From the Guidelines
Methylene blue is not recommended for general wellness use due to lack of sufficient safety and efficacy data. The available evidence focuses on its use in treating methemoglobinemia, where the usual starting dose is 1–2 mg/kg (0.2 mL/kg of a 1% solution) infused intravenously over 3 to 5 minutes, as stated in the 2021 study published in the American Journal of Hematology 1. This dosing is specific to therapeutic use in a medical setting and not applicable to wellness purposes.
Key Considerations
- The study highlights the risk of worsening methemoglobinemia with repeated doses, with toxic levels of methylene blue reached at a total dose > 7 mg/kg 1.
- There is a potential for a rebound phenomenon of increased MetHb levels after completion of therapy, which may necessitate urgent exchange transfusion in severe cases 1.
- For patients requiring ongoing treatment due to continued production of MetHb, repeat dosing every 6–8 hours for up to 2–3 days or a continuous IV infusion of 0.10–0.25 mg/kg/hr may be considered, but this is in the context of medical treatment, not wellness 1.
Safety and Efficacy
Given the lack of data on its safety and efficacy for wellness, and considering the potential risks associated with its use, such as interactions with medications like SSRIs and MAOIs, and side effects like blue discoloration of urine and skin, consultation with a healthcare professional is strongly advised before considering methylene blue for any purpose. The compound's effects as a mitochondrial enhancer and antioxidant in healthy individuals are not well-studied, further emphasizing the need for caution and professional guidance.
From the FDA Drug Label
PACKAGE LABEL.PRINCIPAL DISPLAY PANEL NDC 70771-1768-1 Methylene Blue Injection, USP 50 mg/10 mL (5 mg/mL) Intravenous use only Single-Dose vial Rx only NDC 70771-1768-5 Methylene Blue Injection, USP 50 mg/10 mL (5 mg/mL) Intravenous use only 5 X 10 mL Single-Dose Vial Rx only NDC 70771-1767-1 Methylene Blue Injection, USP 10 mg/2 mL (5 mg/mL) Intravenous use only Single-Dose vial Rx only NDC 70771-1767-5 Methylene Blue Injection, USP 10 mg/2 mL (5 mg/mL) Intravenous use only 5 X 2 mL Single-Dose Vial Rx only
The FDA drug label does not answer the question.
From the Research
Methylene Blue Dosing for Wellness
There is limited research on the appropriate dosing of methylene blue (methylthioninium chloride) for wellness. However, the available studies provide some insights into the dosing of methylene blue for various medical conditions.
Dosing Regimens
- A study on ifosfamide-induced encephalopathy used a prophylactic oral thiamine 100 mg, once a day, one week prior to admission, and methylene blue 50 mg intravenous every 6 h (for a total of four doses) 2.
- A study on cyanide intoxication used a dose of 20 mg/kg of methylene blue, which was found to be innocuous in rats and corresponded to a dose of about 4 mg/kg in humans 3.
- A study on the use of methylene blue in pediatric and neonate patients found that the maximum dose used was 2 mg/kg, but there was no consensus on the infusion rate and drug administration timing 4.
Toxicity and Side Effects
- A study on the adverse effects of methylene blue in peripheral neurons found that increasing concentrations of methylene blue (0.3-10 μM) were associated with neurotoxicity, particularly at 10 μM 5.
- A study on the use of methylene blue in pediatric and neonate patients found that no severe side effects or death related to the use of the medication were reported 4.