What the FDA labels say about taking them together
Clomipramine and methylene blue
Clomipramine's FDA label of November 26, 2024 names methylene blue in its contraindications section, and methylene blue's label names clomipramine too. The clomipramine label: “Starting clomipramine hydrochloride capsules in a patient who is being treated with linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome.”
Check it at the source: the clomipramine FDA label on DailyMed (effective November 26, 2024); the methylene blue FDA label on DailyMed (effective May 28, 2025, American Regent, Inc.).
What does the clomipramine label say about methylene blue?
Clomipramine label, contraindicationsStarting clomipramine hydrochloride capsules in a patient who is being treated with linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome ( see WARNINGS and DOSAGE AND ADMINISTRATION ).
Clomipramine label, warningsSerotonin Syndrome The development of a potentially life-threatening serotonin syndrome has been reported with SNRIs and SSRIs, including clomipramine hydrochloride capsules, alone but particularly with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John's Wort) and with drugs that impair metabolism of serotonin (in particular, MAOIs, both those intended to treat psychiatric disorders and also others, such as linezolid and intravenous methylene blue).
Source: FDA drug label (CLOMIPRAMINE HYDROCHLORIDE), SpecGx LLC, effective November 26, 2024 (SPL set d7cee3fa-d05c-4702-8f75-f446627bdb49), via openFDA; the full label on DailyMed
What does the methylene blue label say about clomipramine?
Methylene blue label, drug interactionsAvoid concomitant use of PROVAYBLUE with medicinal products that enhance serotonergic transmission including antidepressants like SSRIs (selective serotonin reuptake inhibitors), SNRIs (serotonin and norepinephrine reuptake inhibitors), MAOIs (monoamine oxidase inhibitors), bupropion, buspirone, clomipramine, mirtazapine, linezolid, opioids, and dextromethorphan because of the potential for serious CNS reactions, including potentially fatal serotonin syndrome.
Source: FDA drug label (PROVAYBLUE), NDA204630 (Provepharm Sas), as published by American Regent, Inc., effective May 28, 2025 (SPL set 4f6848e5-35ed-4046-b13c-3032b5ba3232), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Clomipramine | Methylene blue | |
|---|---|---|
| Labeled for | n/a | n/a |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.189 per capsule 25 mg capsule | n/a |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once