COVID-19 lessons for medical practice. Methylene blue is a time-tested innovation




COVID-19, methylthioninium chloride, methylene blue, Pembina Blue®, prevention of pneumonia, urinary tract antiseptic


Significance of methylene blue (MB) in therapy of methemoglobinemia, malaria and urinary tract infections (UTI) is well known. The antimicrobial, anti-inflammatory, and antioxidant effect of MB has been demonstrated in different in vitro and in vivo studies. Necessity to find the remedy against COVID-19 attracted the interest of investigators and general practitioners to MB worldwide. The review includes various experiences of MB use, in particular in the patients treated with MB during the COVID-19 epidemic with a preventive effect, as well as own experience on this topic. MB is widely used as a dye in a variety of biological sciences applications — diagnostic procedures and the treatment of multiple disorders, including cyanide, and carbon monoxide poisoning, and is considered to be nontoxic. The beneficial effects of MB in the management of patients with multiple small renal calculi, especially with infected stones, and prevention of new stone formation were presented in a 5-year study. Moreover, due to MB antifungal potential and antimicrobial effect, it reduces symptoms of UTI, improves quality of life and could prevent the recurrence of disease. The patented complex of MB with sage leaf extract and American cranberry fruit extract (Pembina Blue®) demonstrated significant reduction of pain and spasm in cystitis patients. Given the limited number of available UTI therapies with concomitant increase in drug resistance, the demand for the search of new safe and effective UTI treatments are inevitable. Considering the fact that MB is FDA-approved compound that is already used for various therapeutic options, and also owing to the distinct antioxidant, antifungal, antibacterial and anti-inflammatory mechanisms presented in this review, MB could be considered as a promising drug for future.


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Ministry of Нealth of Ukraine. Order on December 31, 2020 № 3094. On Amendments to the Protocol on Providing Medical Care for the Treatment of Coronavirus Disease COVID-19. Available from: Accessed: December 31, 2020. (in Ukrainian).

Alamdari DH, Moghaddam AB, Amini S, et al. Application of methylene blue -vitamin C -N-acetyl cysteine for treatment of critically ill COVID-19 patients, report of a phase-I clinical trial. Eur J Pharmacol. 2020 Oct 15;885:173494. doi:10.1016/j.ejphar.2020.173494.

Wenzhong L, Hualan L. COVID-19: Attaks the 1-beta chain of hemoglobin and captures the porphyrin to inhibit human heme metabolism. ChemRxiv. 2020 Jul 13. doi:10.26434/chemrxiv.11938173.v5.

Henry M, Summa M, Patrick L, Schwartz L. A cohort of cancer patients with no reported cases of SARS-CoV-2 infection: the possible preventive role of Methylene Blue. Substantia. 2020;4(Suppl 1):888. doi:10.13128. 2020.

Fall B, Camara C, Fall M, et al. Plasmodium falciparum susceptibility to standard and potential anti-malarial drugs in Dakar, Senegal, during the 2013-2014 malaria season. Malar J. 2015 Feb 6;14:60. doi:10.1186/s12936-015-0589-3.

Nedu ME, Tertis M, Cristea C, Georgescu AV. Comparative study regarding the properties of methylene blue and proflavine and their optimal concentrations for in vitro and in vivo applications. Diagnostics (Basel). 2020 Apr 15;10(4):223. doi:10.3390/diagnostics10040223.

Pal R, Ansari MA, Saibabu V, Das S, Fatima Z, Hameed S. Nonphotodynamic Roles of Methylene Blue: Display of Distinct Antimycobacterial and Anticandidal Mode of Actions. J Pathog. 2018 Jan 31;2018:3759704. doi:10.1155/2018/3759704.

Gendrot M, Madamet M, Mosnier J, et al. Baseline and multinormal distribution of ex vivo susceptibilities of Plasmodium falciparum to methylene blue in Africa, 2013-18. J Antimicrob Chemother. 2020 Aug 1;75(8):2141-2148. doi:10.1093/jac/dkaa174.

Geller M, Gama CRB, Guimarães OR, et al. Recurrent urinary tract infections: Evaluation of the prophylactic efficacy of urinary antiseptics methenamine and methylthioninium chloride. Rev Bras Med. 2008 Nov;65:367-371.

Boyce WH, McKinney WM, Long TT, Drach GW. Oral administration of methylene blue to patients with renal calculi. J Urol. 1967 May;97(5):783-789. doi:10.1016/s0022-5347(17)63117-3.

Smith MJV. Methylene blue in renal calculi: results of five-year study. Urology. 1975 Dec;6(6):676-679. doi:10.1016/0090-4295(75)90793-1.



How to Cite

Ivanov, D. (2021). COVID-19 lessons for medical practice. Methylene blue is a time-tested innovation. KIDNEYS, 10(1), 36–41.



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