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Preparation. Administration. Evidence.

IV Dilution &
Medication Reference

Search 255 medications, read preserved historical references, and inspect separately reviewed preparation statements. Full monograph updates remain pending.

Version 6.4Release date 2026-11-04For healthcare professionals
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Medication reference

Methylene blue

Monograph awaiting updateThis monograph will be updated in the future.

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No original site article was mapped to this record. The available historical structured fields and official-source links are retained.

Historical first look: uses, mechanism, dosing context, and administration

Recovered v5.1 source content; historical, awaiting current review.

Id
methylene-blue
Source IDH51-D7094C35D55EC992D5413B23
Generic name
Methylene blue
Source IDH51-9274AD123D2FCCEB19A2F72D
Class
Toxicology and reversal
Source IDH51-C3FFEF18AA27501556CDCD94
Subclass
Oxidation-reduction agent
Source IDH51-46DE01EA179F5AACECF5674E
Primary uses
  1. Acquired methemoglobinemia
    Source IDH51-6804E6B000889615D8A08AA3
Mechanism
Accelerates NADPH-dependent reduction of methemoglobin and also inhibits nitric-oxide signaling at higher exposure.
Source IDH51-9FE92453F4D40A99FDA6ECB6
Mechanism level
drug_specific
Source IDH51-69CA22477E2296330A2A3009
Basic dosing orientation
Adult and pediatric | Existing preparation record; use current package insert for indication-specific selection | 1 mg/kg as 0.1 mL/kg of 1% solution; repeat only per response and label | Not normalized in the preparation record | See current package insert and professional guidance | IV infusion
Source IDH51-73B7DD8195C1267769C54167
Administration orientation
Infuse over 5 to 30 minutes according to product and urgency
Source IDH51-984BB7806150BE2C9B563194
Renal and population orientation
Separate renal reference: Open Renal Dosing Master (opens in a new tab)Renal function materially affects toxicity, monitoring, or titration even when a fixed table may not apply.
Source IDH51-2E2FF9FA27A5D78BDF577B76
Key safety orientation
  1. Serotonin syndrome with serotonergic drugs.
    Source IDH51-D466C6CFD9A55CDF6F5AB38E
  2. Hemolysis risk in G6PD deficiency.
    Source IDH51-4E3FEBCE05731396D4ABB3CF
  3. Paradoxical methemoglobinemia at excessive doses.
    Source IDH51-96E83D1E1638D31B81C3436B
Coverage path
structured_local_snapshot
Source IDH51-339769584E88484F2CC8A6A0
Coverage path label
Structured GlobalRPh route snapshot
Source IDH51-DA4E12A857E5A14DFB3FE93D
Review note
First-look orientation only. Verify indication, patient population, weight basis, organ function, exact IV product, dose, concentration, compatibility, rate, and current labeling before use.
Source IDH51-2733B4085F2058DF8F49FE20
Search text
Methylene blue Toxicology and reversal Oxidation-reduction agent Acquired methemoglobinemia Accelerates NADPH-dependent reduction of methemoglobin and also inhibits nitric-oxide signaling at higher exposure. Adult and pediatric | Existing preparation record; use current package insert for indication-specific selection | 1 mg/kg as 0.1 mL/kg of 1% solution; repeat only per response and label | Not normalized in the preparation record | See current package insert and professional guidance | IV infusion Infuse over 5 to 30 minutes according to product and urgency Renal function materially affects toxicity, monitoring, or titration even when a fixed table may not apply. Serotonin syndrome with serotonergic drugs. Hemolysis risk in G6PD deficiency. Paradoxical methemoglobinemia at excessive doses. Structured GlobalRPh route snapshot
Source IDH51-AC174CF218E20931B5401C86
Official access mode
search
Source IDH51-90B4DE17178F51E033E4813D
Official search query
Methylene blue
Source IDH51-82D0E95D1F78802303D84D42
Official access reason
A source-backed DailyMed search is available; select and confirm the exact IV product.
Source IDH51-5E9FA08AFB61B86B10B5FC8F
Product identifiers and clinical review status

This monograph will be updated in the future. Historical material is available where present in the original sources; full current exact-product and claim-level review remains pending.

Exact formulation, concentration, container, manufacturer, regulatory identifiers, and a reproducible label snapshot have not all been reconciled.

