Urex
 

Pills
 

ED Pills

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Urex


Pronunciation: meth-EN-a-meen
Generic Name: Methenamine
Brand Name: Examples include Hiprex and Urex
Urex is used for:

Preventing urinary tract infections.

Urex is a urinary antiseptic. It works by concentrating in the urine as formaldehyde, which kills bacteria in the urine.

Do NOT use Urex if: you are allergic to any ingredient in Urex you have kidney problems you are taking a sulfonamide (eg, sulfamethizole)

Contact your doctor or health care provider right away if any of these apply to you.

Before using Urex:

Some medical conditions may interact with Urex. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have diarrhea, a stomach infection, liver or kidney problems, or gout, or you are severely dehydrated

Some MEDICINES MAY INTERACT with Urex. Tell your health care provider if you are taking any other medicines, especially any of the following:

Sulfonamides (eg, sulfamethizole) because they may decrease Urex's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Urex may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Urex:

Use Urex as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Take Urex by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation. Before you begin using an antacid, check with your doctor or pharmacist. If you miss a dose of Urex, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Urex.

Important safety information: It is important that your urine be acidic while you are taking Urex. Check with your doctor to see if you should eat or avoid certain foods to keep your urine acidic. Urex may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Urex. Lab tests, including urine pH, may be performed while you use Urex. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. PREGNANCY and BREAST-FEEDING: It is not known if Urex can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Urex while you are pregnant. Urex is found in breast milk. If you are or will be breast-feeding while you use Urex, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Urex:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Nausea; upset stomach.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blood in the urine.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Urex side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Urex:

Store Urex at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Urex out of the reach of children and away from pets.

General information: If you have any questions about Urex, please talk with your doctor, pharmacist, or other health care provider. Urex is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Urex. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Urex resources Urex Side Effects (in more detail) Urex Use in Pregnancy & Breastfeeding Drug Images Urex Drug Interactions Urex Support Group 0 Reviews for Urex - Add your own review/rating Urex Advanced Consumer (Micromedex) - Includes Dosage Information Urex Concise Consumer Information (Cerner Multum) Methenamine Monograph (AHFS DI) Methenamine Prescribing Information (FDA) Hiprex Prescribing Information (FDA) Compare Urex with other medications Bladder Infection Prevention of Bladder infection


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Urinary anti-infectives


A drug may be classified by the chemical type of the active ingredient or by the way it is used to treat a particular condition. Each drug can be classified into one or more drug classes.

Urinary anti-infectives are drugs that are used to prevent or treat urinary tract infections. There are several classes of antibacterial agents in this category and they have different mechanisms of action. However, majority of these drugs tend to have high concentration in the urine and therefore are ideal to treat urinary tract infections, or used as prophylaxis for urinary tract infections.

See also

Medical conditions associated with urinary anti-infectives:

Bladder Infection Methemoglobinemia Otitis Media Pneumocystis Pneumonia Prevention of Bladder infection Transurethral Prostatectomy Urinary Tract Infection Drug List: Monurol Hiprex Mandelamine Macrodantin Macrobid Cinobac Furadantin-Suspension Neggram Primsol-Solution Proloprim Trimpex Urex Urolene-Blue-Oral-And-Injection


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Bladder Infection Medications


Definition of Bladder Infection: Inflammation of the urinary bladder.

Drugs associated with Bladder Infection

The following drugs and medications are in some way related to, or used in the treatment of Bladder Infection. This service should be used as a supplement to, and NOT a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners.

See sub-topics

Topics under Bladder Infection Alkylating Agent Cystitis (0 drugs) Hemorrhagic Cystitis Prophylaxis (1 drug) Prevention of Bladder infection (19 drugs) Learn more about Bladder Infection

Medical Encyclopedia:

Cystitis - acute Cystitis - noninfectious Cystitis - recurrent Urinary tract infection - adults Urinary tract infection - children

Harvard Health Guide:

