Methylene blue

Methylene blue, also known as methylthioninium chloride, is a chemical that is commonly used in medical practice as an antiseptic. Here is a brief characterization of this substance:

1. Antiseptic action: Methylene blue has antiseptic property, which means it can kill germs and prevent the development of infection on the skin and mucous membranes. Because of this, it can be used to treat wounds, burns, and other superficial infections.
2. Use in microscopy: Methylene blue is also widely used in biological and medical laboratories as a dye for staining cells and tissues in the preparation of preparations for microscopic examination.
3. Safety: Methylene blue is generally considered safe when used properly. However, it may cause irritation or burns if it comes in contact with skin, mucous membranes or eyes. It is therefore important to observe precautions when using it.
4. Other uses: Methylene blue is also used in textiles, food processing and in chemical laboratories for various purposes.

This is only a brief characterization of methylene blue, and its use may vary depending on the specific purposes of use and doctor's recommendations.

Indications Methylene blue

1. Antiseptic treatment: Methylene blue can be used as an antiseptic for the treatment of wounds, burns, cuts and other superficial injuries
2. Antidote to poisoning: Methylene blue can be used as an antidote for poisoning by cyanide or other poisonous substances. It helps to bind and neutralize toxins, promoting the formation of methemoglobin and thereby alleviating poisoning.
3. Microscopic applications: In biological and medical laboratories, methylene blue is used as a dye to stain cells and tissues in the preparation of preparations for microscopic examination.
4. Other indications: Methylene blue may be used in various other instances as recommended by a physician, such as for the treatment of methamphetamine intoxication or in tissue staining procedures.

Release form

Forms of release of Methylene blue:

1. Solution for injection: Methylene blue in the form of a solution for injection is used clinically, especially for the treatment of methemoglobinemia and as an antidote for poisoning by certain chemicals.
2. Oral tablets: This form is used to treat urologic disorders, including cystitis, and may be used to treat methemoglobinemia in conditions where injections are impractical.
3. Solutionfor topical application: Methylene blue in the form of a solution can be used to treat wounds and skin lesions as an antiseptic.
4. Bladder Wash Solution: Used in urology to diagnose and treat certain conditions of the urinary tract.

Applications:

• Methemoglobinemia: A solution for injection is used to reduce the level of methemoglobin in the blood.
• Cystitis and other urologic disorders: Tablets and topical solutions are used to treat and relieve symptoms.
• Antiseptic: A solution for topical application can be used for wound care.

Pharmacodynamics

1. Antimicrobial action:

   • Methylene blue has a broad spectrum of antimicrobial activity, including bacteria, fungi and viruses. It can be used to treat a variety of infections such as purulent wounds, burns, ulcers, as well as for urinary tract disinfection and intraoperative prophylaxis.

2. Antiseptic action:

   • Methylene blue can kill microorganisms and prevent their growth, making it useful as an antiseptic in the treatment of wounds and burns.

3. Antioxidant action:

   • Methylene blue exhibits antioxidant properties and can help fight oxidative stress and free radicals in the body.

4. Activity against methemoglobin:

   • In low concentrations, methylene blue can restore methemoglobin to normal hemoglobin, making it effective in the treatment of methemoglobinemia.

5. Antiparasitic action:

   • In some cases, methylene blue can be used to treat parasitic infections such as malaria.

6. Anti-allergic action:

   • Some studies have shown that methylene blue may have anti-allergic properties and help in reducing the symptoms of allergic reactions.

7. Applications in oncology:

   • Methylene blue is sometimes used as an aid in the diagnosis and treatment of certain cancers.

Pharmacokinetics

1. Absorption: After topical application, methylene blue may be absorbed from mucous membranes or skin.
2. Distribution: It is distributed in the body, penetrating into various tissues and organs, including the skin, mucous membranes and in some cases the blood.
3. Metabolism: Methylene blue is not normally metabolized in the body.
4. Excretion: It is excreted mainly through the kidneys in unchanged form.
5. Half-life: The half-life of methylene blue in the body is relatively short, which may mean that its effects disappear quickly after discontinuation of use.
6. Mechanism of Action: The mechanism of action of methylene blue is related to its ability to stain proteins and tissues, as well as its antiseptic and antibacterial action.

Dosing and administration

Solution for injection

• Methemoglobinemia: For adults and children the standard dose is 1-2 mg per kg body weight administered intravenously slowly over 5-10 minutes. The maximum dose should not exceed 7 mg per kg body weight. It is possible to repeat the dose after 30-60 minutes if symptoms persist.

Oral tablets

• Cystitis and other urological disorders: The dosage for adults is usually 100 mg to 200 mg (1-2 tablets) taken 3-4 times a day. For children, the drug and dosage are prescribed by a doctor individually.

Solution for topical application

• Wound treatment and antiseptic: The solution is applied directly to affected skin areas or used as a wash.

Bladder flushing solution

• Use and dosage should be determined by a physician depending on the specific condition and procedure.

