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Interações medicamentosas

Fluoxetine + Methylene blue

Gravidade: Contraindicada

Fluoxetine and Methylene blue: contraindicated interaction.

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Para profissionais de saúde — apenas referência. Esta página é um resumo breve, não é aconselhamento médico nem substitui a bula oficial ou o julgamento clínico. Verifique sempre antes de prescrever ou dispensar.

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Resumo

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.

O que esta interação significa em palavras simples

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.

Nível de evidência: High

Por que acontece

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

O que fazer

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.

O que perguntar ao farmacêutico

  • 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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Perguntas frequentes

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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