Drug & supplement interaction

Methylene Blue + Chlordiazepoxide, Clidinium Bromide

Chlordiazepoxide, Clidinium Bromide brand name: Librax.

Moderate Interaction
The bottom line Moderate

Methylene Blue has a moderate interaction with Chlordiazepoxide, Clidinium Bromide. Concomitant use may increase anticholinergic effects and adverse effects.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Methylene Blue and Chlordiazepoxide, Clidinium Bromide

Here is the interaction we found between these two, with the evidence behind it.

Moderate

Anticholinergic Drugs

Why this applies to Chlordiazepoxide, Clidinium Bromide

Chlordiazepoxide, Clidinium Bromide falls under Anticholinergic Drugs — the group Methylene Blue interacts with.

Concomitant use may increase anticholinergic effects and adverse effects. In a case report, a critically-ill male in his mid-60s developed a toxicological process attributed to anticholinergic syndrome following treatment with methylene blue for vasoplegia. Symptoms included anhidrosis, fever, lactic acidosis, mucosal dryness, and pupil dilation. Potential exacerbating factors included renal failure and use of fentanyl intra-operatively.
Severity Moderate Likelihood Possible Evidence D

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the thing to keep an eye on with Librax and methylene blue. The clidinium part of Librax is an anticholinergic, meaning it already dials down things like saliva, sweat, and gut activity. Methylene blue can add its own anticholinergic-type burden on top of that, so the two together may push those effects further than either would alone.

In real terms, you might notice more dry mouth, blurred vision, constipation, trouble urinating, confusion, a fast heartbeat, or trouble cooling down in the heat. Honestly, this warning leans on a single case report in a very sick patient, so it's more of a theoretical concern than a proven, common problem. Still, it's worth a quick chat with your pharmacist or doctor before combining them, especially if you're older.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Methylene Blue Also Interacts With Other Medications

Methylene Blue has 314 moderate known drug interactions in our database — the Chlordiazepoxide, Clidinium Bromide one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Methylene Blue

Covers the 2,830 medications we’ve checked against Methylene Blue. Pick one to open its full report.

From our Q&A

Questions About Methylene Blue or Chlordiazepoxide, Clidinium Bromide

These are real questions from readers, answered by the pharmacists at HelloPharmacist — written by a person, not generated from a database. Each one covers Methylene Blue or Chlordiazepoxide, Clidinium Bromide, not necessarily both, but if one is close to what you were about to ask it will usually go further than a database entry can:

Not quite your question? Ask our pharmacists directly — it is free, there is no account required, and answers usually come back within 24 hours.

Everything else you take

See Every Supplement That Interacts With Chlordiazepoxide, Clidinium Bromide

This page covers Methylene Blue only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Chlordiazepoxide, Clidinium Bromide page lists 188 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Beer (major), Gamma-hydroxybutyrate (ghb) (major) and Grapefruit (major).

By severity: 10 major · 142 moderate · 36 minor.

From our pharmacist’s overview on the Chlordiazepoxide, Clidinium Bromide page

“Librax combines chlordiazepoxide, a benzodiazepine, with clidinium, an anticholinergic, and both halves interact with supplements, 188 ingredients in all. This is a list to approach with real care, starting with the 10 rated major.”

Reviewed by 2 · Jul 18, 2026

Open the Chlordiazepoxide, Clidinium Bromide interaction page

How much people look this up

Where Methylene Blue and Chlordiazepoxide, Clidinium Bromide Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Methylene Blue
Top half

#681 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Chlordiazepoxide, Clidinium Bromide
Top half

#985 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Methylene Blue

What is Methylene Blue?

Methylene Blue
  • Methemoglobinemia (a blood disorder)
  • Claimed energy or mental focus support
  • Anti-aging or longevity claims
  • Antimicrobial or antimalarial uses (historical)
  • Dye for medical and lab procedures

Methylene blue is a synthetic dye that is an FDA-approved prescription medicine for a rare blood disorder called methemoglobinemia, and it is also used as a diagnostic dye. Its popular use as a supplement for energy, brain health, or anti-aging is not well supported by solid human evidence, and it can cause serious side effects. Talk to a pharmacist or doctor before using it, and never take non-pharmaceutical or industrial-grade products.

Read the full Methylene Blue monograph & all interactions
Medication

About Chlordiazepoxide and Clidinium

What Is Chlordiazepoxide and Clidinium Used For?

Brand name: Librax

This combination is used to control emotional and somatic (physical) factors in gastrointestinal disorders. In plain terms, it targets digestive problems where stress or nerves play a part.

It may also be used as add-on treatment for peptic ulcer, irritable bowel syndrome (irritable colon, spastic colon, mucous colitis) and acute enterocolitis (sudden inflammation of the small intestine and colon). The label lists these same uses for the generic capsules and for Librax.

See full Chlordiazepoxide and Clidinium drug information
Keep checking

Other Drugs & Methylene Blue

Browse every other medication we’ve checked against Methylene Blue — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
314Moderate
0Minor
2,515No known interaction
Moderate

314 interactions

Showing 60 of 314 moderate interactions — see all 314 on the Methylene Blue page.

No interaction 2,515 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Methylene Blue and Chlordiazepoxide, Clidinium Bromide Together: Common Questions

Can you take Methylene Blue with Chlordiazepoxide, Clidinium Bromide?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Methylene Blue and Chlordiazepoxide, Clidinium Bromide interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Chlordiazepoxide, Clidinium Bromide and Methylene Blue?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.