Methylone

A documented fatality occurred in a 16-year-old with congenital cardiac malformation at a blood methylone concentration (272 ng/mL) well below levels found incidentally in surviving individuals (up to 4.8 mg/L). Structural cardiac abnormalities are an absolute contraindication.

Methylone-induced sympathomimetic effects pose extreme risk in individuals with congenital or acquired long QT syndrome.

Uncontrolled or severe hypertension substantially increases the risk of acute cardiovascular events during methylone use.

Pre-existing arrhythmias including long QT syndrome are absolute contraindications due to additive arrhythmia risk.

Asthma was a documented co-morbidity in a fatal methylone case (Kovács et al. 2012). Individuals with asthma may face elevated risk.

Individuals with a history of psychosis or psychotic disorders face elevated risk of acute psychotic episodes from methylone's dopaminergic stimulation.

Hepatic steatosis was documented at autopsy in a fatal methylone case. Patients with pre-existing liver disease may face increased exposure due to impaired metabolism and additive hepatotoxicity.

No reproductive toxicity data exist for methylone. Contraindicated on precautionary grounds given sympathomimetic and serotonergic pharmacological activity.

No reproductive toxicity data exist. Given high BBB permeability and monoamine-releasing mechanism, fetal exposure is assumed to carry substantial risk.

Concurrent use of any monoamine oxidase inhibitor (MAOI) with methylone is absolutely contraindicated due to the risk of fatal serotonin syndrome and hypertensive crisis.

Concurrent SSRI or SNRI use increases serotonin syndrome risk.