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Interazioni tra farmaci

Fluoxetine + Methylene blue

Gravità: Controindicata

Fluoxetine and Methylene blue: contraindicated interaction.

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Sintesi

Methylene blue is a reversible MAO-A inhibitor and, combined with a serotonergic SSRI such as fluoxetine, can precipitate serotonin syndrome. Features include agitation, hyperthermia, clonus, autonomic instability and seizures.

Cosa significa questa interazione in parole semplici

Fluoxetine 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

MAO-A inhibition by methylene blue adds to serotonin reuptake inhibition, producing excess serotonergic activity.

Cosa fare

Avoid unless methylene blue is needed urgently for a life-threatening condition; then stop fluoxetine and monitor for serotonin toxicity for several hours to days. Because of fluoxetine's long half-life, do not restart it until the washout period in labeling has been observed.

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 Fluoxetine with Methylene blue?

MediHelp rates the interaction as contraindicated. Fluoxetine 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 is a reversible MAO-A inhibitor and, combined with a serotonergic SSRI such as fluoxetine, can precipitate serotonin syndrome. Features include agitation, hyperthermia, clonus, autonomic instability and seizures.

How serious is the interaction between Fluoxetine 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 unless methylene blue is needed urgently for a life-threatening condition; then stop fluoxetine and monitor for serotonin toxicity for several hours to days. Because of fluoxetine's long half-life, do not restart it until the washout period in labeling has been observed.

What other medicines interact with Fluoxetine?

MediHelp also lists interactions of Fluoxetine with, for example, Isocarboxazid, Mavacamten, Phenelzine. The full list is on the Fluoxetine page.

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