The protocol at a glance
The US label dose is 1 mg per kg given into a vein over 5 to 30 minutes. A second dose of up to 1 mg per kg can follow one hour later if needed.
| Use | Amount |
|---|---|
| US label, IV | 1 mg/kg over 5 to 30 minutes |
| Repeat dose | Up to 1 mg/kg one hour later if blood levels stay above 30% or symptoms continue |
| Moderate or severe kidney problems | One 1 mg/kg dose only |
| Not allowed | Do not give under the skin |
| Oral low-dose for aging | Not established |
From the Provayblue US prescribing information (openFDA, label effective May 2025). The label covers IV use for methemoglobinemia only.
Community posts often take 5 to 20 mg by mouth daily for energy or focus. This is community talk, not a labeled use.
What people say they do, collected from community discussions. Not tested in a trial; shown so you can compare it with the evidence above.
Mixing
No mixing table here: this one is used as a capsule, nasal spray or skin product, or has no human amount to calculate from. The general mixing calculator works for any vial.
What the trials found
No human trial shows a longevity benefit. The closest human studies were small:
Alda M et al. Br J Psychiatry 2017 (PubMed 27284082, NCT00214877); Provayblue US label. Another human study used one low oral dose and looked at brain scans only (PubMed 26961091).
Side effects
- Boxed warning: it can cause serious or even fatal serotonin syndrome with SSRIs, SNRIs, MAOIs, and opioids.
- Common effects in label trials: headache, low potassium, diarrhea, low magnesium, muscle twitching, nausea and seizure-like events.
- It can break down red blood cells and can throw off pulse oximeter readings.
How it works
Oxidation-reduction agent
The label calls it an oxidation-reduction agent and uses it for methemoglobinemia, where blood cannot carry oxygen properly.
MAO inhibitor
It also blocks the monoamine oxidase enzyme, which is why it clashes with antidepressants.
Sources
- Provayblue (methylene blue) US prescribing information via openFDA, effective 28 May 2025
- Alda M et al. Methylene blue treatment for residual symptoms of bipolar disorder. Br J Psychiatry 2017, NCT00214877
- Methylene blue modulates functional connectivity in the human brain. Brain Imaging Behav 2017 (PubMed 26961091)