What remains to be completed
  • Retrievable exact-product SPL XML with version, revision, retrieval date and reproducible hash
  • Clinically reviewed, individually identified statements with two exact source mappings
  • Exact formulation, strength, container, manufacturer/labeler, application and NDC reconciliation
  • Renal-function methods and dialysis/CRRT modality review where applicable
  • Mechanism provenance, clinical source disagreements and full medication-specific safety reconciliation

Supplemental historical fields

Restored-data provenance and review notes

Source release: 2026-08-31. Current clinical review is incomplete. Original uses of current, verified, or normalized describe the historical source. They do not inherit the status of separately reviewed statements. Product formulations and source dates can differ.

Current review annotations for historical renal, dialysis, mechanism, and product fieldsSeparate renal reference: Open Renal Dosing Master (opens in a new tab)
Renal
Status
not_locally_normalized
Original classification
monitor_or_titrate
Entries
    General note
    Preserve the source-specific renal-function basis. An indexed CrCl table is not interchangeable with unindexed CrCl or eGFR. Generic advice to check a method does not identify the equation for a dose row.
    Dialysis
    Status
    no_local_structured_regimen
    Entries
      General note
      Named modality alone does not establish applicability. CRRT subtype, effluent rate, residual renal function, timing and interruptions require review. Historical absence is not evidence that no guidance exists.
      Mechanisms
      • Source kind
        first_look
        Local pointer
        /mechanism
        Original level
        drug_specific
        Provenance classification
        historical_drug_specific_uncorroborated
        Label derived verified
        false
        Independently corroborated
        false
        Exact label section
        Not recorded
        Original source note
        Not recorded
        Review status
        historical_unverified
        Note
        Drug-specific wording in the old file is not proof of independent corroboration or an exact label locator. Consult separately published current mechanism claims where present.
      Future update
      Status
      pending_review
      Message
      This monograph will be updated in the future as current exact-product and claim-level review is completed.
      Source unavailable
      false
      Reason
      The historical content is restored; comprehensive contemporary verification remains incomplete.

      No separate structured rows were bundled for IV push, continuous infusion, dialysis, CRRT. Historical article content and source links may cover these topics.

      Historical dilution and intermittent infusion preparation

      Recovered v5.1 source content; historical, awaiting current review.

      PopulationAmountReconstitutionDiluentFinal volumeConcentrationRateStabilityNotes
      Source IDH51-247BC67648351729C823916A
      Adult and pediatric
      Source IDH51-075B719207AF9FC57585D9D4
      1 mg/kg as 0.1 mL/kg of 1% solution; repeat only per response and label
      Source IDH51-AD4F0B6CA681445A70293E43
      Withdraw from 5 mg/mL product; dilute if required by product label.
      Source IDH51-D41CC31E48F84C9BAA7FF36F
      D5W preferred by many labels because chloride may reduce solubility
      Source IDH51-EB139850AD1D95D655E075CC
      50 mL commonly
      Source IDH51-E89542AB54459CF5390AFC86
      Protocol-specific
      Source IDH51-29B4377B36E59337DCB44C73
      Infuse over 5 to 30 minutes according to product and urgency
      Source IDH51-2749852A96DD20A789657504
      Use the shorter of current product labeling, validated stability data, and the applicable USP <797> sterility-based BUD ceiling.
      Source IDH51-416BBA2F07A10042CE967DD5
      Confirm product concentration because methylene blue products have differed.
      Source IDH51-1AA6A37DB375124E9FAD1819

      Historical indication and population dosing

      Recovered tables and source-separated snapshots; full clinical revalidation remains pending.

