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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
- acetazolamide
- almotriptan
- brinzolamide ophthalmic
- celecoxib
- chlorothiazide
- chlorthalidone
- codeine
- dabrafenib
- darunavir
- deutetrabenazine
- dorzolamide ophthalmic
- fosamprenavir
- glimepiride
- glipizide
- glyburide
- hydrochlorothiazide
- indapamide
- linezolid
- mafenide topical
- meperidine
- metolazone
- morphine
- opicapone
- opium
- ozanimod
- potassium chloride
- potassium citrate
- rasagiline
- rizatriptan
- safinamide
- selegiline
- silver sulfadiazine topical
- sulfacetamide ophthalmic
- sulfacetamide topical
- sulfadiazine
- sulfamethoxazole
- sulfasalazine
- sumatriptan
- tapentadol
- tetrabenazine
- tipranavir
- tramadol
- varicella vaccine, live
- zolmitriptan
- zonisamide
Avoid/Use Alternative
- 5-HTP
- aclidinium inhaled
- alfentanil
- aluminum hydroxide
- amitriptyline
- amoxapine
- amphetamine
- BCG live intravesical
- belladonna alkaloids
- benztropine
- bromocriptine
- buprenorphine
- buspirone
- butalbital
- butorphanol
- calcium carbonate
- carbamazepine
- cholera vaccine, live
- citalopram
- clomipramine
- clonidine
- clozapine
- cocaine
- cyclobenzaprine
- desipramine
- desvenlafaxine
- dexmethylphenidate
- dextroamphetamine
- dextromethorphan
- dichlorphenamide
- dihydrocodeine
- dihydroergotamine
- doxepin
- doxepin topical
- doxylamine
- dronabinol
- duloxetine
- eletriptan
- eluxadoline
- entacapone
- ephedra
- epinephrine inhaled
- ergotamine
- escitalopram
- ethanol (alcoholic beverage)
- ethanol injection
- fenfluramine
- fentanyl
- fluoxetine
- fluvoxamine
- frovatriptan
- glucagon
- glycopyrronium topical
- granisetron
- haloperidol
- hydrocodone
- hydromorphone
- hyoscyamine
- imipramine
- isocarboxazid
- isoniazid
- kava
- kratom
- levomilnacipran
- levorphanol
- lisdexamfetamine
- lithium
- macimorelin
- magnesium carbonate
- magnesium hydroxide
- metaxalone
- methadone
- methamphetamine
- methazolamide
- methylene blue injection
- methylergonovine
- methylphenidate
- metoclopramide
- mexiletine
- midazolam
- milnacipran
- mirtazapine
- nalbuphine
- naratriptan
- nortriptyline
- olanzapine
- oliceridine
- ondansetron
- oxybate
- oxycodone
- oxymorphone
- palonosetron
- paroxetine
- pentazocine
- phenelzine
- pramlintide
- primaquine
- procarbazine
- promethazine
- protriptyline
- remifentanil
- revefenacin inhaled
- rivastigmine
- ropeginterferon alfa-2b
- SAMe
- scopolamine
- selegiline transdermal
- sertraline
- sodium bicarbonate
- sodium citrate
- sofpironium topical
- St. John's wort
- sufentanil
- tedizolid
- thalidomide
- tiotropium inhaled
- tolcapone
- topiramate
- tradipitant
- tranylcypromine
- trazodone
- trimethobenzamide
- trimipramine
- typhoid vaccine, live
- umeclidinium inhaled
- valbenazine
- venlafaxine
- vilazodone
- vortioxetine
- yohimbe
- ziprasidone
- zuranolone
Monitor/Modify Tx
- albuterol
- albuterol inhaled
- aldesleukin
- alprazolam
- arformoterol inhaled
- armodafinil
- atomoxetine
- atropine
- benzphetamine
- bismuth subsalicylate
- black cohosh
- brimonidine topical
- bupropion
- caffeine
- caffeine citrate
- calcium acetate
- calcium citrate
- calcium gluconate
- cannabis
- chlorpromazine
- chromium
- clobazam
- clonazepam
- clorazepate
- daridorexant
- desflurane
- dexmedetomidine
- dexmedetomidine injection
- diazepam
- dicyclomine
- diethylpropion
- diphenoxylate
- dobutamine
- dopamine
- droperidol
- ephedrine injection
- ephedrine oral
- epinephrine
- esketamine
- eszopiclone
- etomidate
- ferric maltol
- ferrous gluconate
- ferrous sulfate
- flecainide
