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Methylene blue: a controversial diagnostic acid and medication?
Marek Bužga1,2, Evžen Machytka3, Eliška Dvořáčková4
1Institute of Laboratory Medicine, University Hospital Ostrava, Ostrava 17. listopadu 1790, OStrava, 70800, Czech Republic.
Toxicology Research
|November 7, 2022
Summary
Methylene blue (MB) has potential risks despite its historical use. This review highlights serious adverse effects, including hemolysis and toxicity, questioning its current clinical safety.
Area of Science:
- Pharmacology
- Toxicology
- Clinical Medicine
Background:
- Methylene blue (MB) is used diagnostically and therapeutically for conditions like methemoglobinemia and vasoplegic syndrome.
- Despite historical use and diagnostic origins, MB's fundamental toxicology in humans remains poorly understood.
- Current clinical application of MB is controversial due to data heterogeneity and lack of preclinical safety data.
Purpose of the Study:
- To review the literature on the administration of methylene blue (MB) in humans.
- To determine potential risks and adverse effects associated with MB use.
- To summarize current understanding of MB indications and toxicological profile.
Main Methods:
- A narrative literature review was conducted.
- Databases searched included MEDLINE, Web of Science, Scopus, and Cochrane.
- Studies were identified to assess MB's safety and efficacy.
Main Results:
- MB is indicated for methemoglobinemia, vasoplegic syndrome, and other conditions.
- Reported adverse effects include dose-dependent hemolysis, methemoglobinemia, nausea, dyspnea, and hypertension.
- MB can induce serotoninergic toxicity, manifesting as neuromuscular hyperactivity, and skin irritation.
Conclusions:
- The clinical use of MB presents a controversial issue due to insufficient preclinical data and varied clinical findings.
- Adverse effects of MB can be severe and may outweigh benefits in certain contexts.
- There is a need for standardized guidelines and further research to ensure the safe medicinal use of MB.
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