Adult Dosing
Drug-induced methemoglobinemia
- 1-2 mg/kg IV x1; inject IV slowly over a period of several minutes
Pediatric Dosing
Drug-induced methemoglobinemia
- 1-2 mg/kg IV x1; inject IV slowly over a period of several minutes
[Outline]
- Therapy may cause serious CNS reactions when methylene given to patients taking certain serotonergic psychiatric medications
- Use to detect aspirations in enteral feedings is not recommended as serious toxicity including deaths has been reported
- Subcutaneous administration may result in necrotic abscesses or extravasation occurs
- Intrathecal injection may cause neural damage
- Large IV doses may cause precordial pain, dizziness, headache, hypertension, profuse sweating, mental confusion, the formation of methemoglobin, cyanosis, nausea, vomiting or abdominal pain. Do not exceed recommended IV dose
- If injected too rapidly, methemoglobin production may be increased; inject IV slowly over several minutes to prevent a local high concentration of methylene blue
- Methylene blue may stain skin; a hypochlorite solution may remove skin stains
- Complete blood counts including reticulocyte counts recommended following methylene blue therapy to assure that hemolysis has not occurred due to accelerated destruction of erythrocytes
- Monitor methemoglobin concentrations 1 to 2 hours following administration of methylene blue to assess the effectiveness of therapy
- Closely monitor patients for greenish blue to blue discoloration of urine and feces; diarrhea nausea and vomiting; painful urination or increased urinary frequency
Cautions: Use cautiously in
- G6PD deficiency (risk of hemolysis and paradoxical Methemoglobinemia)
- Pediatrics
- Elderly patients
Pregnancy Category:C
Breastfeeding: Safety unknown. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
