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;37(2):213-217
Silent Hypoxia From Benzocaine-Induced Methemoglobinemia Following Transesophageal Echocardiogram.
Cureus. 2025;17(7):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;29(6):650-653
Case Report: An Uncommon Etiology of Vulvar Irritation and Swelling in an Adolescent Patient.
Journal of pediatric and adolescent gynecology. 2022;35(6):715-717
Benzocaine-related methaemoglobinemia after transoesophageal echocardiography: a rare, life-threatening complication.
BMJ case reports. 2021;14(4)
Topical Benzocaine and Methemoglobinemia.
American journal of therapeutics. 2017;24(5):e596-e598
An Uncommon Complication With Use of Topical Local Anesthetic Agents: Methemoglobinemia.
American journal of therapeutics. 2016;23(6):e1968-e1969
Nosocomial Methemoglobinemia Resulting from Self-Administration of Benzocaine Spray.
Case reports in anesthesiology. 2015;2015:685304
An Atypical Case of Methemoglobinemia due to Self-Administered Benzocaine.
Case reports in emergency medicine. 2015;2015:670979
Central cyanosis on a psychiatric unit treated at the Salford Royal Hospital.
Thorax. 2014;69(12):1157-8
Methemoglobinemia precipitated by benzocaine used during intubation.
Proceedings (Baylor University. Medical Center). 2014;27(2):133-5
Methemoglobinemia with the use of benzocaine spray for awake fiberoptic intubation.
Middle East journal of anaesthesiology. 2013;22(3):337-40
Risk of acquired methemoglobinemia with different topical anesthetics during endoscopic procedures.
Local and regional anesthesia. 2011;4:25-8
Benzocaine induced methemoglobinemia: a potentially fatal complication of transesophageal echocardiography.
Ochsner journal. 2003;5(2):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;22(6):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;76(2):99-102
Benzocaine and lidocaine induced methemoglobinemia after bronchoscopy: a case report.
Journal of medical case reports. 2008;2:16
Methemoglobinemia and benzocaine.
Gastroenterology nursing : the official journal of the Society of Gastroenterology Nurses and Associates. 2007;30(5):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;167(18):1977-82
Severe methemoglobinemia from topical anesthetic spray: case report, discussion and qualitative systematic review.
CJEM. 2001;3(1):51-6
Methemoglobinemia-induced cardio-respiratory failure secondary to topical anesthesia.
American journal of therapeutics. 2006;13(6):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;9(2):289-90
Benzocaine-induced methemoglobinemia.
Anesthesia progress. 2005;52(4):136-9
Acquired methemoglobinemia: a retrospective series of 138 cases at 2 teaching hospitals.
Medicine. 2004;83(5):265-273
Reported adverse event cases of methemoglobinemia associated with benzocaine products.
Archives of internal medicine. 2004;164(11):1192-6
Critical rebound methemoglobinemia after methylene blue treatment: case report.
Pharmacotherapy. 2004;24(4):538-40
Benzocaine-induced methemoglobinemia: a potentially fatal complication of transesophageal echocardiography.
Texas Heart Institute journal. 2003;30(4):308-10
Severe methemoglobinemia after transesophageal echocardiography.
American journal of therapeutics. 2003;10(3):225-7
Severe methemoglobinemia on reexposure to benzocaine.
Journal of clinical anesthesia. 2001;13(2):128-30
Unexpected cyanosis in the surgical patient.
Surgical endoscopy. 2000;14(6):595
Benzocaine-induced methemoglobinemia: report of a severe reaction and review of the literature.
The Annals of pharmacotherapy. 1994;28(5):643-9
Benzocaine-adultered street cocaine in association with methemoglobinemia.
Clinical chemistry. 1992;38(4):596-7