What the FDA labels say about taking them together
Methylene blue and sertraline
Sertraline's FDA label of August 8, 2023 names methylene blue in its contraindications section; methylene blue's label does not name sertraline itself but warns about its class (serotonin reuptake inhibitors). The sertraline label: “The concomitant use of SSRIs including ZOLOFT and MAOIs increases the risk of serotonin syndrome.”
Check it at the source: the methylene blue FDA label on DailyMed (effective May 28, 2025, American Regent, Inc.); the sertraline FDA label on DailyMed (effective August 8, 2023, Viatris Specialty LLC).
What does the methylene blue label say about sertraline?
Methylene blue's label does not name sertraline 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
What does the sertraline label say about methylene blue?
Sertraline label, contraindicationsCONTRAINDICATIONS ZOLOFT is contraindicated in patients: Taking, or within 14 days of stopping, MAOIs, (including the MAOIs linezolid and intravenous methylene blue) because of an increased risk of serotonin syndrome [See Warnings and Precautions (5.2), Drug Interactions (7.1) ].
Sertraline label, drug interactionsMonoamine Oxidase Inhibitors (MAOIs) Clinical Impact: The concomitant use of SSRIs including ZOLOFT and MAOIs increases the risk of serotonin syndrome. Intervention: ZOLOFT is contraindicated in patients taking MAOIs, including MAOIs such as linezolid or intravenous methylene blue [See,, ]. Examples: selegiline, tranylcypromine, isocarboxazid, phenelzine, linezolid, methylene blue
Sertraline label, warnings and precautionsIf it is necessary to initiate treatment with an MAOI such as linezolid or intravenous methylene blue in a patient taking ZOLOFT, discontinue ZOLOFT before initiating treatment with the MAOI [See Contraindications (4), Drug Interactions (7.1) ].
Sertraline Hcl label (Almatica Pharma LLC, August 24, 2023), drug interactionsMonoamine Oxidase Inhibitors (MAOIs) Clinical Impact: The concomitant use of SSRIs, including Sertraline HCl Capsules, and MAOIs increases the risk of serotonin syndrome. Intervention: Sertraline HCl Capsules is 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 (Sertraline Hcl, NDA215133), Almatica Pharma LLC, effective August 24, 2023 (SPL set 8c8bcba9-eaeb-aa44-f9ea-b580de55a439), via openFDA
Source: FDA drug label (Zoloft), Viatris Specialty LLC, effective August 8, 2023 (SPL set fda754f6-d0f3-4dce-a17a-927d64f912f7), 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
| Methylene blue | Sertraline | |
|---|---|---|
| Labeled for | n/a | Depression, Anxiety |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | n/a | $0.0507 per tablet 100 mg tablet |
| 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