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Uribel Tabs
methenamine/ benzoic acid/ phenyl salicylate/ methylene blue/ hyoscyamine
Adult Dosing .
Dosage forms: TAB: 81.6 mg/9 mg/36.2 mg/10.8 mg/0.12 mg
Special Note
- [prescribing info]
- Info: not FDA-approved or regulated as a drug
dysuria
- [1 tab PO 4x/day]
- Info: give with plenty of water
renal dosing
- [see below]
- renal impairment: not defined, caution advised
- HD/PD: not defined, caution advised
hepatic dosing
- [see below]
- mild-moderate impairment: not defined; severe impairment: not defined, caution advised
Peds Dosing .
- Dosage forms: TAB: 81.6 mg/9 mg/36.2 mg/10.8 mg/0.12 mg
Special Note
- [prescribing info]
- Info: not FDA-approved or regulated as a drug
dysuria
- [>6 yo]
- Dose: individualize dose; Info: give with plenty of water
renal dosing
- [see below]
- renal impairment: not defined, caution advised
- HD/PD: not defined, caution advised
hepatic dosing
- [see below]
- mild-moderate impairment: not defined; severe impairment: not defined, caution advised
Contraindications / Cautions .
- hypersensitivity to drug or ingredient
- G6PD deficiency
- myocardial ischemia
- cardiovascular status, unstable
- caution: hypersensitivity to salicylates
- caution: hypersensitivity to belladonna alkaloids
- caution: elderly patients
- caution: autonomic neuropathy
- caution: environmental temperature, high
- caution: fever
- caution: renal impairment
- caution: hepatic impairment, severe
- caution: hyperthyroidism
- caution: HTN
- caution: cardiac disease
- caution: glaucoma
- caution: GI disease, obstructive
- caution: GI ulcer
- caution: myasthenia gravis
- caution: uropathy, obstructive
- caution: diarrhea, unexplained
Drug Interactions .
Overview
benzoic acid
urine acidifier
- urine acidifier
hyoscyamine
anticholinergic
- alters gallbladder contraction/motility
- anticholinergic effects
- binds to polyvalent cations
- CNS depression
- gastric pH modulator
- tachycardia
- caution advised with concurrent oral drugs requiring rapid onset; hyoscyamine delays gastric emptying, may alter absorption of concomitant oral drugs
methenamine
urinary antiseptic
- impairs immunomodulatory bacterial infective agent
- urine pH sensitive
methylene blue oral
urinary antiseptic; MAOI
- MAO non-selective inhibitor
- serotonergic effects (MAOI)
phenyl salicylate
salicylate, non-acetylated
- affects growth hormone diagnostic test results
- hyperuricemic effects
Contraindicated
Avoid/Use Alternative
Monitor/Modify Tx
Caution Advised
Adverse Reactions .
Serious Reactions
- hypersensitivity reaction
- anaphylaxis
- crystalluria
- hemolytic anemia
- serotonin syndrome
- syncope
- heat stroke
- IOP incr.
- psychosis, anticholinergic
- hallucinations
Common Reactions
- tachycardia
- flushing
- dyspnea
- dry mouth
- nausea
- vomiting
- drowsiness
- dizziness
- blurred vision
- urinary retention
- difficulty urinating
- urine discoloration
- fecal discoloration
- anticholinergic effects
Safety/Monitoring .
Monitoring Parameters
no routine tests recommended
Pregnancy/Lactation .
Pregnancy
Clinical Summary
weigh risk/benefit during pregnancy; risk of fetal harm low based on limited human data with methenamine, methylene blue, or hyoscyamine; no human data available with benzoic acid or phenyl salicylate
Lactation
Clinical Summary
weigh risk/benefit while breastfeeding; no known risk of infant harm based on limited human data with methenamine; no human data available to assess risk of infant harm with benzoic acid, phenyl salicylate, methylene blue, or hyoscyamine; no human data available, though theoretical risk of decr. milk production based on decr. prolactin levels with hyoscyamine
Pharmacology .
Metabolism: for methenamine: urine; CYP450: unknown; Info: active metabolite (formaldehyde); for benzoic acid: liver; CYP450: unknown; for phenyl salicylate: liver; CYP450: unknown; Info: active metabolite (salicylate); for methylene blue: liver extensively; CYP450: 1A2, 2C19, 2D6 substrate; UGT: 1A4, 1A9 substrate; Info: active metabolite; for hyoscyamine: liver; CYP450: unknown
Excretion: for methenamine: urine >90%; Half-life: 4.3h; for benzoic acid: urine; Half-life: unknown; for phenyl salicylate: urine; Half-life: unknown; for methylene blue: urine (40% unchanged), bile; Half-life: 24h; for hyoscyamine: urine primarily (30-50% unchanged); Half-life: 2-3.5h
Subclass: Analgesics, Urinary ; Antiseptics, Urinary ; Urinary Acidifiers
Mechanism of Action
for methenamine: prodrug hydrolyzed to formaldehyde and ammonia in acidic urine, exerting non-specific antibacterial effects via formaldehyde protein denaturation; for benzoic acid: acidifies urine; for phenyl salicylate: hydrolyzes to salicylate, inhibiting cyclooxygenase to produce analgesia; for methylene blue: possesses weak antiseptic activity; for hyoscyamine: antagonizes acetylcholine receptors, producing antispasmodic effects (anticholinergic)
Formulary .
No Formulary Selected
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