Refer to the following important safety details for information on intended use, potential side effects and risks, considerations for specific groups, and possible drug interactions linked to the prescription treatments mentioned.
Reporting Side Effects
Riovie encourages users to promptly report any side effects or adverse reactions to a licensed healthcare provider and the pharmacy that dispensed the medication. To report suspected reactions to these medications, contact the FDA at 1-800-FDA-1088 or visit www.fda.gov/medwatch.
For emergencies, call 911 or go to your nearest emergency department.
Advertisements by Riovie
All advertisements from riovie.com are paid for by Riovie and are intended to market Riovie’s services. Some advertisements may feature paid actors or dramatizations. When real Riovie customers or endorsements are included, this will be clearly disclosed. Individual results may vary, and specific outcomes are not guaranteed.
Riovie’s Role
Riovie connects users with licensed healthcare providers for evaluations regarding the suitability of the treatments advertised. It may also assist with prescription coordination through an external pharmacy network.
Riovie acts as a managed services provider and does not offer medical advice, fill prescriptions, or function as a licensed healthcare facility or pharmacy. Instead, it provides technology and administrative support to enable medical consultations and prescription logistics. For further details, see Riovie’s Terms of Service.
Promotional Offers on riovie.com
Occasionally, the website may present promotional pricing or special introductory offers. Pricing may change at any time due to supply or market conditions at the discretion of riovie.com. Introductory or promotional pricing, including “first month” offers, applies only to the plan and product listed at the time of purchase.
Prescriptions and Medications
Prescription drugs require evaluation and approval by a qualified healthcare provider, and issuance is solely at the provider’s discretion. Access to treatment plans and medications is not assured.
Prescriptions issued through Riovie may be filled by licensed pharmacies within its affiliated network.
All prescription medications involve potential risks. Please review all associated safety details and consult your provider for personalized advice.
Compounded Drug Formulations
In certain situations, healthcare providers may prescribe compounded medications, which are custom-prepared by licensed compounding pharmacies based in the U.S. These medications are not FDA-approved for safety or effectiveness but may be used when alternatives are not available or appropriate.
Riovie helps facilitate compounded medication fulfillment via its partner pharmacy network. These formulations are personalized to meet individual patient requirements and may differ from commercial products.
Trademark Notice
Riovie is not affiliated with, sponsored by, or endorsed by the manufacturer of any brand-name medication. Any brand names referenced are the property of their respective owners and are used for identification only.
Contact Information
For any questions about Riovie’s services or advertising content, please reach out to support@riovie.com.
Methylene Blue — Oral Capsule
Important Safety Information Regarding Compounded Methylene Blue
Please be aware that compounded drugs are not FDA-approved and do not undergo clinical studies to evaluate for safety and efficacy. Your healthcare provider may prescribe compounded methylene blue based on your medical consultation.
Methylene blue is a synthetic thiazine dye with a long history of medical use. An FDA-approved injectable formulation exists for the hospital treatment of acquired methemoglobinemia; that is a different product, given at different doses, for a different purpose. The compounded oral capsule offered here is prescribed at a provider’s discretion as part of a wellness plan. It is not a treatment for any disease, it is not a treatment for depression or any other psychiatric or neurological condition, and it is not a substitute for prescribed therapy.
Serotonin syndrome — read this before your first dose. Methylene blue is a potent inhibitor of monoamine oxidase A. Taken together with a medication that raises serotonin, it can cause serotonin syndrome, a reaction that can be life-threatening. Tell your provider about every prescription medication, over-the-counter product and supplement you take, including any you take only occasionally. Medications of concern include, but are not limited to:
- SSRIs and SNRIs, including fluoxetine, sertraline, paroxetine, citalopram, escitalopram, venlafaxine and duloxetine
- Tricyclic antidepressants, MAO inhibitors, bupropion, buspirone, mirtazapine and lithium
- Triptans for migraine, tramadol, meperidine, fentanyl and dextromethorphan
- Linezolid, and the herbal supplement St John’s wort
Seek medical attention immediately if you develop agitation, confusion, hallucinations, a racing or irregular heartbeat, shivering, sweating, fever, muscle twitching or stiffness, loss of coordination, nausea, vomiting or diarrhea.
Do not use methylene blue if:
- You have glucose-6-phosphate dehydrogenase (G6PD) deficiency — methylene blue can cause severe destruction of red blood cells.
- You take any serotonergic medication, unless your provider has specifically reviewed and approved the combination.
- You are pregnant, trying to become pregnant, or breastfeeding.
- You have had an allergic reaction to methylene blue or another thiazine dye.
Inform your healthcare provider if you:
- Have kidney disease — methylene blue is cleared renally and may require dose adjustment or avoidance.
- Have anemia, a history of methemoglobinemia, or any inherited red blood cell disorder.
- Have a history of a psychiatric condition, or take any medication that affects mood, sleep or appetite.
- Are scheduled for surgery or any procedure involving anesthesia.
Serious risks include:
- Serotonin syndrome when combined with serotonergic medications
- Hemolytic anemia in people with G6PD deficiency
- Methemoglobinemia at higher doses, with shortness of breath and a bluish or grey tint to the lips, fingertips or skin
- Serious allergic reactions, including anaphylaxis
Common side effects: blue or blue-green discolouration of the urine, which is expected and harmless, along with blue-tinged stool or saliva, nausea, abdominal discomfort, loose stools, headache, dizziness, and a temporary metallic taste. Staining of the skin, teeth or clothing can occur if a capsule is opened or broken.
Administration: Take one capsule by mouth daily at the dose your physician sets, at about the same time each day. Swallow the capsule whole with water. Do not open, crush or chew it, and do not change your dose or frequency without speaking to your physician.
Monitoring: Your provider may order laboratory work before or during treatment — including screening for G6PD deficiency where appropriate — and will review how you are responding at scheduled check-ins.
Reporting side effects: Contact the FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
