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Yes. Pharmaceutical-grade methylene blue at therapeutic doses requires a valid prescription from a licensed provider.
Urine and stool discoloration (blue-green) is expected and harmless. Nausea and headache are possible at higher doses. Serotonin syndrome is a rare risk at high doses.
Contraindicated in patients with G6PD deficiency and not recommended with serotonergic medications due to the risk of serotonin syndrome. Avoid if pregnant or breastfeeding.
Serious interactions with SSRIs, SNRIs, MAOIs, and other serotonergic agents. Full psychiatric medication review is required before starting.
Patients with G6PD deficiency, renal impairment, or psychiatric conditions on serotonergic drugs require careful evaluation before use.
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