Symptoms and treatment for Bladder Infection (Cystitis)
Drug List: Ala-Tet Amoxil Bio-Cef Cedax Cefizox Ceftin Cefzil Ceptaz Cinobac Cipro Cipro-I-V Cipro-Xr-Extended-Release-Tablets Cloxapen Dispermox Elmiron Floxin Fortaz Furadantin-Suspension Gantrisin-Suspension Gantrisin-Pediatric Geocillin Hiprex Keflex Levaquin Levaquin-Leva-Pak Lithostat Lorabid Lorabid-Pulvules Macrobid Macrodantin Mandelamine Maxaquin Monurol Neggram Noroxin Panixine Primsol-Solution Proloprim Proquin_Xr Raniclor Spectrobid Sumycin Suprax Tazicef Tegopen Tequin Tequin-Teqpaq Trimox Trimpex Truxazole Urex Vantin Velosef Zinacef


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Methenamine Mandelate


Class: Urinary Anti-infectives
Note: This monograph also contains information on Methenamine, Methenamine Hippurate
VA Class: AM550
CAS Number: 100-97-0
Brands: Hiprex, Mandelamine, Urex

Introduction

Antibacterial.100 101 102

Uses for Methenamine Mandelate Urinary Tract Infections (UTIs)

Prophylaxis or suppression of recurrent UTIs (bacteriuria), especially when long-term therapy is considered necessary.100 101 102

Use only after UTI has been eradicated by other appropriate anti-infectives.100 101

Not effective in systemic bacterial infections and has no effect on bacteria in blood or tissues outside the urinary tract.a Do not use alone in the treatment of acute parenchymal infections causing systemic symptoms (e.g., chills, fever).100 102

Monitor efficacy by periodic urine cultures.100 101

Antibacterial effects are maximal when urine pH is ?5.5.102 Monitor urinary pH during therapy; use supplementary acidification, if required.101 102 Supplementary acidification may be achieved by dietary regulation and/or concomitant administration of acidifying agents (e.g., ammonium chloride, ascorbic acid, methionine).a This is particularly important when the causative organisms are urea-splitting strains of Proteus or Pseudomonas which increase urinary pH.100 101

Methenamine Mandelate Dosage and Administration General

Acidic urine is essential for antibacterial activity; maximum efficacy occurs when urine pH is ?5.5.102 Restrict alkalinizing food and medication;101 102 use supplemental acidification if needed.100 101 102 a

Administration Oral Administration

Administer orally.100 101 102

Dosage

Available as methenamine hippurate and methenamine mandelate; dosage expressed in terms of the salt.100 101 102

Pediatric Patients Prophylaxis or Suppression of Urinary Tract Infections (UTIs) Methenamine Hippurate Oral

Children <6 years of age: Dosage not established.a

Children 6–12 years of age: 500 mg to 1 g twice daily (morning and night).100 101

Children >12 years of age: 1 g twice daily (morning and night).100 101

Methenamine Mandelate Oral

Children <6 years of age: 18.4 mg/kg 4 times daily, (after meals and at bedtime).102

Children 6–12 years of age: 500 mg 4 times daily (after meals and at bedtime).102

Children >12 years of age: 1 g 4 times daily (after meals and at bedtime).102

Alternatively, some clinicians recommend 50 mg/kg daily in 3 divided doses for children.a

Adults Prophylaxis or Suppression of Urinary Tract Infections (UTIs) Methenamine Hippurate Oral

1 g twice daily (morning and night).100 101

Methenamine Mandelate Oral

1 g 4 times daily (after meals and at bedtime).102

Special Populations

No special population dosage recommendations at this time.100 101 102

Cautions for Methenamine Mandelate Contraindications

Known hypersensitivity to the drug.102

Renal insufficiency.100 101 102

Severe hepatic insufficiency100 101 or severe dehydration.100 101

Warnings/Precautions Warnings Dysuria

Large doses (8 g daily for 3–4 weeks) have caused bladder irritation, painful and frequent micturition, albuminuria, and gross hematuria.100 101

Dysuria may be controlled by reducing dosage and/or reducing urine acidification.102

Hepatic Effects

Patients with preexisting hepatic insufficiency may have adverse effects from the small amounts of ammonia and formaldehyde that are produced following administration of methenamine.100 Acute hepatic failure may occur in some patients.100

Transient elevations in serum AST and ALT concentrations have occurred in patients receiving methenamine hippurate.100 101

Perform periodic liver function tests in patients receiving methenamine hippurate, especially in those with hepatic impairment.100 101 (See Hepatic Impairment under Cautions.)

