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methylene blue

Trade name: proveblue

Small moleculeapprovedOrphan Drug FDA

Approved

Apr 8, 2016

Methylene blue, also known as methylthioninium chloride, is a medication from WHO's list of essential medicines. Upon administration, methylene blue is converted to leukomethylene blue by erythrocyte methemoblobin reductase in the presence of NADPH. Leukomethylene blue than reduces methemoglobin to oxyhemoglobin, thus restoring oxygen carrying capacity of the blood. Methylene blue is also used as a dye for various diagnostic procedures, for treatment of ifosfamide toxicity and for in vitro staining. Historically, it was used as a photosensitizer for photodynamic therapy for topical treatment of dermatologic or mucocutaneous infections, as an antidote for cyanide poisoning, but these applications are no longer approved. Methylene blue is investigated in clinical trials for treatment of septic shock and Alzheimer's disease. — NCATS

Clinical trial activity

128 trials · 133 clinical orgs · 10 marketing orgs

Phase 1
28
Phase 2
52
Phase 3
20
Phase 4
12

Earliest trial started Feb 1, 2000 (NCT00005067)

Timeline

2000s

  1. Jan 1, 2000

    Earliest Phase 1 Sponsor(trial)

  2. Jan 1, 2003

    Earliest Phase 2 Sponsor(trial)

  3. Jan 1, 2003

    Earliest Phase 3 Sponsor(trial)

2010s

  1. Dec 18, 2012

    Orphan Drug Designation

  2. Apr 8, 2016

    Provepharm Sas — Earliest FDA Approval

  3. Apr 8, 2016

    Provepharm Sas — NDA Organization

  4. Apr 29, 2016

    Flamel Technologies — NDA Secondary Org

2020s

  1. Dec 5, 2023

    Zydus Discovery DMCC — Marketing Organization

  2. Nov 21, 2024

    Nexus Pharmaceuticals — Marketing Organization

  3. Nov 22, 2024

    STERISCIENCE — Marketing Organization

  4. Dec 17, 2024

    Apicore — Marketing Organization

  5. Dec 17, 2024

    Hikma — Marketing Organization

  6. Jan 23, 2025

    Meitheal — Marketing Organization

  7. Jul 30, 2025

    Exeltis — Marketing Organization

  8. Dec 23, 2025

    CHENGDU SHUODE — Marketing Organization

Indications

Approved for

Studied for

Mechanism of action

Approval history

  • approvedAcceleratedApr 8, 2016

Chemistry & pharmacology

Loading structure…

SMILES

CN(C)c1ccc2nc3ccc(=[N+](C)C)cc-3sc2c1
Mol. weight
284.41 g/mol
Lipinski Ro5
Pass
Rule of 3
Yes
Chirality
Achiral Molecule
Inorganic
No
Polymer
No
Delivery
Parenteral
Availability
Prescription Only

Oral

No

Parenteral

Yes

Topical

No

Black box warningProdrug

Sources

Also known as

  • aizen methylene blue
  • basic blue 9
  • basic blue 9
  • c.i. basic blue 9
  • c.i. basic blue 9
  • dndi1417128
  • dndi1417128
  • lowacryl blue 9
  • lowacryl blue 9
  • methylene blue
  • methylene blue
  • methylene blue
  • methylene blue
  • methylene blue
  • methylene blue
  • methylene blue
  • methylene blue anhydrous
  • methylene blue anhydrous
  • methylene blue cation
  • methylene blue cation
  • methylene blue chloride hydrate
  • methylene blue chloride hydrate
  • methylenium ceruleum
  • methylenium ceruleum
  • methylenum coeruleum
  • methylthionine chloride
  • methylthionine chloride
  • methylthionine hcl
  • methylthionine hcl
  • methylthioninium
  • methylthioninium
  • methylthioninium
  • methylthioninium benzalkonium chloride hydrate
  • methylthioninium benzalkonium chloride hydrate
  • methylthioninium benzalkonium chloride hydrate
  • methylthioninium benzalkonium chloride hydrate
  • methylthioninium benzalkonium chloride hydrate
  • methylthioninium benzalkonium chloride hydrate
  • methylthioninium chloratum
  • methylthioninium chloride
  • methylthioninium chloride
  • methylthioninium chloride
  • methylthioninium chloride
  • methylthioninium chloride
  • methylthioninium chloride
  • methylthioninium chloride
  • methylthioninium chloride hydrate
  • proveblue
  • urolene blue
  • urolene blue

