What the FDA labels say about taking them together
Fluvoxamine and methylene blue
Fluvoxamine's FDA label of June 27, 2026 names methylene blue in its contraindications section; methylene blue's label does not name fluvoxamine itself but warns about its class (serotonin reuptake inhibitors). The fluvoxamine label: “Starting Fluvoxamine Maleate Tablets 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. …”
Check it at the source: the fluvoxamine FDA label on DailyMed (effective June 27, 2026, Zydus Pharmaceuticals USA Inc.); the methylene blue FDA label on DailyMed (effective May 28, 2025, American Regent, Inc.).
What does the fluvoxamine label say about methylene blue?
Fluvoxamine label, contraindicationsStarting fluvoxamine maleate extended-release capsules 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 ] ).
Fluvoxamine label, warnings and precautionsThe development of a potentially life-threatening serotonin syndrome has been reported with SNRIs and SSRIs, including fluvoxamine maleate extended-release capsules, alone but particularly with concomitant use of serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, meperidine, methadone, lithium, tramadol, tryptophan, buspirone, amphetamines 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).
Fluvoxamine Maleate label (ANI Pharmaceuticals, Inc., August 4, 2025), contraindicationsStarting Fluvoxamine Maleate Tablets 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 ( 2.5 ), Warnings and Precautions ( 5.2 )]. Coadministration of tizanidine, thioridazine, alosteron, pimozide
Fluvoxamine Maleate label (ANI Pharmaceuticals, Inc., August 4, 2025), warnings and precautionsIf it is necessary to initiate treatment with an MAOI such as linezolid or intravenous methylene blue in a patient taking Fluvoxamine Maleate Tablets, discontinue Fluvoxamine Maleate Tablets before initiating treatment with the MAOI [see Contraindications ( 4 ), Drug Interactions ( 7.2 )].
Source: FDA drug label (Fluvoxamine Maleate, NDA021519), ANI Pharmaceuticals, Inc., effective August 4, 2025 (SPL set 7ecd83ec-88f5-4f85-9cc2-9068375d8820), via openFDA
Source: FDA drug label (Fluvoxamine maleate extended-release), Zydus Pharmaceuticals USA Inc., effective June 27, 2026 (SPL set 6c71d4f6-54b5-4d3a-8d2f-b7773c92c32e), via openFDA; the full label on DailyMed
What does the methylene blue label say about fluvoxamine?
Methylene blue's label does not name fluvoxamine 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
| Fluvoxamine | Methylene blue | |
|---|---|---|
| Labeled for | n/a | n/a |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $4.08 per capsule 100 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
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