      Existing dose and route snapshots

      RoutePopulationIndicationDoseIntervalDurationAdministrationSource levelNotes
      Source IDH51-3976F3D5544E8245328A229A
      IV infusion
      Source IDH51-042CC63B196D83A399DF9BD9
      Adult and pediatric
      Source IDH51-481AA8DB36E3373568FA6FA2
      Existing preparation record; use current package insert for indication-specific selection
      Source IDH51-B52F33F988E892CC8D6C4D63
      1 mg/kg as 0.1 mL/kg of 1% solution; repeat only per response and label
      Source IDH51-D6E7B76F64122945BD262BA7
      Not normalized in the preparation record
      Source IDH51-0361751D3E6BDAB9E9CEBABE
      See current package insert and professional guidance
      Source IDH51-DAFC4C4EF559AFB3198CA249
      Infuse over 5 to 30 minutes according to product and urgency
      Source IDH51-7A44CAE68194C289B0C5B4C4
      Existing GlobalRPh structured preparation snapshot
      Source IDH51-E4B2EA3DFD8064FB784B37D3
      Confirm product concentration because methylene blue products have differed.
      Source IDH51-636D46F4857D5819BB38EADA

      Historical renal-function guidance

      Recovered v5.1 source content; historical, awaiting current review.

      Separate renal reference: Open Renal Dosing Master (opens in a new tab)
      Classification
      monitor_or_titrate
      Source IDH51-4A9AD3713FA7E52312150B6C
      Summary
      Renal function materially affects toxicity, monitoring, or titration even when a fixed table may not apply.
      Source IDH51-8CD6228E293A39527A9AFA55
      Method note
      Use the renal function estimate and body-size convention specified by the selected label or institutional protocol. Do not interchange Cockcroft-Gault CrCl, indexed eGFR, and de-indexed eGFR without confirming the dosing source.
      Source IDH51-4941D073BCA4E695059E2AB0

      Historical Common IV uses

      Recovered v5.1 source content; historical, awaiting current review.

      1. Acquired methemoglobinemia
        Source IDH51-1362350B3E69AE98E88B924B

      Historical Warnings and safeguards

      Recovered v5.1 source content; historical, awaiting current review.

      1. Serotonin syndrome with serotonergic drugs.
        Source IDH51-07DB81BBFFA875BE08D6E018
      2. Hemolysis risk in G6PD deficiency.
        Source IDH51-6914FFAC522DFCD1AF00C4DE
      3. Paradoxical methemoglobinemia at excessive doses.
        Source IDH51-D1B2D6E8C983FCD7AD9B9656

      Historical Monitoring

      Recovered v5.1 source content; historical, awaiting current review.

      1. Methemoglobin level and oxygenation
        Source IDH51-20D6A51A28A952E5CB3F9CA4
      2. Neurologic/serotonergic findings
        Source IDH51-281FAF39F60D315687702C3D
      3. Hemolysis
        Source IDH51-4155DAD552F29258393740E7
      Other recovered source fields and original editorial metadata

      Original status words such as current, verified, or normalized describe the historical source release. They do not change the clinical review status of this release.

      Catalog source fields

      Id
      methylene-blue
      Source IDH51-ACB662F7CFE55E5082603BD4
      Generic name
      Methylene blue
      Source IDH51-E27D549E8F087D068D2F6B72
      Brand names
      1. ProvayBlue
        Source IDH51-D175BDC82D95F17C2340165E
      Class
      Toxicology and reversal
      Source IDH51-9B5C18D9FBBCA7EB826A0FB4
      Subclass
      Oxidation-reduction agent
      Source IDH51-C7C3E7038D9EACAB532A6F74
      Summary
      Concentrated antidotal agent requiring dilution and controlled administration; product strength and serotonin-toxicity risk must be reviewed.
      Source IDH51-7BC7CE3A5A1F528DDF78F822
      Populations
      1. Adult
        Source IDH51-C4A082EC6A3F1832BCA4B16F
      2. Pediatric
        Source IDH51-54A18E36C131B16CCDC162F6
      Evidence tier
      Core reference - verify current label
      Source IDH51-E8575DA1F140F37477976425
      High alert
      true
      Source IDH51-2E41B677EB4A7B6C9457B3B4
      Hazardous
      false
      Source IDH51-A471B16FFC166097476B9908
      Status
      Active
      Source IDH51-7BBAF72F599BB73787147F1E
      Reviewed
      2026-08-29
      Source IDH51-4199BFFF62C3FF2A9370F638
      Version added
      1.2
      Source IDH51-54DA6F0127C8F14CB1114EE1
      Sources
      LabelUrlKind
      Source IDH51-471CA8F4DDF36CC45DF15082
      DailyMed label search
      Source IDH51-BE5B8F68F8E5F9160E8808CC
      https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Methylene+blue (opens in a new tab)
      Source IDH51-87EDDE5CF119546677C802A2
      Primary
      Source IDH51-6CAC6A2C615C2D0A1B8DE4F0
      Source IDH51-6AD362AD0CF36047A9907A44
      GlobalRPh legacy IV dilution monograph
      Source IDH51-E08DE9A1FB9A55827A931AEE
      legacy:auto
      Source IDH51-6D1A84C585AA381EE6DCFF2E
      Legacy
      Source IDH51-4D5F180F7BBCA0BCE4C0F8D2
      Clinical release verification
      Audit version
      3.4
      Source IDH51-D976D766B34ABF2B42A20CC7
      Audited on
      2026-08-30
      Source IDH51-2348B976E7CC6EF33BE5ECC0
      Level
      amber
      Source IDH51-B61D4FA1F20E0AC51F23618B
      Release gate
      trusted_professional_source_present_exact_label_unconfirmed
      Source IDH51-6F84724C5752DD5AD2099C70
      Exact current label candidate
      false
      Source IDH51-F9B0B47875A5E3D6CF8B835C
      Numeric support ratio
      0
      Source IDH51-4267724DED7B5D186A17E356
      Reference url count
      1
      Source IDH51-8906E1C5D9017E47347ECDEA
      Broken reference count
      0
      Source IDH51-9F794362DF95A3EF941945A5
      Point of use confirmation required
      true
      Source IDH51-310502A939C9D22244738D7F
      Note
      Do not treat this record as a fully current product-specific monograph until the exact IV formulation and current sources are confirmed.
      Source IDH51-46599D3A5B4A4B68A4E1752E