- fluphenazine
- flurazepam
- formoterol inhaled
- gabapentin
- gabapentin enacarbil
- gepirone
- glycopyrrolate
- hoodia
- hydroxyzine
- ifosfamide
- isoproterenol
- ketamine
- ketoconazole
- lanthanum
- lemborexant
- levalbuterol inhaled
- levoketoconazole
- lifileucel
- liraglutide
- loperamide
- lorazepam
- lumateperone
- magnesium citrate
- magnesium oxide
- magnesium supplement
- methotrexate
- methscopolamine
- modafinil
- molindone
- nefazodone
- nelarabine
- olodaterol inhaled
- orphenadrine
- oxazepam
- oxybutynin
- pentobarbital
- perphenazine
- phendimetrazine
- phenobarbital
- phentermine
- phenylephrine ophthalmic
- pregabalin
- primidone
- probenecid
- propofol
- pseudoephedrine
- quazepam
- quinapril
- remimazolam
- rotigotine transdermal
- salmeterol inhaled
- sevoflurane
- sincalide
- solriamfetol
- sucralfate
- sucroferric oxyhydroxide
- sulfate bowel prep
- suvorexant
- terbutaline
- thioridazine
- thiothixene
- triazolam
- trospium
- vilanterol inhaled
- viloxazine
- zaleplon
- ziconotide
- zinc oral
- zolpidem
Caution Advised
- aceclidine ophthalmic
- acetaminophen
- allopurinol
- alosetron
- amantadine
- apomorphine
- apraclonidine ophthalmic
- aripiprazole bimonthly injection
- aripiprazole lauroxil
- aripiprazole monthly injection
- aripiprazole oral
- asenapine
- aspirin
- atropine ophthalmic
- baclofen
- baclofen intrathecal
- barium
- bethanechol
- botulinum toxin
- brexpiprazole
- brimonidine ophthalmic
- brivaracetam
- brompheniramine
- cannabidiol
- carbinoxamine
- cariprazine
- carisoprodol
- cenobamate
- cetirizine
- cevimeline
- chamomile, German
- chlophedianol
- chlorcyclizine
- chlordiazepoxide
- chlorpheniramine
- chlorzoxazone
- cisapride
- clemastine
- clidinium
- cyclopentolate ophthalmic
- cyproheptadine
- dantrolene
- darifenacin
- dexbrompheniramine
- dexchlorpheniramine
- difelikefalin
- difenoxin
- dimenhydrinate
- diphenhydramine
- disopyramide
- domperidone
- donepezil
- doxazosin
- efavirenz
- elinzanetant
- entrectinib
- erenumab
- erythromycin
- eslicarbazepine acetate
- estazolam
- ethanol (in some formulations)
- ethosuximide
- felbamate
- fesoterodine
- flavoxate
- flibanserin
- foslevodopa
- fosphenytoin
- galantamine
- ganaxolone
- gepotidacin
- glofitamab
- glycopyrrolate inhaled
- guanfacine
- homatropine
- iloperidone
- ipratropium inhaled
- ipratropium nasal
- isoflurane
- lacosamide
- lamotrigine
- levetiracetam
- levocetirizine
- levodopa
- linvoseltamab
- lofexidine
- loxapine
- lurasidone
- meclizine
- melatonin
- meprobamate
- methacholine inhaled
- methocarbamol
- methohexital
- methsuximide
- methyldopa
- metyrapone
- metyrosine
- milsaperidone
- mirabegron
- mitotane
- mosunetuzumab
- mycophenolate mofetil
- naltrexone
- naphazoline ophthalmic
- neostigmine
- oxcarbazepine
- paliperidone
- passion flower
- perampanel
- pheniramine
- phenytoin
- pilocarpine
- pilocarpine ophthalmic
- pimozide
- potassium acid phosphate
- potassium gluconate
- potassium phosphate
- pramipexole
- procainamide
- prochlorperazine
- pyridostigmine
- pyrilamine
- quetiapine
- quinidine (antiarrhythmic)
- quinidine (CYP2D6 inhibitor)
- ramelteon
- repotrectinib
- risperidone
- ropinirole
- rufinamide
- salsalate
- selinexor
- solifenacin
- stiripentol
- tasimelteon
- temazepam
- tetrahydrozoline ophthalmic
- thiotepa
- tiagabine
- tizanidine
- tolterodine
- trifluoperazine
- trihexyphenidyl
- triprolidine
- tropicamide ophthalmic
- valerian
- valproic acid
- vibegron
- vigabatrin
- willow bark
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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