Sensitivity Reactions Tartrazine Sensitivity

Hiprex tablets contain tartrazine (FD&C yellow No. 5), which may cause allergic reactions, including bronchial asthma, in susceptible individuals.101 Incidence of tartrazine sensitivity is low, but it frequently occurs in patients who are sensitive to aspirin.101

General Precautions Acidic Urine

Ensure that urine is maintained at an acidic pH during treatment, especially when causative organisms are urea-splitting strains of Proteus or Pseudomonas.100 101 (See Dosage and Administration.)

Manufacturer of methenamine mandelate states the drug is not recommended if urine acidification is contraindicated or unattainable (e.g., when some urea-splitting bacteria are present).102

Selection and Use of Anti-infectives

To reduce development of drug-resistant bacteria and maintain effectiveness of methenamine and other antibacterials, use only to prevent infections proven or strongly suspected to be caused by susceptible bacteria.101

When selecting or modifying anti-infective therapy, use results of culture and in vitro susceptibility testing.101 In the absence of such data, consider local epidemiology and susceptibility patterns when selecting anti-infectives for empiric therapy.101

Specific Populations Pregnancy

Category C.100 102

One manufacturer of methenamine hippurate states that safety during the last trimester is suggested, but not definitely proven.101

Effects of methenamine during labor and delivery are unknown and there are no recognized uses for the drug during labor or delivery.100

Lactation

Distributed into milk; discontinue nursing or the drug.100

Pediatric Use

Has been used in children without unusual toxicity.100

Geriatric Use

Insufficient experience in patients ?65 years of age to determine whether they respond differently than younger adults; clinical experience has not identified differences.101

Select dosage with caution, usually starting at the low end of the dosage range, because of possible age-related decreases in hepatic, renal, and/or cardiac function and concomitant disease and drug therapy.101

Hepatic Impairment

Perform periodic liver function tests.100 101

Methenamine hippurate is contraindicated in those with severe hepatic insufficiency.100 101

Common Adverse Effects

GI disturbances (nausea, vomiting, diarrhea, abdominal cramps, anorexia), pruritus, rash, dysuria.100 101 102 a

Interactions for Methenamine Mandelate Specific Drugs and Laboratory Tests

Drug or Test

Interaction

Comments

Sulfonamides

Insoluble precipitate forms in urine between formaldehyde and some sulfonamides (e.g., sulfamethizole, sulfathiazole [not commercially available in the US])100 101 102

Avoid concomitant use100 101 102

Test for 17-hydroxycorticosteroid

Formaldehyde in urine causes falsely elevated concentrations when Porter-Silber method is used102

Test for 5-hydroxyindoleacetic acid (5HIAA)

Formaldehyde in urine causes falsely decreased concentrations when nitrosonaphthol methods are used102

Test for urinary catecholamines and vanillylmandelic acid (VMA)

Formaldehyde in urine causes erroneously high results when fluorometric procedures are used102

Test for urine estriol

Formaldehyde in urine causes falsely decreased urine estriol concentrations when acid hydrolysis techniques are used101 102

Enzymatic hydrolysis technique unaffected101 102

Methenamine Mandelate Pharmacokinetics Absorption Bioavailability

Readily absorbed from the GI tract.a About 10–30% of oral dose is hydrolyzed by gastric acidity to formaldehyde and ammonia.a Enteric coating of methenamine mandelate tablets reduces hydrolysis in the GI tract and rate of absorption.a

Plasma Concentrations

Following oral administration of a usual single dose to healthy fasting adults, concentrations of methenamine and formaldehyde in plasma are generally very low and antibacterial activity in plasma is negligible.a

Distribution Extent

Crosses the placenta.100

Distributed into milk.100

Elimination Elimination Route

Within 24 hours, ?70–90% of a single oral dose is excreted intact in the urine by glomerular filtration and tubular secretion.a When urine is acidic, methenamine is hydrolyzed to formaldehyde and ammonia; maximum hydrolysis occurs when urine pH is ?5.5.a

Mandelic acid (mandelate) and hippuric acid (hippurate) are excreted in urine by glomerular filtration and tubular excretion.101 102

Stability Storage Oral Tablets

15–30°C100 101 102 in tight, light resistant containers.102

Actions and SpectrumActions

Synthetic antibacterial agent chemically unrelated to other currently available anti-infectives.a

Antibacterial effect of methenamine hippurate or methenamine mandelate depends on conversion of methenamine to formaldehyde in an acid medium (acidic urine).a