      Dosing source fields

      Id
      methylene-blue
      Source IDH51-EA8E91D51B0BA86C244A9630
      Generic name
      Methylene blue
      Source IDH51-9ACFC2B5801AD8A9F25C3CE5
      Coverage status
      direct_official_label_access_plus_local_snapshot
      Source IDH51-6E96016EEFFBE990DEEC89F9
      Package insert
      Query name
      Methylene blue
      Source IDH51-F810D3E562875E94E912DFB5
      Product and route must match
      true
      Source IDH51-B75C9AD4F172AE062804AC81
      Live current label enabled
      false
      Source IDH51-A6A8925715CA09574C6EF76B
      Source priority
      Reviewed local summary when available, then a verified DailyMed label or product search when available, followed by professional references and institutional policy.
      Source IDH51-D4123E66CE7EB2C3F35BEA69
      Direct official label access enabled
      true
      Source IDH51-EC316C27036EC4CE97CE1693
      Outbound server request required
      false
      Source IDH51-5C4448E2E49A407F26B7A9F1
      Local summary status
      not_bundled
      Source IDH51-D4E19D5BDC3D31324C144746
      Clinical review
      Locally normalized
      false
      Source IDH51-259AB76735EC3E88DD868308
      Reviewed
      2026-08-29
      Source IDH51-7568D1E2378A7E46FABB326C
      Status
      Direct official package-insert access enabled; indication-specific local normalization pending.
      Source IDH51-81813AFCBADB0D1AEF2BACD9
      Clinical release verification
      Audit version
      3.4
      Source IDH51-70F0D1CA8107ADD79C3C386E
      Audited on
      2026-08-30
      Source IDH51-14CA7E68D7E31AA3D6C659AB
      Level
      amber
      Source IDH51-4BCE660332B476E00AD0B41C
      Release gate
      trusted_professional_source_present_exact_label_unconfirmed
      Source IDH51-A5ED37BA6B75F209E42A47A5
      Exact current label candidate
      false
      Source IDH51-EB878ECF43F92C04B9CCDECE
      Numeric support ratio
      0
      Source IDH51-BCA3C2F23E8BD88B2C830A3F
      Reference url count
      1
      Source IDH51-BCF389A43E8C98186FCA968A
      Broken reference count
      0
      Source IDH51-0A18218258A05557D8EEBE5D
      Point of use confirmation required
      true
      Source IDH51-AD7225CEAFA53FD54DA2FA65
      Note
      Do not treat this record as a fully current product-specific monograph until the exact IV formulation and current sources are confirmed.
      Source IDH51-6DA7B581C32C2EDA3D770CEF
      Historical preparation assessment

      Recovered v5.1 source content; historical, awaiting current review.

