Methylene Blue

Methylene Blue

[1 vial and $7.06]

ADMINISTRATION ROUTES:

  • IV

ALTERNATIVE NAMES:

  • Methylene Blue

ICU INDICATIONS:

  1. methaemoglobinaemia
  2. vasoplegic shock (particularly after cardiopulmonary bypass)

PRESENTATION AND ADMINISTRATION:

  • IV:
    1% Methylene Blue (10mg/1ml) 5 ml vials.
    Inject Methylene Blue intravenously very slowly over a period of several minutes.
    Store at room temperature

DOSAGE:

  • IV:
    0.5-2mg/kg as a single dose; may give a subsequent dose if required.

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

  • No data available

DOSAGE IN PAEDIATRICS:

  • IV:
    0.5-2mg/kg as a single dose; may give a subsequent dose if required.

CLINICAL PHARMACOLOGY:

  • Methylene Blue is 3,7-bis(dimethylamino)-phenothiazin-5-ium chloride trihydrate. It will produce two opposite actions on hemoglobin. Low concentrations will convert methemoglobin to hemoglobin. High concentrations convert the ferrous iron of reduced hemoglobin to ferric iron which results in the formation of methemoglobin. Methylene Blue is thought to reduce vasoplegia through actions involving nitric oxide.

CONTRAINDICATIONS:

  • None

WARNINGS

  • Administration of Methylene Blue leads to decreased oxygen saturation recorded by pulse oximetry or continuous mixed venous or central venous oxygen saturation monitoring.

PRECAUTIONS

  • General:
    Use of more than the recommended dose leads to methaemoglobinaemia. Do not exceed recommended dose.
  • Laboratory Tests: No tests in addition to routine ICU tests are required.
  • Drug/Laboratory Test Interactions: None noted.

IMPORTANT DRUG INTERACTIONS FOR THE ICU

  • None of note

ADVERSE REACTIONS

  • Body as a Whole:
    Dizziness, headache, confusion, methaemoglobinaemia
  • Gastrointestinal effects:
    Abdominal pain

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