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Bleicher RJ, Kloth DD, Robinson D, Axelrod P.

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These include nitroglycerin (Nitrostat) and isosorbide dinitrate (Isordil). It can cause your blood pressure to drop too low. Sildenafil (Viagra) can also interact with blood pressure medications. Other drug interactions are with certain antifungals and antivirals like ritonavir (Norvir). They can raise the risk of side effects like headaches and flushing.

Chronic harms

It's important to tell your prescriber and pharmacist about all the medications you take and plan to take. They can make sure all your medications are safe to take together and adjust them to keep you safe if needed. The typical dose is 50 mg taken by mouth about 1 hour before sex, as needed. You can also take it anywhere from 30 minutes to 4 hours before sex. Your dose might be lower if you're an older adult or if you have liver or kidney problems. Inflammatory cutaneous adverse effects of methylene blue dye injection for lymphatic mapping/sentinel lymphadenectomy.

George M. Methylene-blue-induced hyperbilirubinemia and phototoxicity in a neonate. A case of green urine due to a traditional Chinese medicine containing methylene blue. Pulmonary edema associated with methylene blue dye administration during sentinel lymph node biopsy. Postoperative Serotonin Syndrome Following Administration of Preoperative Intrapulmonary Methylene Blue and pills to increase sex drive male Intraoperative Granisetron: A Case Report. Postoperative Serotonin Syndrome Following Methylene Blue Administration for Vasoplegia After Cardiac Surgery: A Case Report and Review of the Literature. A Case of Serotonin Syndrome Caused by the Concomitant Utilization of Methylene Blue and Venlafaxine in an Oncological Patient. J Pharm Pract 2020;33(5):705-707. Hashmi AT, Gupta SS, Shankar S, Seneviratne C, Yoon TS, Kupfer Y. Life-Threatening Serotonin Syndrome Due to Methylene Blue-Citalopram Interaction.

Perioperative Diagnosis and Treatment of Serotonin Syndrome Following Administration of Methylene Blue.

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Serotonin Syndrome Following Methylene Blue Administration for Vasoplegic Syndrome. Wolvetang T, Janse R, Ter Horst M.

Storage Condition Temperature Range Humidity Light Exposure Storage Location Recommended
Cool, dry place 15-25°C < 60% Dark storage Medicine cabinet, away from sunlight
Room temperature 20-25°C Low Indirect light Pharmacy shelves
Refrigerator (if specified) 2-8°C N/A Not required Refrigerator
Keep out of reach Any N/A N/A Childproof containers

Serotonin Syndrome After Methylene Blue Administration During Cardiac Surgery: A Case Report and Review. Serotonin syndrome following methylene blue administration during cardiothoracic surgery. J Pharm Pract 2015;28(2):207-11.

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Donaldson CJ, Sequeira Campos M, El-Sayed M. Inadvertent foetal exposure to methylene blue in the first trimester. Methylene blue-induced Heinz body hemolytic anemia in a premature neonate. Safety tolerability and bioavailability in healthy volunteers. Anaphylactic-like reaction to methylene blue: case report and review of perioperative hypersensitivity reactions. McDonnell AM, Rybak I, Wadleigh M, Fisher DC. Suspected serotonin syndrome in a patient being treated with methylene blue for ifosfamide encephalopathy. The role of methylene blue in serotonin syndrome following cardiac transplantation: a case report and review of the literature. Methylene blue for COVID-19 ARDS: insights from a randomized Clinical Trial. METHYLENE BLUE FOR TREATMENT OF HOSPITALIZED COVID-19 PATIENTS: A RANDOMIZED, CONTROLLED, OPEN-LABEL CLINICAL TRIAL, PHASE 2. Application of methylene blue -vitamin C -N-acetyl cysteine for treatment of critically ill COVID-19 patients, report of a phase-I clinical trial.

Country Major Companies Production Volume (per year) Certification Health Standards
United States PharmaTech, BlueMeds 1.2 billion units FDA, ISO 9001
India MedGlobal, CyanLabs 980 million units GMP, WHO Prequalification
China SinoPharm, BluePharm 1.5 billion units CFDA, ISO 13485
Germany BioCure, BlueVita 600 million units EMA, GMP

Guo X, Ding W, Liu L, Yang S. Intradiscal Methylene Blue Injection for Discogenic Low Back Pain: A Meta-Analysis.

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This can potentially lead to permanent vision loss. Before starting sildenafil (Viagra), tell your prescriber about your full medical history. If your eye specialist has told you that you have a "crowded" optic disc, you might be at higher risk of vision changes with this medication. Your prescriber can decide if sildenafil (Viagra) is right for you based on the risks and benefits. Some people who took sildenafil (Viagra) had problems with hearing.

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Sometimes, this happened along with ringing in the ears (tinnitus) and dizziness. It's not clear if these problems are directly related to sildenafil (Viagra). If you notice any changes in your hearing in one or both of your ears, stop taking this medication and call your prescriber right away. Risk factors: Taking nitrate medications Taking blood pressure medications Taking alpha blockers Taking certain antifungals or antivirals Taking other ED medications at the same time Sildenafil (Viagra) can interact with certain medications. These drug interactions can raise your risk of side effects, including dangerously low blood pressure. Pain Pract 2019;19(1):118-129. Deng M, Huang H, Ma YG, Zhou Y, Chen Q, Xie P.

