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Escitalopram + Methylene blue

Gravità: Controindicata

Escitalopram and Methylene blue: contraindicated interaction.

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Sintesi

Methylene blue inhibits monoamine oxidase A, and combining it with an SSRI can cause serotonin syndrome, which has been reported with intravenous use. Features include confusion, agitation, myoclonus, hyperthermia and autonomic instability.

Cosa significa questa interazione in parole semplici

Escitalopram 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.

Livello di evidenza: High

Perché avviene

Methylene blue inhibits MAO-A, raising serotonin levels on top of SSRI reuptake blockade.

Cosa fare

Avoid the combination in elective settings. If methylene blue is urgently needed, stop escitalopram and monitor for serotonin toxicity for up to 2 weeks or 24 hours after the last methylene blue dose, whichever comes first.

Cosa chiedere al farmacista

  • 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Domande frequenti

Can I take Escitalopram with Methylene blue?

MediHelp rates the interaction as contraindicated. Escitalopram 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 combining it with an SSRI can cause serotonin syndrome, which has been reported with intravenous use. Features include confusion, agitation, myoclonus, hyperthermia and autonomic instability.

How serious is the interaction between Escitalopram 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 the combination in elective settings. If methylene blue is urgently needed, stop escitalopram and monitor for serotonin toxicity for up to 2 weeks or 24 hours after the last methylene blue dose, whichever comes first.

What other medicines interact with Escitalopram?

MediHelp also lists interactions of Escitalopram with, for example, Cisapride, Citalopram, Isocarboxazid. The full list is on the Escitalopram page.

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