Methylthioninium chloride


Generic Medicine Info
Contraindications
Hypersensitivity to methylthioninium chloride or other thiazine dyes. G6PD deficiency, NADPH reductase deficiency, nitrite-induced methaemoglobinaemia during treatment of cyanide poisoning, chlorate-induced methaemoglobinaemia. Pregnancy and lactation.
Special Precautions
Patients with hyperglycaemia or diabetes mellitus. Not intended to be administered via SC or intraspinal inj. Hepatic and renal impairment. Children; newborn and infants (<3 months). Patient Counselling This drug may cause dizziness, confusion, or visual disturbances, if affected, do not drive or operate machinery. Monitoring Parameters Monitor arterial blood gases, CBC, methaemoglobin levels (via co-oximeter), transcutaneous oxygen saturation, renal function, ECG, blood pressure.
Adverse Reactions
Significant: Hypersensitivity; haemolytic anaemia, methaemoglobinaemia (at high doses or in G6PD deficient patients), CNS depression, cutaneous photosensitivity reaction, skin and body fluid discolouration (blue: skin, blue green: urine, faeces). Cardiac disorders: Chest pain, tachycardia, cardiac arrhythmia. Eye disorders: Mydriasis. Gastrointestinal disorders: Nausea, vomiting, abdominal pain, dysgeusia. General disorders and administration site conditions: Inj site pain or necrosis, fever. Investigations: Hb decreased. Metabolism and nutrition disorders: Hyperbilirubinaemia. Musculoskeletal and connective tissue disorders: Pain in extremity. Nervous system disorders: Dizziness, headache, paraesthesia, tremor. Psychiatric disorders: Anxiety, confusional state, agitation, aphasia. Respiratory, thoracic and mediastinal disorders: Dyspnoea, tachypnoea. Skin and subcutaneous tissue disorders: Hyperhidrosis. Vascular disorders: Hypertension, hypotension.
Potentially Fatal: Serotonin syndrome (in combination with serotonergic drugs).
Drug Interactions
May increase plasma concentrations of sensitive CYP1A2, CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6 and CYP3A4 substrates. May transiently increase exposure of cimetidine, metformin, aciclovir.
ATC Classification
V03AB17 - methylthioninium chloride ; Belongs to the class of antidotes. Used in the management of prilocaine overdose.
V04CG05 - methylthioninium chloride ; Belongs to the class of diagnostic agents used to determine gastric secretion.
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