Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
The safety of PROVAYBLUE
® was determined in 82 healthy adults of median age of 36 years (range, 19-55 years); 54% were male, and 68% were white. Each individual in the safety population received a single dose of PROVAYBLUE
® 2 mg/kg intravenously. There was one serious adverse reaction reported (syncope due to sinus pauses of 3-14 seconds). The most common (≥2%) moderate or severe adverse reactions were pain in the extremity (56%), headache (7%), feeling hot (6%), syncope (4%), back pain (2%), hyperhidrosis (2%) and nausea (2%). Table 1 lists the adverse reactions of any severity that occurred in at least 2% of individuals who received PROVAYBLUE
®.
Table 1. Adverse Reactions Following Infusion of PROVAYBLUE
® 2 mg/kg
| Adverse Reaction | Any Grade TEAE
(n=82) | Moderate-
Severe TEAE
(n=82) |
| Pain in extremity | 69 | 84% | 46 | 56% |
| Chromaturia | 61 | 74% | 0 | |
| Dysgeusia | 16 | 20% | 1 | 1% |
| Feeling hot | 14 | 17% | 5 | 6% |
| Dizziness | 13 | 16% | 4 | 5% |
| Hyperhidrosis | 11 | 13% | 2 | 2% |
| Nausea | 11 | 13% | 2 | 2% |
| Skin discoloration | 11 | 13% | 0 | |
| Headache | 8 | 10% | 6 | 7% |
| Musculoskeletal pain | 7 | 9% | 0 | |
| Paresthesia oral | 7 | 9% | 0 | |
| Paresthesia | 7 | 9% | 0 | |
| Infusion site pain | 5 | 6% | 1 | 1% |
| Feeling cold | 5 | 6% | 0 | |
| Pallor | 4 | 5% | 0 | |
| Dermatitis contact | 4 | 5% | 0 | |
| Syncope | 3 | 4% | 3 | 4% |
| Influenza like illness | 3 | 4% | 1 | 1% |
| Pruritus | 3 | 4% | 1 | 1% |
| Anxiety | 3 | 4% | 0 | |
| Decreased appetite | 3 | 4% | 0 | |
| Chest discomfort | 3 | 4% | 0 | |
| Back pain | 2 | 2% | 2 | 2% |
| Cold sweat | 2 | 2% | 1 | 1% |
| Dizziness postural | 2 | 2% | 1 | 1% |
| Muscle spasms | 2 | 2% | 1 | 1% |
| Presyncope | 2 | 2% | 1 | 1% |
| Vomiting | 2 | 2% | 1 | 1% |
| Arthralgia | 2 | 2% | 1 | 1% |
| Chills | 2 | 2% | 0 | |
| Diarrhea | 2 | 2% | 0 | |
| Discomfort | 2 | 2% | 0 | |
| Dyspnea | 2 | 2% | 0 | |
| Erythema | 2 | 2% | 0 | |
| Hypoesthesia oral | 2 | 2% | 0 | |
| Infusion site discomfort | 2 | 2% | 0 | |
| Limb discomfort | 2 | 2% | 0 | |
| Oral discomfort | 2 | 2% | 0 | |
| Catheter site pain | 2 | 2% | 0 | |
| Ecchymosis | 2 | 2% | 0 | |
Other adverse reactions reported to occur following administration of methylene blue class products include the following:
Blood and lymphatic system disorders: hemolytic anemia, hemolysis, hyperbilirubinemia, methemoglobinemia
Cardiac disorders: palpitations, tachycardia
Eye disorders: eye pruritus, ocular hyperemia, vision blurred
Gastrointestinal disorders: abdominal pain lower, dry mouth, flatulence, glossodynia, tongue eruption
General disorders and administration site conditions: death, infusion site extravasation, infusion site induration, infusion site pruritus, infusion site swelling, infusion site urticaria, peripheral swelling, thirst
Investigations: elevated liver enzymes
Musculoskeletal and connective tissue disorders: myalgia
Renal and urinary disorders: dysuria
Respiratory, thoracic and mediastinal disorders: nasal congestion, oropharyngeal pain, rhinorrhea, sneezing
Skin and subcutaneous tissue disorders: necrotic ulcer, papule, phototoxicity
Vascular disorders: hypertension