Formaldehyde is a nonspecific antibacterial agent which is usually bactericidal in action.a The acid portions of methenamine salts (hippuric acid, mandelic acid) have some nonspecific antibacterial activity and may enhance the liberation of formaldehyde from methenamine in vivo by maintaining urinary acidity.a

Formaldehyde is active against both gram-positive and gram-negative bacteria including Enterobacter, Escherichia coli, Klebsiella, Proteus, Pseudomonas aeruginosa, Staphylococcus aureus, S. epidermidis, and Enterococcus faecalis (formerly Streptococcus faecalis).a

Because formaldehyde, hippuric acid, and mandelic acid have nonspecific antibacterial activity, resistance does not usually develop during prolonged therapy with methenamine hippurate or methenamine mandelate.a

Advice to Patients

Advise patients that antibacterials (including methenamine hippurate and methenamine mandelate) should only be used for bacterial infections and not used to treat viral infections (e.g., the common cold).101

Importance of completing full course of therapy, even if feeling better after a few days.101

Advise patients that skipping doses or not completing the full course of therapy may decrease effectiveness and increase the likelihood that bacteria will develop resistance and will not be treatable with methenamine or other antibacterials in the future.101

Importance of informing clinicians of existing or contemplated concomitant therapy, including prescription and OTC drugs or laboratory tests.100 101 102

Importance of women informing clinicians if they are or plan to become pregnant or plan to breast-feed.100 101 102

Importance of informing patients of other important precautionary information.100 101 102 (See Cautions.)

Preparations

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

* available from one or more manufacturer, distributor, and/or repackager by generic (nonproprietary) name

Methenamine Hippurate

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Tablets

1 g*

Hiprex (with povidone and tartrazine; scored)

Sanofi-Aventis

Methenamine Hippurate Tablets

Corepharma

Urex (with povidone; scored)

Vatring

Methenamine Mandelate

Routes

Dosage Forms

Strengths

Brand Names

Manufacturer

Oral

Tablets, film-coated

500 mg

Mandelamine Hafgrams (with povidone and polyethylene glycol)

Warner Chilcott

1 g

Mandelamine (with povidone and polyethylene glycol)

Warner Chilcott

Comparative Pricing

This pricing information is subject to change at the sole discretion of DS Pharmacy. This pricing information was updated 04/2011. Actual costs to patients will vary depending on the use of specific retail or mail-order locations and health insurance copays.

Hiprex 1GM Tablets (SANOFI-AVENTIS U.S.): 20/$49.99 or 60/$139.97

Methenamine Hippurate 1GM Tablets (COREPHARMA LLC): 100/$185.99 or 300/$535.99

Urex 1GM Tablets (VATRING PHARMACEUTICALS): 30/$68.99 or 90/$199.97

Disclaimer

This report on medications is for your information only, and is not considered individual patient advice. Because of the changing nature of drug information, please consult your physician or pharmacist about specific clinical use.

The American Society of Health-System Pharmacists, Inc. and Drugs.com represent that the information provided hereunder was formulated with a reasonable standard of care, and in conformity with professional standards in the field. The American Society of Health-System Pharmacists, Inc. and Drugs.com make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, with respect to such information and specifically disclaims all such warranties. Users are advised that decisions regarding drug therapy are complex medical decisions requiring the independent, informed decision of an appropriate health care professional, and the information is provided for informational purposes only. The entire monograph for a drug should be reviewed for a thorough understanding of the drug's actions, uses and side effects. The American Society of Health-System Pharmacists, Inc. and Drugs.com do not endorse or recommend the use of any drug. The information is not a substitute for medical care.

AHFS Drug Information. © Copyright, 1959-2011, Selected Revisions January 01, 2008. American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland 20814.

References

100. Vatring. Urex (methenamine hippurate) prescribing information. Wytheville, VA; 2004 Aug.

101. Sanofi-Aventis. Hiprex (methenamine hippurate) prescribing information. Bridgewater, NJ; 2006 Mar.

102. Warner Chilcott. Mandelamine (methenamine mandelate) prescribing information. Rockaway, NJ; 2006 Oct.

a. AHFS Drug Information 2007. McEvoy GK, ed. Methenamine. Bethesda, MD: American Society of Health-System Pharmacists; 2007:889-90.

