QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Résumé Extracto Full Text PDF Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Articles Ahead of Print [Order Reprint] Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Patel, P. N Search for Related Content PubMed PubMed Citation Articles by Patel, P. N

DRUG INFORMATION ROUNDS

Methylene Blue for Management of Ifosfamide-Induced Encephalopathy

Assistant Clinical Professor, Department of Clinical Pharmacy Practice; Director, Drug Information Center, College of Pharmacy and Allied Health Professions, St. John's University, St. Albert Hall, Rm. 114, 8000 Utopia Pkwy., Queens, NY 11439-0001, fax 718/990-2151, patelp2{at}stjohns.edu

Reprints: Dr. Patel.

OBJECTIVE: To evaluate the use of methylene blue for the treatment of ifosfamide-induced encephalopathy.

DATA SOURCES: MEDLINE (1966–August 2005) and International Pharmaceutical Abstracts (1971–August 2005) were searched using the terms methylene blue, ifosfamide, encephalopathy, and neurotoxicity.

DATA SYNTHESIS: Several case reports and one retrospective chart review described the use of methylene blue for ifosfamide-induced encephalopathy, but no controlled clinical trials were found. Methylene blue appeared to aid in the resolution of encephalopathic symptoms as rapidly as within 10 minutes of administration in some patients, but it had modest efficacy in most patients. Symptoms in patients who did not receive methylene blue resolved in the same time frame; this indicates that ifosfamide-induced encephalopathy may resolve without treatment.

CONCLUSIONS: Available data from case reports indicate that methylene blue is an option in the treatment of ifosfamide-induced encephalopathy, especially in patients with severe symptoms of toxicity. However, the lack of controlled clinical trials and the possibility of spontaneous resolution of encephalopathy make the usefulness of methylene blue unclear.

Key Words: encephalopathy, ifosfamide, methylene blue, neurotoxicity

Published Online, January 3, 2006. www.theannals.com, DOI 10.1345/aph.1G114

This article has been cited by other articles:

				A. Jarkowski III Possible contribution of aprepitant to ifosfamide-induced neurotoxicity Am. J. Health Syst. Pharm., December 1, 2008; 65(23): 2229 - 2231. [Abstract] [Full Text] [PDF]

				J. E Howell, A. H Szabatura, A. Hatfield Seung, and S. A Nesbit Characterization of the occurrence of ifosfamide-induced neurotoxicity with concomitant aprepitant Journal of Oncology Pharmacy Practice, September 1, 2008; 14(3): 157 - 162. [Abstract] [PDF]

				H. Atamna, A. Nguyen, C. Schultz, K. Boyle, J. Newberry, H. Kato, and B. N. Ames Methylene blue delays cellular senescence and enhances key mitochondrial biochemical pathways FASEB J, March 1, 2008; 22(3): 703 - 712. [Abstract] [Full Text] [PDF]

				M. Hamadani and F. Awan Role of thiamine in managing ifosfamide-induced encephalopathy Journal of Oncology Pharmacy Practice, December 1, 2006; 12(4): 237 - 239. [Abstract] [PDF]