      Id
      methylene-blue
      Source IDH51-3B8B563F53CF679CC3AAE0D5
      Name
      Methylene blue
      Source IDH51-DCC6518A5A8064C18A90CAF1
      Brands
      ProvayBlue
      Source IDH51-F5BA095735821B675797C259
      Therapeutic class
      Toxicology and reversal
      Source IDH51-C4DD64D257F1CFE21E542F56
      Review version
      3.1
      Source IDH51-75B4073E88211BAE2E9C7430
      Review date
      2026-08-30
      Source IDH51-F177E2D6DF0AA10266181FD7
      Release status
      structured_record_current_label_not_confirmed
      Source IDH51-708A6A84F7FD56B102F51BA6
      Market status
      Status
      no_current_us_iv_spl_confirmed
      Source IDH51-7BDBB4489507A270AC6C958A
      Basis
      No high-confidence current IV SPL was automatically selected; legacy information is segregated
      Source IDH51-2B1F75060A208C47BFE51837
      Ten point assessment
      Exact formulation
      Not established in the currently normalized record. Use the current-label panel before clinical use.
      Source IDH51-5D26535E441984F21D88B929
      Reconstitution concentration
      Withdraw from 5 mg/mL product; dilute if required by product label.
      Source IDH51-294F290A4CEBAAC36D6C20C8
      Maximum or recommended final concentration
      Not established in the currently normalized record. Use the current-label panel before clinical use.
      Source IDH51-BF37332DC496359DDFB73FB3
      Appropriate standardized containers
      50 mL commonly
      Source IDH51-775D9FA9E5347FD17B848FCD
      Adult dosing range
      1 mg/kg as 0.1 mL/kg of 1% solution; repeat only per response and label
      Source IDH51-CF4F9A1B0F943181C68465C7
      Pediatric dosing range
      Not established in the currently normalized record. Use the current-label panel before clinical use.
      Source IDH51-3D80EFF0FD435CB05E15BFAE
      Neonatal dosing range
      Not established in the currently normalized record. Use the current-label panel before clinical use.
      Source IDH51-688C326B4F2E3E5788334B3E
      Infusion time
      Infuse over 5 to 30 minutes according to product and urgency
      Source IDH51-12014EF570F43037A2BE1A6F
      Fluid restriction alternatives
      Not established in the currently normalized record. Use the current-label panel before clinical use.
      Source IDH51-AC805DFD5D64B981619A3463
      Current manufacturer labeling
      Match confidence
      unresolved
      Source IDH51-63591F2AFC2A2D4547BA4917
      Field provenance
      Exact formulation
      Primary
      not_found
      Source IDH51-ECADD707B71F7E18E99AE5CA
      Reconstitution concentration
      Primary
      existing_structured_record
      Source IDH51-9D505689B7670042CE02B846
      Maximum or recommended final concentration
      Primary
      not_found
      Source IDH51-62AED46D4214A189824B9EF9
      Appropriate standardized containers
      Primary
      existing_structured_record
      Source IDH51-765BFCA6715DF580E829587C
      Adult dosing range
      Primary
      existing_structured_record
      Source IDH51-2BC0F7F1EC0713F27A59D027
      Pediatric dosing range
      Primary
      not_found
      Source IDH51-7E0FFCBF0B0898D5AB07A3D5
      Neonatal dosing range
      Primary
      not_found
      Source IDH51-6D47304B9B529D8DDF49E37A
      Infusion time
      Primary
      existing_structured_record
      Source IDH51-CBE8AEB3905D0A7982C817B6
      Fluid restriction alternatives
      Primary
      not_found
      Source IDH51-D520EBE9AACBF7FD661B50B5
      Current manufacturer labeling
      Primary
      DailyMed search gateway
      Source IDH51-FFC9AC9923C6D03B1429D352
      Population applicability
      Adult
      Applicability
      supported_or_source_present
      Source IDH51-B09CEBEB6F976FA27A462DC6
      Guide generation allowed
      true
      Source IDH51-AB666C1417A9A32DA83C87EE
      Pediatric
      Applicability
      supported_or_source_present
      Source IDH51-B765DA882E122D7C1AF3B37C
      Guide generation allowed
      false
      Source IDH51-EEB0BCC464415DA310392D51
      Neonatal
      Applicability
      not_established
      Source IDH51-6565CE8F79DBB8803F4AA7DF
      Guide generation allowed
      false
      Source IDH51-315FA57E074F3B6AF6EABA5B
      Route presence
      Structured dilution
      true
      Source IDH51-88FC7E889C7C2F68DD06AE6B
      Iv push
      false
      Source IDH51-0E505EFA309D04000747B3F2
      Continuous infusion
      true
      Source IDH51-F5C3FDCCDAB955D32EA3FD40
      Pediatric source
      true
      Source IDH51-21ECCF725F1125213D63CFC1
      Neonatal source
      false
      Source IDH51-039F567E77E7D76BA450DDA1
      Legacy reference
      Status
      not_available
      Source IDH51-52E7795B14AA4BF01D43B7CD
      Label resolution
      Status
      build_environment_network_unavailable
      Source IDH51-93D0EF7C97E8FB4BAABB8267
      Source files
      1. catalog.json
        Source IDH51-4BC17CC920DAF04B26352C6B
      2. dosing.json
        Source IDH51-E478DEF9A08D833E65D96EDB
      3. new-in-v1.2.json
        Source IDH51-7834785A335307771B867315
      Clinical release note
      Preparation instructions are released only at the evidence level shown. Legacy content remains visibly separate. Exact product, NDC, route, current labeling, and institutional policy must be confirmed.
      Source IDH51-7213776EAF6C70C2DC28FCCD
      Historical statement IDs and source locations