More Methenamine Mandelate resources Methenamine Mandelate Side Effects (in more detail) Methenamine Mandelate Dosage Methenamine Mandelate Use in Pregnancy & Breastfeeding Drug Images Methenamine Mandelate Drug Interactions Methenamine Mandelate Support Group 5 Reviews for Methenamine Mandelate - Add your own review/rating Methenamine Prescribing Information (FDA) Hiprex Prescribing Information (FDA) Hiprex Concise Consumer Information (Cerner Multum) Hiprex Advanced Consumer (Micromedex) - Includes Dosage Information Hiprex MedFacts Consumer Leaflet (Wolters Kluwer) Compare Methenamine Mandelate with other medications Bladder Infection Prevention of Bladder infection


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Methenamine


Pronunciation: meth-EN-a-meen
Generic Name: Methenamine
Brand Name: Examples include Hiprex and Urex
Methenamine is used for:

Preventing urinary tract infections.

Methenamine is a urinary antiseptic. It works by concentrating in the urine as formaldehyde, which kills bacteria in the urine.

Do NOT use Methenamine if: you are allergic to any ingredient in Methenamine you have kidney problems you are taking a sulfonamide (eg, sulfamethizole)

Contact your doctor or health care provider right away if any of these apply to you.

Before using Methenamine:

Some medical conditions may interact with Methenamine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

if you are pregnant, planning to become pregnant, or are breast-feeding if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement if you have allergies to medicines, foods, or other substances if you have diarrhea, a stomach infection, liver or kidney problems, or gout, or you are severely dehydrated

Some MEDICINES MAY INTERACT with Methenamine. Tell your health care provider if you are taking any other medicines, especially any of the following:

Sulfonamides (eg, sulfamethizole) because they may decrease Methenamine's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Methenamine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Methenamine:

Use Methenamine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Take Methenamine by mouth with or without food. If stomach upset occurs, take with food to reduce stomach irritation. Before you begin using an antacid, check with your doctor or pharmacist. If you miss a dose of Methenamine, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Methenamine.

Important safety information: It is important that your urine be acidic while you are taking Methenamine. Check with your doctor to see if you should eat or avoid certain foods to keep your urine acidic. Methenamine may interfere with certain lab tests. Be sure your doctor and lab personnel know you are taking Methenamine. Lab tests, including urine pH, may be performed while you use Methenamine. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments. PREGNANCY and BREAST-FEEDING: It is not known if Methenamine can cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Methenamine while you are pregnant. Methenamine is found in breast milk. If you are or will be breast-feeding while you use Methenamine, check with your doctor. Discuss any possible risks to your baby. Possible side effects of Methenamine:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Nausea; upset stomach.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blood in the urine.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Methenamine side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately.

Proper storage of Methenamine:

Store Methenamine at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Methenamine out of the reach of children and away from pets.

General information: If you have any questions about Methenamine, please talk with your doctor, pharmacist, or other health care provider. Methenamine is to be used only by the patient for whom it is prescribed. Do not share it with other people. If your symptoms do not improve or if they become worse, check with your doctor. Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Methenamine. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012 Database Edition 12.1.1.002 Copyright © 2012 Wolters Kluwer Health, Inc. More Methenamine resources Methenamine Side Effects (in more detail) Methenamine Dosage Methenamine Use in Pregnancy & Breastfeeding Drug Images Methenamine Drug Interactions Methenamine Support Group 5 Reviews for Methenamine - Add your own review/rating Methenamine Monograph (AHFS DI) Methenamine Prescribing Information (FDA) methenamine Concise Consumer Information (Cerner Multum) methenamine Advanced Consumer (Micromedex) - Includes Dosage Information Hiprex Prescribing Information (FDA) Compare Methenamine with other medications Bladder Infection Prevention of Bladder infection


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Neutra-Phos


Generic Name: potassium phosphate and sodium phosphate (poe TASS ee um FOSS fate and SEW dee um FOSS fate)
Brand Names: K-Phos M.F., K-Phos Neutral, K-Phos No. 2, Neutra-Phos, Uro-KP-Neutral

What are Neutra-Phos (potassium phosphate and sodium phosphate)?

Phosphorus is a naturally occurring substance that is important in every cell in the body. The majority of phosphorus in the body is found in the bones. The potassium and sodium salt forms of phosphorus are called phosphates.

Potassium phosphate and sodium phosphate is used to acidify the urine and lower the urinary calcium concentration. This may reduce rash and odor caused by ammonium in the urine. Potassium phosphate and sodium phosphate may also increase the antibiotic effect of methenamine (Hiprex, Urex). Potassium phosphate and sodium phosphate is also used as a phosphorus supplement to prevent and/or treat a phosphorus deficiency.

