{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:03:33Z","timestamp":1792429413564,"version":"4.5.0"},"reference-count":102,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,8,30]],"date-time":"2022-08-30T00:00:00Z","timestamp":1661817600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>A narrative review of the literature was conducted to determine if the administration of methylene blue (MB) in humans has potential risks. Studies were identified from MEDLINE, Web of Science, Scopus, and Cochrane. MB is a diagnostic substance used during some diagnostic procedures and also a part of the treatment of several diseases including methemoglobinemia, vasoplegic syndrome, fosfamide-induced encephalopathy, and cyanide intoxication, and the detection of leaks or position of parathyroid corpuscles during surgery. Although the use of MB is historically justified, and it ought to be safe, because it originated as a diagnostic material, the basic toxicological characteristics of this substance are unknown. Despite reports of severe adverse effects of MB, which could significantly exceed any possible benefits evaluated for the given indication. Therefore, the clinical use of MB currently represents a controversial problem given the heterogeneity of available data and the lack of preclinical data. This is in conflict with standards of safe use of such substances in human medicinal practice. The toxic effects of the application of MB are dose-dependent and include serious symptoms such as hemolysis, methemoglobinemia, nausea and vomitus, chest pain, dyspnoea, and hypertension. Some countries regard MB as harmful because of the resulting skin irritation and triggering of an adverse inflammatory response. MB induced serotoninergic toxicity clinically manifests as neuromuscular hyperactivity. This review aims to summarize the current understanding concerning the indications for MB administration and define the potential adverse effects of MB.<\/jats:p>","DOI":"10.1093\/toxres\/tfac050","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T09:36:43Z","timestamp":1661333803000},"page":"711-717","source":"Crossref","is-referenced-by-count":70,"title":["Methylene blue: a controversial diagnostic acid and medication?"],"prefix":"10.1093","volume":"11","author":[{"given":"Marek","family":"Bu\u017ega","sequence":"first","affiliation":[{"name":"Institute of Laboratory Medicine, University Hospital Ostrava , Ostrava 17. listopadu 1790, OStrava, 70800 , Czech Republic"},{"name":"Department of Physiology and Pathophysiology , Faculty of Medicine, , Ostrava Syllabova 19, Ostrava Vitkovice, 70030 , Czech Republic"},{"name":"University of Ostrava , Faculty of Medicine, , Ostrava Syllabova 19, Ostrava Vitkovice, 70030 , Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ev\u017een","family":"Machytka","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Experimental Medicine, Hepatogastroenterology Department , Prague Vide\u0148ska 1958\/9, Praha, 14021 , Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli\u0161ka","family":"Dvo\u0159\u00e1\u010dkov\u00e1","sequence":"additional","affiliation":[{"name":"Institute of Pharmacology , 1st Faculty of Medicine, , Prague Albertov 4, Praha, 12108 , Czech Republic"},{"name":"Charles University , 1st Faculty of Medicine, , Prague Albertov 4, Praha, 12108 , Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zden\u011bk","family":"\u0160vagera","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine, University Hospital Ostrava , Ostrava 17. listopadu 1790, OStrava, 70800 , Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Stejskal","sequence":"additional","affiliation":[{"name":"Institute of Laboratory Medicine, University Hospital Ostrava , Ostrava 17. listopadu 1790, OStrava, 70800 , Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"M\u00e1ca","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pathophysiology , Faculty of Medicine, , Ostrava Syllabova 19, Ostrava Vitkovice, 70030 , Czech Republic"},{"name":"University of Ostrava , Faculty of Medicine, , Ostrava Syllabova 19, Ostrava Vitkovice, 70030 , Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Kr\u00e1l","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Experimental Medicine, Hepatogastroenterology Department , Prague Vide\u0148ska 1958\/9, Praha, 14021 , Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,8,30]]},"reference":[{"issue":"1","key":"2022110110351410100_ref1","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1196\/annals.1403.016","article-title":"Neuro- and cardioprotective effects of blockade of nitric oxide action by administration of methylene blue","volume":"1122","author":"Wiklund","year":"2007","journal-title":"Ann N Y Acad Sci"},{"issue":"4","key":"2022110110351410100_ref2","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1002\/jps.2600610422","article-title":"Pharmacokinetics of highly ionized drugs. 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