Methylene blue

A synthetic basic dye.

Phase of research

Potential treatment - pre-clinical evidence

How it helps

Antiviral

Drug status

Used to treat other disease

2
Supporting references
0
Contradictory references
13
AI-suggested references
8
Clinical trials

General information

Methylene blue is a synthetic basic dye used e.g. in oncologic surgery. It is used as a drug to convert methaemoglobin to haemoglobin (NCIt).

Methylene blue on DrugBank
Methylene blue on PubChem
Methylene blue on Wikipedia


Synonyms

Methylthioninium chloride; Swiss Blue


Marketed as

METHYLTHIONINIUM CHLORIDE PROVEBLUE; PROVAYBLUE

 

Structure image - Methylene blue

CN(C)C1=CC2=C(C=C1)N=C3C=CC(=[N+](C)C)C=C3S2.[Cl-]


Supporting references

Link Tested on Impact factor Notes Publication date
Methylene blue inhibits replication of SARS-CoV-2 in vitro
Small molecule In vitro
Vero E6 cells; SARS-CoV-2 strain IHUMI-3 4.62

Inhibited SARS-CoV-2 infection in Vero E6 cells with sub-micromolar EC50 and selectivity index of more than 333. The concentration achievable in human plasma was more than 10-times higher than EC50. The compound is superior to both hydroxychloroquine and azithromycin in these parameters.

Oct/16/2020
Methylene Blue Inhibits the SARS-CoV-2 Spike–ACE2 Protein-Protein Interaction–a Mechanism that can Contribute to its Antiviral Activity Against COVID-19
Spike protein ACE2 Small molecule In vitro
in vitro binding assay; hACE-expressing HEK293T cells; SARS-CoV-2 Spike pseudovirus 4.23

Inhibits the interaction between SARS-CoV-2 Spike and the host’s ACE2 receptor in vitro in a dose-dependent manner with IC50 of 3 μM. It also blocks the cell entry of a SARS-CoV-2 Spike pseudovirus with IC50 of 3.5 μM. These concentrations are achievable in blood after oral administration of the drug, as proved by other studies.

Jan/13/2021

AI-suggested references

Link Publication date
Exploring SARS-CoV-2 Delta variant spike protein receptor-binding domain (RBD) as a target for tanshinones and antimalarials.
Feb/03/2021
METHYLENE BLUE FOR TREATMENT OF HOSPITALIZED COVID-19 PATIENTS: A RANDOMIZED, CONTROLLED, OPEN-LABEL CLINICAL TRIAL, PHASE 2.
May/22/2021
Methylene Blue Is a Nonspecific Protein-Protein Interaction Inhibitor with Potential for Repurposing as an Antiviral for COVID-19.
May/18/2022
Methylene Blue Inhibits the SARS-CoV-2 Spike-ACE2 Protein-Protein Interaction-a Mechanism that can Contribute to its Antiviral Activity Against COVID-19.
Jan/13/2021
In Vitro Evaluation of the Antiviral Activity of Methylene Blue Alone or in Combination against SARS-CoV-2.
Jul/06/2021
Identification of broad anti-coronavirus chemical agents for repurposing against SARS-CoV-2 and variants of concern
Jan/15/2022
High-titre methylene blue-treated convalescent plasma as an early treatment for outpatients with COVID-19: a randomised, placebo-controlled trial.
Mar/01/2022
Methylene Blue has a potent antiviral activity against SARS-CoV-2 and H1N1 influenza virus in the absence of UV-activation in vitro
Jul/12/2021
What Binds Cationic Photosensitizers Better: Brownian Dynamics Reveals Key Interaction Sites on Spike Proteins of SARS-CoV, MERS-CoV, and SARS-CoV-2
Aug/15/2021
Intravenous Methylene Blue as a Rescue Therapy in the Management of Refractory Hypoxia in COVID-19 ARDS Patients: A Case Series
Jul/27/2021
A Drug Repurposing Approach for Antimalarials Interfering with SARS-CoV-2 Spike Protein Receptor Binding Domain (RBD) and Human Angiotensin-Converting Enzyme 2 (ACE2)
Apr/26/2022
Repurposing methylene blue in the management of COVID-19: Mechanistic aspects and clinical investigations.
Aug/10/2021
Application of methylene blue -vitamin C -N-acetyl cysteine for treatment of critically ill COVID-19 patients, report of a phase-I clinical trial.
Aug/20/2020