Potassium phosphate and sodium phosphate may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about Neutra-Phos (potassium phosphate and sodium phosphate)? Do not take antacids containing aluminum, calcium, or magnesium while taking potassium phosphate and sodium phosphate, except under the supervision of your doctor. Antacids may decrease phosphate absorption.

If you have kidney stones, there is a possibility that you will pass old stones after starting treatment with potassium phosphate and sodium phosphate.

Who should not take Neutra-Phos (potassium phosphate and sodium phosphate)? You cannot take potassium phosphate and sodium phosphate if you have

high levels of potassium in your body,

high levels of phosphorus in your body,

infected phosphate stones, or

severe kidney disease.

Before taking potassium phosphate and sodium phosphate, tell your doctor if you have

Addison's disease,

a bowel obstruction,

heart disease,

high blood pressure,

kidney disease, liver disease or cirrhosis,

swelling or water retention,

high levels of sodium in your body,

low levels of calcium in your body,

hypoparathyroidism,

pancreatitis, or

rickets.

You may not be able to take potassium phosphate and sodium phosphate, or you may require a lower dose or special monitoring if you have any of the conditions listed above.

Potassium phosphate and sodium phosphate is in the FDA pregnancy category C. This means that it is not known whether potassium phosphate and sodium phosphate will harm an unborn baby. Do not take this medication without first talking to your doctor if you are pregnant. It is also not known whether potassium phosphate and sodium phosphate will harm a nursing infant. Do not take potassium phosphate and sodium phosphate without first talking to your doctor if you are breast-feeding baby. How should I take Neutra-Phos (potassium phosphate and sodium phosphate)?

Take potassium phosphate and sodium phosphate exactly as directed by your doctor or as directed on the package. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each tablet with a full glass of water.

The K-Phos Original tablets should be dissolved in 6 to 8 ounces (180 to 240 mL) of water. Let the tablets soak for 2 to 5 minutes, or more if necessary, and stir. If tablet particles remain, they can be crushed and stirred to speed dissolution. Drink the solution once the tablets are completely dissolved.

Do not swallow the Neutra-Phos capsules whole. They must be opened, and the contents mixed with water. Mix the Neutra-Phos powder and capsule contents with 75 mL (approximately one-third cup) of water, and drink the solution. Do not take more of this medication than is recommended. If your symptoms are not being treated, notify your doctor. Store potassium phosphate and sodium phosphate at room temperature away from moisture and heat. What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medication unless otherwise directed.

What happens if I overdose? Seek emergency medical attention.

Most commonly, symptoms of an overdose include nausea, vomiting, diarrhea, dehydration, and severe and prolonged muscle cramps or paralysis.

What should I avoid while taking Neutra-Phos (potassium phosphate and sodium phosphate)? Do not take antacids containing aluminum, calcium, or magnesium while taking potassium phosphate and sodium phosphate, except under the supervision of your doctor. Antacids may decrease phosphate absorption. Neutra-Phos (potassium phosphate and sodium phosphate) side effects Stop taking potassium phosphate and sodium phosphate and seek emergency medical attention if you experience an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives).

Other, less serious side effects may also to occur. Nausea, vomiting, stomach pain, and diarrhea are among the most common. These side effects usually lessen after a few days of therapy. Notify your doctor if you develop these side effects.

If you have kidney stones, there is a possibility that you will pass old stones after starting treatment with potassium phosphate and sodium phosphate.

Less commonly, the following side effects have been reported:

headache;

dizziness or confusion;

weakness or heaviness of the legs;

diarrhea;

seizures;

unusual tiredness or weakness;

muscle cramps;

numbness, tingling, pain, or weakness of the hands or feet;

swelling of the feet or lower legs;

unusual weight gain;

increased thirst;

decreased urine; or

bone or joint pain.

Notify your doctor if you develop any of the side effects listed above.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Neutra-Phos (potassium phosphate and sodium phosphate)? Do not take antacids containing aluminum, calcium, or magnesium while taking potassium phosphate and sodium phosphate, except under the supervision of your doctor. Antacids may decrease phosphate absorption.