Clinical trials

NCT IDPhaseStart dateSponsor(s)
NCT07179003Phase 2Apr 30, 2026University of Rochester
NCT07264543Phase 2/Phase 3 (Phase 3)Dec 3, 2025Centro de Estudos e Pesquisa em Emergencias Medicas e Terapia Intensiva
NCT07311070Phase 3Oct 21, 2025Mashhad University of Medical Sciences
NCT07311057Phase 3Oct 21, 2025Mashhad University of Medical Sciences
NCT06887036Phase 2Sep 30, 2025Fondazione Epatocentro Ticino
NCT07164807Phase 4Aug 30, 2025Putian University
NCT07169487Phase 1Jun 28, 2025China Academy of Chinese Medical Sciences
NCT06900140Phase 3Jun 2, 2025Lakeridge Health Science Center
NCT06834087N/AMar 15, 2025Kafrelsheikh University
NCT06660680Phase 3Oct 25, 2024Anhui Medical University
NCT06532240Phase 3Aug 5, 2024Nanjing Medical University
NCT06481410N/AJun 20, 2024Guangxi Medical University, Taizhou Enze Medical Center Group, The First People's Hospital of Huzhou, Yuyao People's Hospital of Zhejiang Province, Zhejiang University
NCT06052956Phase 2May 31, 2024University of Rochester
NCT06306001Phase 2/Phase 3 (Phase 3)Mar 15, 2024Postgraduate Institute of Medical Education and Research
NCT06520306N/AMar 15, 2024Yangzhou University
NCT06005558Phase 2/Phase 3 (Phase 3)Aug 1, 2023National Cancer Institute, Egypt, National Cancer Institute (NCI)
NCT06284941N/AJun 20, 2023Yangzhou University
NCT07067814Phase 2/Phase 3 (Phase 3)Jun 1, 2023Ain Shams University
NCT05830630N/AMay 1, 2023Tanta University
NCT05850611Early Phase 1 (Phase 1)Apr 30, 2023Mashhad University of Medical Sciences
Showing 20 of 128 trials
Page 1 / 7

Organizations

Research & Development (133)

OrganizationOrg typeTrialsAs lead sponsorPhasesEarliest year
National Cancer Institute (NCI)Government14342000
State University of New York, BuffaloAcademic/Hospital6632004
University of HeidelbergAcademic/Hospital6512006
Mashhad University of Medical SciencesAcademic/Hospital4422020
People's Liberation Army of ChinaGovernment4322013
Shahid Beheshti University of Medical SciencesAcademic/Hospital4422008
Ain Shams UniversityAcademic/Hospital3322019
Light Sciences OncologyFor profit3312003
University of Nove de JulhoAcademic/Hospital3312015
University of OxfordAcademic/Hospital3332013
University of PennsylvaniaAcademic/Hospital3122000
University of RochesterAcademic/Hospital3322014
University of Sao PauloAcademic/Hospital3332009
Case Western Reserve UniversityAcademic/Hospital2222013
Chinese Academy of Medical SciencesAcademic/Hospital2212013
Cosmo PharmaceuticalsFor profit2222013
Fondazione Epatocentro TicinoAcademic/Hospital2212020
Fudan UniversityAcademic/Hospital2212019
Kafrelsheikh UniversityAcademic/Hospital2122021
Provepharm SasFor profit2122018
133 organizations
Page 1 / 7

Marketing (11)

OrganizationOrg typeRelationshipDate
ApicoreFor profitMKTGDec 17, 2024
CHENGDU SHUODEFor profitMKTGDec 23, 2025
ExeltisFor profitMKTGJul 30, 2025
Flamel TechnologiesFor profitNDA2Apr 29, 2016
HikmaFor profitMKTGDec 17, 2024
MeithealFor profitMKTGJan 23, 2025
Nexus PharmaceuticalsFor profitMKTGNov 21, 2024
Provepharm SasFor profitNDAApr 8, 2016
STERISCIENCEFor profitMKTGNov 22, 2024
Zydus Discovery DMCCFor profitMKTGDec 5, 2023
Zydus Discovery DMCCFor profitSYNDec 5, 2023