Box 1.
Common Agents Causing MetHb
| Chemicals |
| Aniline dyes |
| Fava Beans |
| Fumes (Wood, Plastic, Automobile exhaust) |
| Ginkgo biloba |
| Herbicides |
| Mothballs |
| Nitratesa |
| Octane Boosters |
| Petrol |
| Well water |
| Medications |
| Acetaminophena |
| Acetanilide |
| Benzocainea |
| Bismuth subnitrate |
| Chloramine |
| Chloroquine |
| Copper sulfate |
| Dapsone |
| Flutamide |
| Lidocainea |
| Metoclopramidea |
| Nitric Oxidea |
| Nitromethane |
| Nitrofurans |
| Nitroglycerina |
| Nitroprussidea |
| Paraquat |
| Phenacetin |
| Phenazopyridine |
| Phenytoina |
| Prilocainea |
| Primaquine |
| Rasburicase |
| Silver nitrate |
| Sodium valproatea |
| Sulfasalazine |
| Sulfonamidesa |
| Zopiclone |
Notes: aCommon agent used in the operating room. Reprinted from Barash M, Reich KA, Rademaker D. Lidocaine-induced methemoglobinemia: A clinical reminder. J Am Osteopath Assoc. 2015;115(2):94–98. Creative Commons.3