Before taking potassium phosphate and sodium phosphate, tell your doctor if you are taking any of the following medicines

calcium and/or vitamin D supplements;

potassium supplements or salt substitutes;

a diuretic (water pill) such as triamterene (Dyrenium, Dyazide, Maxzide), spironolactone (Aldactone), or amiloride (Midamor);

a heart medication such as guanethidine (Ismelin), diazoxide (Hyperstat, Proglycem), hydralazine (Apresoline), methyldopa (Aldomet), or reserpine (Ser-Ap-Es); or

a steroid medicine such as corticotropin (ACTH, Acthar), cortisone (Cortone), hydrocortisone (Cortef, others), prednisone (Orasone, Deltasone, others), prednisolone (Prelone, Pediapred, Delta-Cortef, others), methylprednisolone (Medrol, others), triamcinolone (Aristocort, Kenalog, Tri-Kort, Trilog, others), dexamethasone (Decadron), or betamethasone (Celestone).

You may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with potassium phosphate and sodium phosphate. Talk to your doctor and pharmacist before taking any prescription or over-the-counter medicines.

More Neutra-Phos resources Neutra-Phos Side Effects (in more detail) Neutra-Phos Use in Pregnancy & Breastfeeding Neutra-Phos Drug Interactions Neutra-Phos Support Group 0 Reviews for Neutra-Phos - Add your own review/rating K-Phos Neutral Advanced Consumer (Micromedex) - Includes Dosage Information K-Phos Neutral MedFacts Consumer Leaflet (Wolters Kluwer) Compare Neutra-Phos with other medications Hypophosphatemia Urinary Acidification Where can I get more information? Your pharmacist has more information about potassium phosphate and sodium phosphate written for health professionals that you may read.

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Maxzide


Generic Name: hydrochlorothiazide and triamterene (HYE dro klor oh THY a zide and trye AM ter een)
Brand Names: Dyazide, Maxzide, Maxzide-25

What is Maxzide (hydrochlorothiazide and triamterene)?

Hydrochlorothiazide is a thiazide diuretic (water pill) that helps prevent your body from absorbing too much salt, which can cause fluid retention.

Triamterene is a potassium-sparing diuretic that also prevents your body from absorbing too much salt and keeps your potassium levels from getting too low.

The combination of hydrochlorothiazide and triamterene is used to treat fluid retention (edema) and high blood pressure (hypertension).

Hydrochlorothiazide and triamterene may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Maxzide (hydrochlorothiazide and triamterene)? You should not use this medication if you are allergic to hydrochlorothiazide or triamterene, or if you have kidney disease, urination problems, high levels of potassium in your blood, or if you are taking other diuretics similar to triamterene. Do not use potassium supplements unless your doctor has told you to.

Before using this medication, tell your doctor if you have heart or liver disease, glaucoma, diabetes, a breathing disorder, gout, lupus, kidney stones, a pancreas disorder, or an allergy to sulfa drugs or penicillin.

Drinking alcohol can further lower your blood pressure and may increase certain side effects of hydrochlorothiazide and triamterene.

Avoid a diet high in salt. Too much salt will cause your body to retain water and can make this medication less effective.

Do not use potassium supplements, salt substitutes, or low-sodium milk while you are taking hydrochlorothiazide and triamterene, unless your doctor has told you to.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

If you are being treated for high blood pressure, keep using this medication even if you feel fine. High blood pressure often has no symptoms.

What should I discuss with my doctor before taking Maxzide (hydrochlorothiazide and triamterene)? You should not use this medication if you are allergic to hydrochlorothiazide (HCTZ, HydroDiuril, Lotensin HCT, Prinzide, Zestoretic, Ziac, and others) or triamterene (Dyrenium), or if you have: kidney disease or are unable to urinate;

high potassium levels (hyperkalemia);

if you are taking diuretics similar to triamterene, such as amiloride (Midamor, Moduretic), spironolactone (Aldactone, Aldactazide); or

if you are taking potassium supplements (unless your doctor tells you to).

To make sure you can safely take hydrochlorothiazide and triamterene, tell your doctor if you have any of these other conditions:

diabetes;

heart disease;

cirrhosis or other liver disease;

glaucoma;

a breathing disorder;

gout;

lupus;

a history of kidney stones;

a pancreas disorder; or

an allergy to sulfa drugs or penicillin.

