Resource_Adverse-Medications-List
Methylene Blue Drug Interactions List.
Search 201+ medications, from SSRIs to opioids to MAOIs, that can interact with methylene blue.
Why Methylene Blue Interacts With Medications.
Methylene blue slows down an enzyme called MAO-A. Your body uses MAO-A to break down serotonin and norepinephrine, two chemical messengers that affect mood, alertness, and blood pressure. When MAO-A slows down, those messengers stay active longer.1
On its own, that is part of how methylene blue works. The problem comes when it is combined with medications that also raise those messengers. With SSRIs, SNRIs, certain opioids, triptans, and supplements like St. John's Wort or 5-HTP, serotonin can build up and cause serotonin syndrome. With stimulants and decongestants such as Adderall or Sudafed, blood pressure can rise too high. Drugs.com also lists moderate interactions with other drug classes, including some sedatives and blood pressure medications, so check each medication in the list below.2
About 50 cases of serotonin syndrome have been published. Nearly all involved methylene blue given by IV during surgery, at roughly 70 to 560 mg for an average adult, in people already taking antidepressants.3 Our capsules contain 18 mg or less, a small fraction of those doses, but the FDA notes the risk at lower oral doses is not known,1 so we take it seriously.
Do not combine methylene blue with the medications below without talking to your doctor. This list is not medical advice and is not complete.
Medications to Avoid with Methylene Blue.
Methylene Blue Drug Interaction FAQs.
Can I take methylene blue with Zoloft, Prozac, Lexapro, or other SSRIs?
Drugs.com's interaction checker lists SSRIs such as sertraline (Zoloft), fluoxetine (Prozac), and escitalopram (Lexapro) as a major interaction with methylene blue, citing a risk of serotonin syndrome. This is not medical advice. Talk to a healthcare provider before combining methylene blue with any SSRI or SNRI.
Can I take methylene blue with Adderall, Ritalin, or other ADHD stimulant medications?
According to Drugs.com, amphetamine (Adderall) and methylphenidate (Ritalin, Concerta) are both listed as major interactions with methylene blue, citing a risk of dangerously high blood pressure. This is not medical advice. Consult a healthcare provider before combining methylene blue with any stimulant medication.
Is it safe to take methylene blue with opioid pain medications like Vicodin, Percocet, or tramadol?
Drugs.com classifies common opioids, including hydrocodone (Vicodin, Norco), oxycodone (OxyContin, Percocet), and tramadol (Ultram), as major interactions with methylene blue, citing risks including serotonin syndrome and respiratory depression. This is not medical advice. Consult a healthcare provider before combining methylene blue with any opioid medication.
Can I take methylene blue if I'm on an MAOI like Marplan, Parnate, or Emsam?
Drugs.com lists MAOIs such as isocarboxazid (Marplan), tranylcypromine (Parnate), and selegiline (Emsam, Eldepryl) as major interactions with methylene blue, since methylene blue itself has MAOI-like activity. This is not medical advice. Consult a healthcare provider before combining methylene blue with any MAOI.
Does methylene blue interact with Sudafed or other decongestants?
According to Drugs.com, pseudoephedrine (Sudafed) and phenylephrine are both listed as major interactions with methylene blue, citing a risk of hypertensive crisis. This is not medical advice. Check the label of any cold or allergy medication and consult a healthcare provider before combining it with methylene blue.
Can I take methylene blue with migraine medications like Imitrex or Maxalt?
Drugs.com classifies triptans such as sumatriptan (Imitrex) and rizatriptan (Maxalt) as major interactions with methylene blue, citing an increased risk of serotonin syndrome. This is not medical advice. Consult a healthcare provider before combining methylene blue with any triptan medication.
Is methylene blue safe with St. John's Wort or other serotonergic supplements?
Drugs.com lists St. John's Wort, L-tryptophan, and 5-HTP as major interactions with methylene blue, citing combined serotonergic effects that may raise the risk of serotonin syndrome. This is not medical advice. Consult a healthcare provider before combining methylene blue with any serotonergic supplement.
Does methylene blue interact with anti-nausea medication like Zofran?
According to Drugs.com, ondansetron (Zofran) is listed as a major interaction with methylene blue due to combined serotonergic effects. This is not medical advice. Consult a healthcare provider before combining methylene blue with any anti-nausea medication.
Can I take methylene blue with psilocybin mushrooms, LSD, MDMA, or other psychedelics?
Psilocybin mushrooms, LSD, MDMA, DMT, ayahuasca, and similar substances are not included in the Drugs.com-based list above. That does not mean the combination is safe. In a 2011 Drug Safety Communication, the FDA warned of serotonin syndrome when methylene blue is given to patients taking serotonergic psychiatric medications, and published research (Ramsay et al., British Journal of Pharmacology, 2007) describes methylene blue as a monoamine oxidase (MAO-A) inhibitor. These substances are described in the medical literature as acting on the serotonin system, and ayahuasca is described as containing MAO inhibitors of its own. Do not use Nutricel methylene blue products with any of these substances. This is not medical advice. Consult a healthcare provider.
Warning
Consult your doctor before use. Do not use with SSRIs or antidepressants. Do not use with psilocybin, MDMA, ayahuasca, or other psychedelic substances. Do not take when pregnant or breastfeeding. Not for use under the age of 18. If any adverse reactions occur, stop using this product and consult your doctor.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.