Amoxapine and Methylene blue interaction

Amoxapine and Methylene blue: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Methylene blue (PROVAYBLUE) label · effective 2025-05-28

Major

WARNING: SEROTONIN SYNDROME WITH CONCOMITANT USE OF SEROTONERGIC DRUGS AND OPIOIDS PROVAYBLUE may cause serious or fatal serotonergic syndrome when used in combination with serotonergic drugs and opioids.

Boxed warningby drug classView label on DailyMed
Major

WARNING: SEROTONIN SYNDROME WITH CONCOMITANT USE OF SEROTONERGIC DRUGS AND OPIOIDS See full prescribing information for complete boxed warning.

Boxed warningby drug classView label on DailyMed
Major

PROVAYBLUE may cause serious or fatal serotonergic syndrome when used in combination with serotonergic drugs and opioids.

Boxed warningby drug classView label on DailyMed
Major

Serotonin Syndrome with Concomitant Use of Serotonergic Drugs and Opioids The development of serotonin syndrome has been reported with the use of methylene blue class products.

Warnings and precautionsby drug classView label on DailyMed
Major

Avoid concomitant use of PROVAYBLUE with serotonergic drugs and opioids.

Warnings and precautionsby drug classView label on DailyMed

From the Amoxapine label · effective 2024-10-16

Major

It should not be given concomitantly with monoamine oxidase inhibitors.

Contraindicationsby drug classView label on DailyMed
Major

Hyperpyretic crises, severe convulsions, and deaths have occurred in patients receiving tricyclic antidepressants and monoamine oxidase inhibitors simultaneously.

Contraindicationsby drug classView label on DailyMed
Major

When it is desired to replace a monoamine oxidase inhibitor with amoxapine, a minimum of 14 days should be allowed to elapse after the former is discontinued.

Contraindicationsby drug classView label on DailyMed
Minor

Drug Interactions See CONTRAINDICATIONS about concurrent usage of tricyclic antidepressants and monoamine oxidase inhibitors.

Drug interactionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.