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©2013 UpToDate ® Print Email Agents known to cause methemoglobinemia Acetanilid p-Amino salicylic acid Aniline, aniline dyes Benzene derivatives Clofazimine Chlorates Chloroquine Dapsone Local anesthetic agents Benzocaine Lidocaine Prilocaine Menadione Metoclopramide Methylene blue* Naphthoquinone Naphthalene Nitrites Amyl nitrite Farryl nitrite Sodium nitrite Nitroglycerin Nitric oxide Nitrobenzene Paraquat Phenacetin Phenazopyridine Primaquine Rasburicase Resorcinol Sulfonamides * While methylene blue is a recognized treatment for methemoglobinemia, it is an agent with oxidant potential, and may worsen the clinical situation, since in individuals with glucose-6-phosphate dehydrogenase deficiency it induces acute hemolysis that can further decrease oxygen delivery to the tissues. Paradoxically, in high doses methylene blue can also increase methemoglobinemia.