What the FDA labels say about taking them together
Escitalopram and methylene blue
Escitalopram's FDA label of October 1, 2023 names methylene blue in its contraindications section; methylene blue's label does not name escitalopram itself but warns about its class (serotonin reuptake inhibitors). The escitalopram label: “Concomitant use of SSRIs, including Lexapro, and MAOIs increases the risk of serotonin syndrome.”
Check it at the source: the escitalopram FDA label on DailyMed (effective October 1, 2023, Allergan, Inc.); the methylene blue FDA label on DailyMed (effective May 28, 2025, American Regent, Inc.).
What does the escitalopram label say about methylene blue?
Escitalopram label, contraindicationsStarting Lexapro in a patient who is being treated with MAOIs such as linezolid or intravenous methylene blue is also contraindicated because of an increased risk of serotonin syndrome [ see Dosage and Administration ( 2.6 ) and Warnings and Precautions ( 5.2 ) ]. taking pimozide [see Drug Interactions ( 7 ) ]. with a hypersensitivity to escitalopram or citalopram or any of the inactive ingredients in Lexapro.
Escitalopram label, drug interactionsMonoamine Oxidase Inhibitors (MAOIs) Clinical Impact: Concomitant use of SSRIs, including Lexapro, and MAOIs increases the risk of serotonin syndrome. Intervention: Lexapro is contraindicated in patients taking MAOIs, including MAOIs such as linezolid or intravenous methylene blue [see Dosage and Administration (), Contraindications (), and Warnings and Precautions ()].
Escitalopram label, warnings and precautionsIf it is necessary to initiate treatment with an MAOI such as linezolid or intravenous methylene blue in a patient taking Lexapro, discontinue Lexapro before initiating treatment with the MAOI [see Contraindications ( 4 ) and Dosage and Administration ( 2.7 )].
Escitalopram label (Almatica Pharma LLC, August 31, 2025), contraindicationsCONTRAINDICATIONS Escitalopram Capsules are contraindicated in patients: Taking, or within 14 days of stopping, MAOIs, including linezolid or intravenous methylene blue, because of an increased risk of serotonin syndrome [see Dosage and Administration ( 2.6 ), Warnings and Precautions ( 5.2 ), Drug Interactions ( 7 )].
Escitalopram label (Almatica Pharma LLC, August 31, 2025), drug interactionsPrevention or Management; Escitalopram Capsules are contraindicated in patients taking MAOIs, including MAOIs such as linezolid or intravenous methylene blue [see Dosage and Administration (), Contraindications (), Warnings and Precautions ()].
Source: FDA drug label (Escitalopram, NDA219130), Almatica Pharma LLC, effective August 31, 2025 (SPL set c0401570-a3b0-bef2-7365-c23dc952b8b6), via openFDA
Source: FDA drug label (Lexapro), NDA021323 (Abbvie), as published by Allergan, Inc., effective October 1, 2023 (SPL set 13bb8267-1cab-43e5-acae-55a4d957630a), via openFDA; the full label on DailyMed
What does the methylene blue label say about escitalopram?
Methylene blue's label does not name escitalopram itself; it warns about its class (serotonin reuptake inhibitors):
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.
Methylene blue label, boxed warningAvoid concomitant use of PROVAYBLUE with selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs) and opioids. [see Warnings and Precautions ( 5.1 ) and Drug Interactions ( 7.1 )].
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
| Escitalopram | Methylene blue | |
|---|---|---|
| Labeled for | Depression, Anxiety | n/a |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.0632 per tablet 20 mg tablet | 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