FDA pregnancy category C. It is not known whether hydrochlorothiazide and triamterene will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication. Hydrochlorothiazide and triamterene can pass into breast milk and may harm a nursing baby. You should not breast-feed while taking hydrochlorothiazide and triamterene. How should I take Maxzide (hydrochlorothiazide and triamterene)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Your doctor may occasionally change your dose to make sure you get the best results.

You will need regular medical tests to be sure this medication is not causing harmful effects. Visit your doctor regularly.

This medication can cause unusual results with certain medical tests. Tell any doctor who treats you that you are using hydrochlorothiazide and triamterene.

If you need surgery or a blood transfusion, tell the doctor ahead of time that you are using hydrochlorothiazide and triamterene.

Keep using this medicine as directed, even if you feel well. High blood pressure often has no symptoms. You may need to use blood pressure medication for the rest of your life.

Store at room temperature away from moisture, heat, and light. What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include increased urination, nausea, vomiting, weakness, fever, warmth or flushing in your face, or muscle spasms.

What should I avoid while taking Maxzide (hydrochlorothiazide and triamterene)? Drinking alcohol can further lower your blood pressure and may increase certain side effects of hydrochlorothiazide and triamterene.

Avoid a diet high in salt. Too much salt will cause your body to retain water and can make this medication less effective.

Do not use potassium supplements, salt substitutes, or low-sodium milk while you are taking hydrochlorothiazide and triamterene, unless your doctor has told you to. Hydrochlorothiazide and triamterene may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Avoid becoming overheated or dehydrated during exercise and in hot weather. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

Maxzide (hydrochlorothiazide and triamterene) side effects Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using hydrochlorothiazide and triamterene and call your doctor at once if you have a serious side effect such as:

eye pain, vision problems;

slow, fast, or uneven heartbeat;

feeling like you might pass out;

swelling or rapid weight gain;

urinating less than usual or not at all;

headache, trouble concentrating, memory problems, weakness, loss of appetite, feeling unsteady, hallucinations, fainting, seizure, shallow breathing or breathing that stops;

low potassium (confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, muscle weakness or limp feeling);

high potassium (irregular heart rate, weak pulse, muscle weakness, tingly feeling);

severe pain in your upper stomach spreading to your back, nausea and vomiting, fast heart rate;

easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;

patchy skin color, red spots, or a butterfly-shaped skin rash over your cheeks and nose (worsens in sunlight);

fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or

jaundice (yellowing of the skin or eyes).

Less serious side effects may include:

mild nausea, diarrhea, constipation;

dizziness, headache;

blurred vision;

dry mouth;

skin rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs can affect Maxzide (hydrochlorothiazide and triamterene)? Before using hydrochlorothiazide and triamterene, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by hydrochlorothiazide and triamterene.

Tell your doctor about all other medicines you use, especially:

lithium (Eskalith, LithoBid);

amphotericin B (Amphotec, AmBisome, Abelcet);

methenamine (Hipprex, Mandelamine, Urex);

gout medication such as allopurinol (Zyloprim), colchicine (Colcrys), or probenecid (Benemid);

steroid medication (prednisone and others);

a blood thinner such as warfarin (Coumadin, Jantoven);

insulin or oral diabetes medication;

laxatives;

an ACE inhibitor such as benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil, Zestril), quinapril (Accupril), ramipril (Altace), and others; or

indomethacin (Indocin) or other NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn, Naprelan, Treximet), celecoxib (Celebrex), diclofenac (Arthrotec, Cambia, Cataflam, Voltaren, Flector Patch, Pennsaid, Solareze), indomethacin (Indocin), meloxicam (Mobic), and others.

This list is not complete and other drugs may interact with hydrochlorothiazide and triamterene. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

More Maxzide resources Maxzide Side Effects (in more detail)Maxzide Use in Pregnancy & BreastfeedingDrug ImagesMaxzide Drug InteractionsMaxzide Support Group2 Reviews for Maxzide - Add your own review/rating Maxzide Prescribing Information (FDA) Maxzide Advanced Consumer (Micromedex) - Includes Dosage Information Maxzide MedFacts Consumer Leaflet (Wolters Kluwer) Dyazide Prescribing Information (FDA) Dyazide Consumer Overview Compare Maxzide with other medications EdemaHigh Blood Pressure Where can I get more information? Your pharmacist can provide more information about hydrochlorothiazide and triamterene.

See also: Maxzide side effects (in more detail)


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Maxzide



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