Important points:

• When administered intravenously, it is important to avoid rapid infusion due to the risk of arterial hypotension.
• Methylene blue can stain the skin, urine and stool blue or green, which is a harmless and temporary effect.
• When taken orally, methylene blue should be taken during or after meals to minimize gastrointestinal irritation.
• Caution should be used with methylene blue in patients with hepatic or renal dysfunction and in certain genetic conditions, such as G6PD deficiency, because of the risk of hemolytic anemia.

Use Methylene blue during pregnancy

Methylene blue is sometimes used in medical practice to treat various conditions such as methemoglobinemia (elevated levels of methemoglobin in the blood) and is used as an antiseptic.

However, it is important to note that the safety of using methylene blue during pregnancy is not fully understood. There is insufficient data on its safety in pregnant women and its use during pregnancy is generally limited.

If you have a need to use methylene blue during pregnancy, be sure to discuss it with your doctor. Your doctor will be able to assess the potential risks and benefits of the drug in your particular case and make an informed decision about its use.

Contraindications

1. Hypersensitivity: Patients with known hypersensitivity to methylene blue or any other ingredients of the product should not use it because of the risk of allergic reactions.
2. Methemoglobinemia: The use of methylene blue may lead to the development of methemoglobinemia, a serious condition in which hemoglobin is converted to methemoglobin, which may result in decreased oxygen-carrying function of the blood. Patients with hemoglobination disorders or diagnosed with methemoglobinemia should avoid the use of methylene blue.
3. Hemolytic Anemia: The use of methylene blue can also be dangerous in patients with hemolytic anemia, a condition in which red blood cells are destroyed faster than their normal renewal rate.
4. Diabetes mellitus: Patients with diabetes should use methylene blue with caution as it may interact with some medications and medical procedures used to manage blood glucose levels.
5. Pregnancy and breastfeeding: Data on the safety of methylene blue during pregnancy and breastfeeding are limited, therefore its use during this period should be cautious and based on the doctor's recommendations.
6. Children: Methylene blue is not recommended for use in children without medical advice.

Side effects Methylene blue

1. Skin irritation: Methylene blue may cause irritation or an allergic reaction in the form of redness, itching or rashes on contact with the skin.
2. Site Reactions: When used as an antiseptic, methylene blue may cause irritation or burning at the site of application, especially in open wounds or skin lesions.
3. Systemic effects: In some cases, methylene blue may cause systemic side effects such as nausea, vomiting, headache, dizziness, increased heart rate, and changes in blood pressure.
4. Pigmentation of skin and mucous membranes: Prolonged use of methylene blue or its penetration into the deep layers of the skin may cause discoloration and pigmentation.
5. Weakness and fatigue: Some patients may experience weakness, fatigue, or general malaise when using methylene blue.
6. Allergic reactions: In rare cases, serious allergic reactions such as anaphylactic shock, urticaria or Quincke's edema may occur.

Overdose

There is limited information on methylene blue (methylthioninium chloride) overdose, but various undesirable effects may occur if consumed in excessive amounts or if this substance is misused. In case of methylene blue overdose, the following symptoms may occur:

1. Methemoglobinemia: One of the most serious complications of methylene blue overdose is the development of methemoglobinemia, a condition in which normal tissue oxygenation is impaired due to elevated levels of methemoglobin in the blood. This can lead to oxygen deprivation and serious complications such as dizziness, weakness, fatigue, shortness of breath, seizures, cardiac arrhythmias, and even loss of consciousness.
2. Toxic effects on organs: Toxic effects on various organs and systems such as liver, kidneys, nervous system and respiratory system may also be observed in methylene blue overdose.
3. Other unwanted effects: Other possible effects of methylene blue overdose include nausea, vomiting, diarrhea, headache, dizziness, seizures, and decreased blood pressure.

Interactions with other drugs

1. Drugs that increase aminoglycoside toxicity: Methylene blue may increase the toxicity of aminoglycoside antibiotics such as gentamicin or amikacin. This is due to its antibacterial properties and its ability to alter cell membrane permeability. When coadministered, caution should be exercised and blood levels of aminoglycosides should be monitored.
2. Drugs affecting the central nervous system (CNS): The central effects of methylene blue may be enhanced when co-administered with other drugs affecting the central nervous system, such as sedatives, antidepressants, or alcohol.
3. Drugsaffecting urine acidity: Methylene blue can change the pH of the urine. Therefore, drugs that affect urine acidity, such as ascorbic acid, may affect the rate at which methylene blue is eliminated from the body.
4. Drugs affecting bleeding: Methylene blue may increase bleeding when co-administered with anticoagulants such as warfarin.
5. Drugs affecting the gastrointestinal tract: Methylene blue may increase or decrease the effects of other drugs affecting the gastrointestinal tract, such as probiotics or antacids.
6. Drugs that increase photosensitivity: Methylene blue may increase photosensitivity of the skin. Therefore, it should be used with caution in combination with other drugs that increase the risk of sunburn or photosensitivity.