      These IDs identify recovered source units. They are not evidence-qualified clinical claims.

      Historical IDOriginal source locationStatus
      H51-ACB662F7CFE55E5082603BD4catalog.json
      /records/161/id
      Historical; current review incomplete
      H51-E27D549E8F087D068D2F6B72catalog.json
      /records/161/generic_name
      Historical; current review incomplete
      H51-D175BDC82D95F17C2340165Ecatalog.json
      /records/161/brand_names/0
      Historical; current review incomplete
      H51-9B5C18D9FBBCA7EB826A0FB4catalog.json
      /records/161/class
      Historical; current review incomplete
      H51-C7C3E7038D9EACAB532A6F74catalog.json
      /records/161/subclass
      Historical; current review incomplete
      H51-7BC7CE3A5A1F528DDF78F822catalog.json
      /records/161/summary
      Historical; current review incomplete
      H51-1362350B3E69AE98E88B924Bcatalog.json
      /records/161/common_uses/0
      Historical; current review incomplete
      H51-247BC67648351729C823916Acatalog.json
      /records/161/preparations/0
      Historical; current review incomplete
      H51-075B719207AF9FC57585D9D4catalog.json
      /records/161/preparations/0/population
      Historical; current review incomplete
      H51-AD4F0B6CA681445A70293E43catalog.json
      /records/161/preparations/0/amount
      Historical; current review incomplete
      H51-D41CC31E48F84C9BAA7FF36Fcatalog.json
      /records/161/preparations/0/reconstitution
      Historical; current review incomplete
      H51-EB139850AD1D95D655E075CCcatalog.json
      /records/161/preparations/0/diluent
      Historical; current review incomplete
      H51-E89542AB54459CF5390AFC86catalog.json
      /records/161/preparations/0/final_volume
      Historical; current review incomplete
      H51-29B4377B36E59337DCB44C73catalog.json
      /records/161/preparations/0/concentration
      Historical; current review incomplete
      H51-2749852A96DD20A789657504catalog.json
      /records/161/preparations/0/rate
      Historical; current review incomplete
      H51-416BBA2F07A10042CE967DD5catalog.json
      /records/161/preparations/0/stability
      Historical; current review incomplete
      H51-1AA6A37DB375124E9FAD1819catalog.json
      /records/161/preparations/0/notes
      Historical; current review incomplete
      H51-07DB81BBFFA875BE08D6E018catalog.json
      /records/161/warnings/0
      Historical; current review incomplete
      H51-6914FFAC522DFCD1AF00C4DEcatalog.json
      /records/161/warnings/1
      Historical; current review incomplete
      H51-D1B2D6E8C983FCD7AD9B9656catalog.json
      /records/161/warnings/2
      Historical; current review incomplete
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