Using Methylene Blue in nebulized form for treating patients with Coronavirus (Covid-19)
As COVID-19(Coronavirus) ravages the world, a quick, novel, cost effective cure for this malaise needs to be found.
Being a pulmonologist (lung specialist) in India, I have been treating pneumonia, other respiratory ailments and Tuberculosis patients (with XDR & MDR TB) for more than 42 years.
I’ve achieved remarkable success in treating my patients with Methylene Blue and with documented evidence. When used in sub lingual and nebulised form M.B. helps remarkably in clearing alveolar capillary block.
Covid causes a silent hypoxia wherein patients despite having acute hypoxia (low oxygen saturation spO2) show no clinical symptoms. Patient is not dyspnoeic in spite of having very low oxygen saturation. These soon escalate to a cytokine storm and patient goes in the irreversible phase of the respiratory distress.
Covid patients show resemblance to methemoglobinemia. MB is considered an approved drug of choice for methemoglobinemia. Additionally, M.B. has a strong antifibrotic action and is very fast acting.
Given the above presentations, Methylene Blue can be used as a treatment to all Coronavirus symptomatic patients & as a prophylactic drug to all vulnerable population. Used in low dosage (as prescribed below) it shows no significant side effects (less than 2% of patients complained of irritation in the nose/nausea for a day which subsided on its own). Given its low cost, it is also a viable regime for poorer countries like India. A number of patients(with varying levels of respiratory distress) have been treated using MB in nebulised/sub-lingual for over the course of my years of practice.
Potential Treatment regime for the novel Coronavirus (Covid-19)
Primary course of administration is in Nebulized form and Sublingually together. For patients with severe Cyanosis (oxygen levels less than 85%), IV may be required based on the clinical condition of the patient.
Administration steps as below (under medical supervision only as MB is known to be toxic in incorrect dosages)
- 0.1% Methylene Blue to be administered as inhalation through a nebulizer (Primary line of treatment)
- Nebulization to be given through a nasal mask
- Sublingual administration will be as a supportive line of treatment
Post my recommendations, a hospital in Mumbai started administering Methylene Blue through Nebulizer as well as sublingually on COVID-19 confirmed patients with positive results.
Methylene blue (Methylthioninium Chloride) is a thiazine dye & a medication. It is easily available in drug stores across India. It is safe to consume in low dosage (0.1 mg/kg in IV form) under proper medical supervision. It was the first antiseptic dye to be used therapeutically and it is present on WHO Model List of Essential Medicines. In fact, its use was widespread even before the advent of sulphonamides and penicillin. Its benefit is it rapidly arrests fibrosis which proves beneficial against virulent strains.
[Update: on why MB works]
There are multiple reasons why MB is effective; the chief is Nitric Oxide mediated reduction in inflammatory cascades in addition to inhibiting canonical inflammasomes.
Radiologically (i.e. X Ray) Covid/Swine Flu are similar & resemble any acute viral/fungal loefflers or aspiration pneumonia. Clinical distinction can be made by giving intranasal oxygen — you’d notice an improvement in normal pneumonia but not for Swine Flu or Covid-19 as these viruses would lead to alveolar capillary blockage (i.e. block ability of the lungs to operate in simple words). MB clears the blockage within 24 hours and O2 levels start improving. Covid-19 is a more virulent strain compared to H1N1 and a fast acting drug is necessitated.
Due to the clinico/pathological resemblance between H1N1 & Covid-19 — final outcome is expected to be similar post administration of MB.
(The above comparative X Rays are a part of a series. X Rays shared post consent from the patient)
Note : Some readers have questioned why it took 4 year to clear the lesions — given the state of the patient when he came to me, the chances of survival more than 6 months were less than 10% as his lung was severely damaged(X ray 1). In medical parlance, the above X Ray (X Ray 2) progress is considered a miracle.
(Will post more details about this as and when I get time — for queries please email me)
Comment below or mail me @ email@example.com
- The World Health Organization. The global tuberculosis report: 2016. http://www.who.int/tb/publications/global_report/en. (Accessed 2019, Feb 9).
- Ozal E, Kuralay E, Yildirim V, et al. Preoperative methylene blue administration in patients at high risk for vasoplegic syndrome during cardiac surgery. Ann Thorac Surg. 2005;79:1615–9.
- Clifton JII, Leikin J, Methylene blue. American Journal of Therapeutics. 2003;10:289–91.
- Beretvas RI, Ponsky J. Endoscopic marking: an adjunct to laparoscopic gastrointestinal surgery. Surgical endoscopy. 2001;15:1202–3
- Schenk P, Madl C, Rezaie-Majd S, Lehr S , Muller C. Methylene blue improves the hepatopulmonary syndrome. Ann Intern Med. 2000;133:701–6
- Methylene Blue: Revisited https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3087269/ (Accessed 25 Apr 2020)
[PS: This Gmail and Medium account is NOT managed by Dr. Deepak directly]