Diferencia entre revisiones de «Methylene blue»
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==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: Fetal risk has been demonstrated | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: X, Fetal risk has been demonstrated | ||
*[[Lactation risk categories|Lactation risk]]: Infant risk cannot be ruled out | *[[Lactation risk categories|Lactation risk]]: Infant risk cannot be ruled out | ||
*Renal dosing: no adjustment | *Renal dosing: no adjustment | ||
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==Mechanism of Action== | ==Mechanism of Action== | ||
*Promotes non-enzymatic redox conversion of methemoglobin to hemoglobin | *Promotes non-enzymatic redox conversion of methemoglobin to hemoglobin | ||
*Improves vascular tone via inhibition of nitric oxide synthase | |||
==Comments== | ==Comments== | ||
==Indications by Condition== | |||
''The following table is automatically generated from disease/condition pages across WikEM.'' | |||
{{#ask:[[Has DrugName::Methylene blue]] | |||
|?Has Indication=Indication | |||
|?Has Dose=Dose | |||
|?Has Context=Context | |||
|?Has Route=Route | |||
|?Has Population=Population | |||
|format=table | |||
|headers=plain | |||
|mainlabel=- | |||
|sort=Has Indication | |||
|limit=50 | |||
}} | |||
==See Also== | ==See Also== | ||
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<references/> | <references/> | ||
[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:Toxicology]] | |||
Revisión actual - 21:57 20 mar 2026
Administration
- Type: Antidote, Vasopressors
- Routes of Administration: IV
Adult Dosing
- Acquired methemoglobinemia: 1 mg/kg IV over 5-30min, may repeat in 1h with up to 1 mg/kg IV if methemoglobin level still >30% or symptoms persist
- Drug-induced methemoglobinemia: 1-2 mg/kg IV slowly over several minutes
- See vasopressors
- For hypotension refractory to catecholamine pressors
- Consider after catecholamine, vasopressin, and mineralocorticoid refractive shock
Pediatric Dosing
- Same as weight-based adult dosing
Special Populations
- Pregnancy Rating: X, Fetal risk has been demonstrated
- Lactation risk: Infant risk cannot be ruled out
- Renal dosing: no adjustment
- Hepatic dosing: no adjustment
Contraindications
- Allergy to class/drug
- G6PD deficiency
- ARDS
- Pulmonary hypertension
Adverse Reactions
Serious[1]
- Hemolytic anemia
- Syncope
- Serotonin syndrome
- Paradoxical methemoglobinemia at doses > 4 mg/kg/hr or per bolus
- Pulmonary vasoconstriction at 3-4 mg/kg/hr or per bolus
Common
- Skin discoloration, urine discoloration, hyperhidrosis
- Nausea, abnormal taste
- Limb pain
- Dizziness, headache
Pharmacology
- Half-life: 24h
- Metabolism: Hepatic
- Excretion: Mostly renal
Mechanism of Action
- Promotes non-enzymatic redox conversion of methemoglobin to hemoglobin
- Improves vascular tone via inhibition of nitric oxide synthase
Comments
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Methemoglobinemia | 1-2mg/kg over 5min; may repeat | Symptomatic OR asymptomatic with MetHb >25% | IV | Adult |
| Vasopressors | 1-2 mg/kg IV bolus over 15 min | Salvage vasopressor | IV | Adult |
See Also
References
- ↑ Pasin L et al. Methylene blue as a vasopressor: a meta-analysis of randomised trials. Crit Care Resusc. 2013 Mar;15(1):42-8.