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Your prescriber can also adjust the dose depending on how it works for you and if you have side effects. The maximum recommended dose is 100 mg. GoodRx has partnered with to provide reviews on the different aspects of Sildenafil (Viagra). Learn more about the effectiveness of Sildenafil (Viagra) based on real life experiences. Based on 14 people taking this medication Based on 28 people taking this medication Based on 34 people who have taken this medication Based on 76 people who have taken this medication Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur.

Top side effects

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Sildenafil (Viagra) will not be safe for you to take. Taking a nitrate medication for chest pain (angina) Taking guanylate cyclase (GC) stimulators, such as Adempas (riociguat) History of allergic reaction to sildenafil (Revatio) High absolute bioavailability of methylene blue given as an aqueous oral formulation. Intradiskal Injection of Methylene Blue for Discogenic Back Pain: A Meta-Analysis of Randomized Controlled Trials.

Farrokhi MR, Lotfi M, Masoudi MS, Gholami M. Effects of methylene blue on postoperative low-back pain and functional outcomes after lumbar open discectomy: a triple-blind, randomized placebo-controlled trial. Potential of Low Dose Leuco-Methylthioninium Bis(Hydromethanesulphonate) (LMTM) Monotherapy for Treatment of Mild Alzheimer's Disease: Cohort Analysis as Modified Primary Outcome in a Phase III Clinical Trial. Multimodal Randomized Functional MR Imaging of the Effects of Methylene Blue in the Human Brain.

Methylene blue modulates functional connectivity in the human brain.

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If you take this medication, be very careful getting up after sitting or lying down. This can help prevent you from feeling dizzy from low blood pressure and possibly falling. Risk factors: Medical conditions that affect the penis Sickle cell anemia Multiple myeloma Leukemia It's not common, but some people who took sildenafil (Viagra) have had an erection that lasted more than 4 hours (priapism). If it's not treated in time, it can lead to permanent damage to your penis. Tell your prescriber about your medical conditions.

Importance of access to harm reduction resources

You're at higher risk of priapism if you have other conditions affecting your penis. The risk might also be higher if you have sickle cell anemia, multiple myeloma, or leukemia. If you have an erection that lasts longer than 4 hours or a painful erection, get medical help right away. If you suddenly notice changes in your vision in one or both of your eyes, go to the emergency room or call your prescriber right away. Although this is rare, sildenafil (Viagra) might raise the risk of eye damage. Brain Imaging Behav 2017;11(3):640-648. Tau aggregation inhibitor therapy: an exploratory phase 2 study in mild or moderate Alzheimer's disease. Complex disposition of methylthioninium redox forms determines efficacy in tau aggregation inhibitor therapy for Alzheimer's disease. Methylene blue treatment for residual symptoms of bipolar disorder: randomised crossover study. A Prospective, Randomized, Controlled Trial of Methylene Blue Injection for Costal Cartilage Harvest Postoperative Analgesia. Soliman M, Salah M, Fadel M, Nasr M, El-Azab H. Contrasting the efficacy of pulsed dye laser and photodynamic methylene blue nanoemulgel therapy in treating acne vulgaris. Antimicrobial Photodynamic Therapy in Onychomycosis Management: A Systematic Review of Clinical Trials. Naylor GJ, Martin B, Hopwood SE, Watson Y. A two-year double-blind crossover trial of the prophylactic effect of methylene blue in manic-depressive psychosis. Effects of post-session administration of methylene blue on fear extinction and contextual memory in adults with claustrophobia. Jia W, Li Q, Ni J, Zhang Y, Wu L, Xu L. Efficacy and safety of methylene blue injection for intractable idiopathic pruritus ani: a single-arm metaanalysis and systematic review.

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Porat R, Gilbert S, Magilner D. Methylene blue-induced phototoxicity: an unrecognized complication. Honoré PJ, Deianova N, Loret G, Hemelsoet D. An easily overlooked cause of toxic encephalopathy: methylene blue in a patient on an SSRI. Methylene blue-induced methemoglobinemia during cardiopulmonary bypass? Xue H, Thaivalappil A, Cao K.

Side Effect Common Symptoms Frequency Severity
Drowsiness Sleepiness, fatigue Common Mild
Allergic Reactions Rash, swelling Rare Moderate to Severe
Liver Damage Yellowing skin, pain Rare Severe
Nausea and Vomiting Upset stomach Common Mild

The Potentials of Methylene Blue as an Anti-Aging Drug. The effect of local infiltration of methylene blue on posthemorrhoidectomy pain: A systematic review and meta-analysis. Molecular Mechanisms of the Neuroprotective Effect of Methylene Blue.

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Allergy-like reactions to methylene blue following laparoscopic chromopertubation: A systematic review of the literature. Aldeghaither S, Deschênes PJF, Samoukovic G. Anticholinergic Toxidrome as a Possible Explanation for Methylene Blue Toxicity. Kirlangitis JJ, Middaugh RE, Zablocki A, Rodriquez F. False indication of arterial oxygen desaturation and methemoglobinemia super p force 160mg following injection of methylene blue in urological surgery.