The Drug-Induced Respiratory Disease Website and App
Frequency - Incidence
Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases
Evidence level/grade
Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic
Methemoglobinemia
Publications
Drug-induced methemoglobinemia in a child with comorbidity and polypragmasia: Case report.
The International journal of risk & safety in medicine 2026 May;37 — 2026 May — 213-217
Silent Hypoxia From Benzocaine-Induced Methemoglobinemia Following Transesophageal Echocardiogram.
Cureus 2025 Jul;17;e87109 — 2025 Jul — e87109
Occult Methemoglobinemia in a Medically-Complex 7-Year-Old Child and the Opportunity for Pharmacist Intervention in Pediatric Emergency Medicine.
The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG 2024 Dec;29;650-653 — 2024 Dec — 650-653
Case Report: An Uncommon Etiology of Vulvar Irritation and Swelling in an Adolescent Patient.
Journal of pediatric and adolescent gynecology 2022 Dec;35;715-717 — 2022 Dec — 715-717
Benzocaine-related methaemoglobinemia after transoesophageal echocardiography: a rare, life-threatening complication.
BMJ case reports 2021 Apr 23;14; — 2021 Apr 23
Topical Benzocaine and Methemoglobinemia.
American journal of therapeutics 2017 Sep/Oct;24;e596-e598 — 2017 Sep/Oct — e596-e598
An Uncommon Complication With Use of Topical Local Anesthetic Agents: Methemoglobinemia.
American journal of therapeutics 2016 Nov/Dec;23;e1968-e1969 — 2016 Nov/Dec — e1968-e1969
Nosocomial Methemoglobinemia Resulting from Self-Administration of Benzocaine Spray.
Case reports in anesthesiology 2015;2015;685304 — 2015 — 685304
An Atypical Case of Methemoglobinemia due to Self-Administered Benzocaine.
Case reports in emergency medicine 2015;2015;670979 — 2015 — 670979
Central cyanosis on a psychiatric unit treated at the Salford Royal Hospital.
Thorax 2014 Dec;69;1157-8 — 2014 Dec — 1157-8
Methemoglobinemia precipitated by benzocaine used during intubation.
Proceedings (Baylor University. Medical Center) 2014 Apr;27;133-5 — 2014 Apr — 133-5
Methemoglobinemia with the use of benzocaine spray for awake fiberoptic intubation.
Middle East journal of anaesthesiology 2013 Oct;22;337-40 — 2013 Oct — 337-40
Risk of acquired methemoglobinemia with different topical anesthetics during endoscopic procedures.
Local and regional anesthesia 2011;4;25-8 — 2011 — 25-8
Benzocaine induced methemoglobinemia: a potentially fatal complication of transesophageal echocardiography.
The Ochsner journal 2003;5;34-5 — 2003 — 34-5
Topical benzocaine-induced methemoglobinemia in the pediatric population.
Journal of pediatric health care : official publication of National Association of Pediatric Nurse Associates & Practitioners 2008 Nov-Dec;22;335-9; quiz 340-1 — 2008 Nov-Dec — 335-9; quiz 340-1
Intraoperative detection of methemoglobinemia in a patient given benzocaine spray to relieve discomfort from a nasogastric tube: a case report.
AANA journal 2008 Apr;76;99-102 — 2008 Apr — 99-102
Benzocaine and lidocaine induced methemoglobinemia after bronchoscopy: a case report.
Journal of medical case reports 2008 Jan 23;2;16 — 2008 Jan 23 — 16
Methemoglobinemia and benzocaine.
Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates 2007 Sep-Oct;30;342-5; quiz 346-7 — 2007 Sep-Oct — 342-5; quiz 346-7
Benzocaine-induced methemoglobinemia based on the Mayo Clinic experience from 28 478 transesophageal echocardiograms: incidence, outcomes, and predisposing factors.
Archives of internal medicine 2007 Oct 08;167;1977-82 — 2007 Oct 08 — 1977-82
Severe methemoglobinemia from topical anesthetic spray: case report, discussion and qualitative systematic review.
CJEM 2001 Jan;3;51-6 — 2001 Jan — 51-6
Methemoglobinemia-induced cardio-respiratory failure secondary to topical anesthesia.
American journal of therapeutics 2006 Nov-Dec;13;545-9 — 2006 Nov-Dec — 545-9
A rare side effect of transesophageal echocardiography: methemoglobinemia from topical benzocaine anesthesia.
European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology 2008 Mar;9;289-90 — 2008 Mar — 289-90
Benzocaine-induced methemoglobinemia.
Anesthesia progress 2005;52;136-9 — 2005 — 136-9
Acquired methemoglobinemia: a retrospective series of 138 cases at 2 teaching hospitals.
Medicine 2004 Sep;83;265-73 — 2004 Sep — 265-73
Reported adverse event cases of methemoglobinemia associated with benzocaine products.
Archives of internal medicine 2004 Jun 14;164;1192-6 — 2004 Jun 14 — 1192-6
Critical rebound methemoglobinemia after methylene blue treatment: case report.
Pharmacotherapy 2004 Apr;24;538-40 — 2004 Apr — 538-40
Benzocaine-induced methemoglobinemia: a potentially fatal complication of transesophageal echocardiography.
Texas Heart Institute journal 2003;30;308-10 — 2003 — 308-10
Severe methemoglobinemia after transesophageal echocardiography.
American journal of therapeutics 2003 May-Jun;10;225-7 — 2003 May-Jun — 225-7
Severe methemoglobinemia on reexposure to benzocaine.
Journal of clinical anesthesia 2001 Mar;13;128-30 — 2001 Mar — 128-30
Unexpected cyanosis in the surgical patient.
Surgical endoscopy 2000 Jun;14;595 — 2000 Jun — 595
Benzocaine-induced methemoglobinemia: report of a severe reaction and review of the literature.
The Annals of pharmacotherapy 1994 May;28;643-9 — 1994 May — 643-9
Benzocaine-adultered street cocaine in association with methemoglobinemia.
Clinical chemistry 1992 Apr;38;596-7 — 1992 Apr — 596-7