this interaction means in plain words
Methylene blue and Rasagiline 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
Methylene blue inhibits MAO-A, which, with rasagiline, raises serotonin levels.
What to do
Avoid unless methylene blue is urgently needed. If so, stop rasagiline and monitor for serotonin toxicity for up to 2 weeks or until 24 hours after the last methylene blue dose, whichever is first.
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 Rasagiline
- Atomoxetine + Rasagiline Contraindicated
- Brimonidine + Rasagiline Contraindicated
- Bupropion-naltrexone + Rasagiline Contraindicated
- Bupropion + Rasagiline Contraindicated
- Clomipramine + Rasagiline Contraindicated
- Desvenlafaxine + Rasagiline Contraindicated
Frequently asked questions
Can I take Methylene blue with Rasagiline?
MediHelp rates the interaction as major. Methylene blue and Rasagiline 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 inhibits MAO-A and, with serotonergic drugs, has caused serotonin syndrome. Rasagiline is an MAO-B inhibitor with serotonergic concern, so the combination may increase toxicity.
How serious is the interaction between Methylene blue and Rasagiline?
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 urgently needed. If so, stop rasagiline and monitor for serotonin toxicity for up to 2 weeks or until 24 hours after the last methylene blue dose, whichever is first.
What other medicines interact with Rasagiline?
MediHelp also lists interactions of Rasagiline with, for example, Atomoxetine, Brimonidine, Bupropion-naltrexone. The full list is on the Rasagiline page.
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