What are the treatment options for methemoglobinemia?

Updated: Dec 09, 2018
  • Author: Mary Denshaw-Burke, MD, FACP; Chief Editor: Emmanuel C Besa, MD  more...
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Treatment modalities include the following:

  • Methylene blue – This is the primary emergency treatment for documented symptomatic methemoglobinemia (contraindicated in G6PD deficiency and ineffective with hemoglobin M)

  • Exchange transfusion - This can be considered for patients who do not respond to methylene blue or G6PD-deficient individuals who are severely symptomatic

  • Hyperbaric oxygen treatment – This is another option when methylene blue therapy is ineffective or contraindicated

  • IV hydration and bicarbonate (for metabolic acidosis)

  • Other medications – These include ascorbic acid, riboflavin, cimetidine, and N-acetylcysteine

  • Dietary measures – Avoidance of precipitants in food or drink

See Treatment and Medication for more detail.

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