Drug General Information (ID: DDI6WV4PO8)
Drug Name			Buprenorphine		Drug Info		Methylene blue		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Analgesics				Antidotes/Mao Inhibitors
Structure

Mechanism of Buprenorphine-Methylene blue Interaction (Severity Level: Major)
Additive CNS depression effects Click to Show/Hide Mechanism Graph
Drug Name		Buprenorphine				Methylene blue
Mechanism		CNS depression effects				CNS depression effects
Key Mechanism Factor 1
		Factor Name		CNS depression effects
		Factor Description		CNS depressants are drugs that inhibit or suppress brain activity and can reduce mental and physical processes. Excessive CNS depression can lead to decreased heart rate, slow breathing (less than 10 breaths per minute), extreme confusion or loss of memory, nausea and vomiting, poor judgment, blue lips or fingertips, irritability and aggression, and clammy or cold skin.
Mechanism Description		Additive CNS depression effects by the combination of Buprenorphine and Methylene blue

Recommended Action
Management		Narcotic analgesics should generally not be used with MAOIs or other agents that possess MAOI activity (e.g., furazolidone, linezolid, methylene blue, procarbazine). At least 14 days should elapse between discontinuation of MAOI therapy and initiation of treatment with opioids.

References
1	Product Information. Emsam (selegiline). Bristol-Myers Squibb, Princeton, NJ.
2	Product Information. Tylenol with Codeine (acetaminophen-codeine). Janssen Pharmaceuticals, Raritan, NJ.
3	Zornberg GL, Hegarty JD "Adverse interaction between propoxyphene and phenelzine." Am J Psychiatry 150 (1993): 1270-1. [PMID: 8328578]