Clinical trials

ID Title Status Phase Start date Completion date
NCT05003492 Utilizing the Crosstalk Among Aerosolized Phenformin , Methylene Blue, Photodynamic Therapy , Zinc and Potassium for Treating Severe COVID-19 Infection and Its Inflammatory Complication Not yet recruiting Phase 1|Phase 2 Sep/01/2021 Nov/01/2021
  • Alternative id - Novel treatment of COVID-19
  • Interventions - Combination Product: Combination therapy plus Standard therapy|Radiation: Photodynamic therapy|Drug: Standard therapy
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Ministry of health.First health cluster ,Riaydh, Riyadh, Saudi Arabia
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: None (Open Label)|Primary Purpose: Treatment
  • Enrollment - 2
  • Age - 18 Years to 70 Years   (Adult, Older Adult)
  • Outcome measures - lung injury score|Serum levels of IL-6,TNF,TLR3,CRP, ESR and Type I interferon|Serum level of COVID19 RNA|All cause mortality rate|Ventilation free days|ICU free days|D-dimers less than 250 ng/mL, or less than 0.4 mcg/mL of blood sample|Time to first negative SARS-CoV-2 PCR in NP swap|Angiotensin 1-7 (Ang 1-7) changes over time|Angiotensin 1-5 (Ang 1-5) changes over time|Renin changes over time|Aldosterone changes over time|Angiotensin-converting enzyme II (ACE2) changes over time|Frequency of adverse events and severe adverse events|Angiotensin II (Ang II) changes over time|Sequential organ failure assessment score(SOFA score) over time and 14 ]|Thrombin time (TT)|Comparison of oxygen saturation dynamics measured by pulse oximeter before and after treatment
NCT04547127 A Study to Evaluate Safety and Efficacy of Convalescent Methylene Blue Treated (MBT) Plasma From Donors Recovered From Coronavirus Disease 2019 (COVID-19) Completed Phase 2 Apr/29/2020 Feb/04/2021
  • Alternative id - GC2003|2020-001299-14
  • Interventions - Biological: Convalescent anti-SARS-CoV-2 MBT Plasma|Drug: Standard Medical Treatment
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Hospital General Universitario de Alicante, Alicante, Spain|Hospital Universitari Vall d'Hebron, Barcelona, Spain|Hospital Universitari de Girona Doctor Josep Trueta, Girona, Spain|Hospital Universitari de Bellvitge, L'Hospitalet De Llobregat, Spain|Hospital Universitari Arnau de Vilanova, Lleida, Spain|Fundación Jimenez Diaz, Madrid, Spain|Hospital Clínico San Carlos, Madrid, Spain|Hospital Universitario La Paz, Madrid, Spain|Hospital Universitario La Princesa, Madrid, Spain|Complejo Hospitalario Universitario de Canarias, Santa Cruz De Tenerife, Spain|Hospital Clínico Universitario de Santiago -CHUS, Santiago, Spain|Hospital Universitari Joan XXIII, Tarragona, Spain
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: None (Open Label)|Primary Purpose: Treatment
  • Enrollment - 200
  • Age - 18 Years and older   (Adult, Older Adult)
  • Outcome measures - All-Cause Mortality Rate|Change from Baseline in National Early Warning Score (NEWS)|Time to Clinical Response as Assessed by NEWS ≤ 2 Maintained for 24 hours|Time to Hospital Discharge|Time to ICU Discharge|Duration of All Oxygen Use|Duration of Mechanical Ventilation|Absolute Value Change from Baseline in Ordinal Scale|Mean Change from Baseline in Ordinal Scale|Percentage of Participants in Each Severity Category of the 7-Point Ordinal Scale
NCT04376788 Exchange Transfusion Versus Plasma From Convalescent Patients With Methylene Blue in Patients With COVID-19 Recruiting Phase 2 May/20/2020 Sep/01/2020
  • Alternative id - FMASU P22/2020
  • Interventions - Biological: exchange blood transfusion from normal donor|Biological: plasma from convalescent patients with COVID-19|Drug: Methylene Blue 5 MG/ML
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Ain Shams University, Cairo, Egypt
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: None (Open Label)|Primary Purpose: Treatment
  • Enrollment - 15
  • Age - 18 Years to 65 Years   (Adult, Older Adult)
  • Outcome measures - improvement of condition|change in organs function with PFS and OS
NCT04619290 Outpatient Treatment With CoVid-19 With Prexablu Recruiting Phase 1 Oct/12/2020 Dec/30/2020
  • Alternative id - 064.I.2020
  • Interventions - Drug: Sublingual Methylene blue|Other: Control patients
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Hospital Regional Lic Adolfo Lopez Mateos, Mexico City, Ciudad De Mexico CDMX (Mexico City), Mexico
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: None (Open Label)|Primary Purpose: Treatment
