Methylene blue, linezolid: serious interactions with psych meds
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Methylene blue, linezolid: serious interactions with psych meds The US FDA has issued drug safety communications for methylene blue [methylthioninium chloride] and linezolid [Zyvox], warning of the risks of serious CNS reactions that may result from giving either of these medications to patients who are currently taking psychiatric medications with serotonergic activity.1,2 Both methylene blue and linezolid exhibit monoamine oxidase inhibitor (MAOI) properties. When these agents are given to patients taking serotonergic psychiatric medications, high levels of serotonin can build up in the brain, resulting in toxicity known as serotonin syndrome. A number of cases of CNS toxicity have been reported to the FDA, including some fatal cases in patients receiving linezolid. The FDA is advising that, in emergency situations requiring urgent treatment with methylene blue or linezolid, psychiatric treatment should be immediately stopped and patients should be monitored for symptoms of CNS toxicity for 2–5 weeks thereafter, depending on the half-life of their serotonergic medication. In non-emergency situations, the patients’ serotonergic psychiatric medications should be stopped at least 2–5 weeks prior to taking methylene blue or linezolid. Serotonergic psychiatric treatment should not be resumed until at least 24 hours after the last dose of methylene blue or linezolid. Additional safety information regarding these potential drug interactions is being added to the drug labels of methylene blue, linezolid and serotonergic psychiatric medications. 1. FDA. FDA Drug Safety Communication: Serious CNS reactions possible when methylene blue is given to patients taking certain psychiatric medications. Internet Document : [3 pages], 26 Jul 2011. Available from: URL: http:// www.fda.gov. 2. FDA. FDA Drug Safety Communication: Serious CNS reactions possible when linezolid (Zyvox) is given to patients taking certain psychiatric medications. Internet Document : [2 pages], 26 Jul 2011. Available from: URL: http:// www.fda.gov. 801161074
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Reactions 6 Aug 2011 No. 1363
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