Drug & supplement interaction

Methylene Blue + Olanzapine

Olanzapine brand name: Zyprexa.

Moderate Interaction
The bottom line Moderate

Methylene Blue has a moderate interaction with Olanzapine. Combining serotonergic drugs with methylene blue can cause additive serotonergic effects, including serotonin syndrome.

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

Methylene Blue and Olanzapine

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

Moderate

Serotonergic Drugs

Why this applies to Olanzapine

Olanzapine falls under Serotonergic Drugs — the group Methylene Blue interacts with.

Combining serotonergic drugs with methylene blue can cause additive serotonergic effects, including serotonin syndrome. Methylene blue inhibits monoamine oxidase A. Intravenous or intrapulmonary use has resulted in serotonin syndrome, including reported fatalities, in patients taking some serotonergic drugs. This effect has not been reported with oral methylene blue. However, tell patients to avoid taking methylene blue with serotonergic drugs.
Severity Moderate Likelihood Possible Evidence C

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 concern with pairing these two. Methylene blue acts like a monoamine oxidase inhibitor, meaning it blocks an enzyme that normally clears certain brain chemicals, especially serotonin. Olanzapine has some serotonin activity of its own, so stacking these together could, in theory, push serotonin too high. That's what we call serotonin syndrome, and it can show up as agitation, a racing heart, sweating, tremor, or high fever.

The good news is that the serious cases have almost all been with injected methylene blue, not oral supplement forms, and this hasn't been clearly reported with olanzapine specifically. Still, since the risk is real and hard to predict, I'd steer clear of combining them. Please check with your pharmacist or doctor before adding methylene blue.

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 Olanzapine 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 Olanzapine

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 Olanzapine, 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 Olanzapine

This page covers Methylene Blue only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Olanzapine page lists 160 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Indian Snakeroot (major), Lithium (major), Rauvolfia Vomitoria (major) and 1,3-dmaa (moderate).

By severity: 4 major · 118 moderate · 38 minor.

From our pharmacist’s overview on the Olanzapine page

“Olanzapine (Zyprexa) is an antipsychotic prescribed for schizophrenia and bipolar disorder, and adding supplements to it warrants genuine care. Four of the 160 ingredients on file rate major, and those four deserve your attention before anything else: lithium supplements raise the risk of serotonin syndrome, activated charcoal can trap…”

Reviewed by 2 · Jul 18, 2026

Open the Olanzapine interaction page

How much people look this up

Where Methylene Blue and Olanzapine 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

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

29 days ago today
Medication Olanzapine
Top half

#1,329 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 Olanzapine

What Is Olanzapine Used For?

Brand name: Zyprexa

Olanzapine treats schizophrenia and the manic or mixed episodes of bipolar I disorder in both adults and adolescents (ages 13–17). It can also be used alongside valproate or lithium to treat manic or mixed episodes in adults. When combined with fluoxetine, olanzapine tablets and orally disintegrating tablets are used to treat depressive episodes associated with bipolar I disorder and treatment-resistant depression in adults.

Olanzapine intramuscular injection (short-acting) is used by healthcare providers to quickly calm acute agitation in adults with schizophrenia or bipolar I mania. Zyprexa Relprevv — a separate, long-acting intramuscular formulation available only through a restricted program — is indicated specifically for the treatment of schizophrenia in adults.

See full Olanzapine 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 Olanzapine Together: Common Questions

Can you take Methylene Blue with Olanzapine?
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 Olanzapine 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 Olanzapine 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.