  • Enrollment - 46
  • Age - 18 Years and older   (Adult, Older Adult)
  • Outcome measures - Change form baseline in Arterial oxygen saturation|Days to clinical improvement|Change Form Baseline in C reactive protein at 7 days|Change Form Baseline in IL-1β|Change Form Baseline in Erythrocyte sedimentation rate like procalcitonin|Change Form Baseline in Ferritin levels|Change Form Baseline in D dimer
NCT04933864 COVID-19 Treatment Using Methylene Blue and Photodynamic Therapy Completed Phase 1 Apr/24/2020 Jul/30/2020
  • Alternative id - 2206
  • Interventions - Drug: Methylene Blue and Photodynamic Therapy
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: Single (Outcomes Assessor)|Primary Purpose: Treatment
  • Enrollment - 60
  • Age - 18 Years to 90 Years   (Adult, Older Adult)
  • Outcome measures - The percentage of participants with negative quantitative Polymerase Chain Reaction test on SARS-CoV-2 on day 2 after methylene blue administration and photodynamic therapy|Comparison of oxygen saturation dynamics measured by pulse oximeter before and after treatment|The percentage of participants with positive dynamics in severity of pneumonia (e.g., from CT-4 to CT-2)|The percentage of participants having positive dynamics in patient status scale (EQ-5D-3L, SHOCS-COVID score) after treatment|The percentage of participants alive at day 28|The percentage of participants alive at day 84
NCT05004805 COVID-19 Methylene Blue Antiviral Treatment Completed Phase 2 Aug/06/2021 Dec/12/2021
  • Alternative id - COMBAT
  • Interventions - Drug: Methylene Blue|Drug: Saline nasal spray
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Irkutsk Regional Hospital, Irkutsk, Irkutskaya Oblast, Russian Federation
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: Single (Outcomes Assessor)|Primary Purpose: Treatment
  • Enrollment - 24
  • Age - 18 Years and older   (Adult, Older Adult)
  • Outcome measures - Recovery|Clinical responce|Overall therapeutic response|Resolution rate|Clinical responce FUV|Overall therapeutic response FUV
NCT04370288 Clinical Application of Methylene Blue for Treatment of Covid-19 Patients Recruiting Phase 1 Apr/19/2020 Sep/21/2020
  • Alternative id - IR.MUMS.REC.1399.122
  • Interventions - Drug: MCN (Methylene blue, vitamin C, N-acetyl cysteine)
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Imam Reza Hospital, Mashhad, Razavi Khorasan, Iran, Islamic Republic of
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: Single (Outcomes Assessor)|Primary Purpose: Treatment
  • Enrollment - 20
  • Age - 18 Years to 90 Years   (Adult, Older Adult)
  • Outcome measures - Proportion of patients remaining free of need for mechanical ventilation in both groups|Mortality rate in both groups|Improvement in Pa02/Fi02 ratio in both groups|Duration of hospital stay in both group.|Duration of Intensive Care Unit stay in both groups|Days free of dialysis in both groups|C-reactive proteins|WBC Count
NCT04635605 Methylene Blue Treatment of COVID-19 Recruiting Phase 2 Nov/05/2020 Dec/31/2022
  • Alternative id - MB treatment of COVID19
  • Interventions - Drug: Methylene Blue|Drug: Control Test
  • Study type - Interventional
  • Study results - No Results Available
  • Locations - Fondazione Epatocentro Ticino, Lugano, Ticino, Switzerland
  • Study designs - Allocation: Randomized|Intervention Model: Parallel Assignment|Masking: Triple (Care Provider, Investigator, Outcomes Assessor)|Primary Purpose: Treatment
  • Enrollment - 64
  • Age - 18 Years and older   (Adult, Older Adult)
  • Outcome measures - to compare the viral load kinetics in the enrolled patients with a SARS-CoV-2 positive nasopharyngeal swab demonstrating a reduction of the area under the curve day 0- day 21 of at least 25%|To calculate the percentage of patients clearing SARS-CoV-2 by 3, 6, 9, 12, 15 and 21 days after diagnosis|To calculate the percentage of patients having a reduction of viral load of > 2 log by day 3|To calculate the percentage of patients having a poor outcome as measured by the need of hospitalization for COVID-19|To calculate the percentage of patients alive|Safety and tolerability of the administered drug are registered as "adverse events", which are all symptoms related or supposed to be related to the drug that appeared after the drug intake and were NOT present at baseline or before|To measure the compliance by calculating the number of capsules taken by the patient and the overall number of patients who complete the treatment