1. Hyoscyamine:
   • Function: Hyoscyamine is an alkaloid found in certain plants, including deadly nightshade (Atropa belladonna). It has antimuscarinic properties, meaning it blocks the effects of acetylcholine, a neurotransmitter, on muscarinic receptors.
   • Medical Uses: Hyoscyamine is used to treat various conditions, such as irritable bowel syndrome (IBS), peptic ulcers, and urinary incontinence. It helps to relax smooth muscles, including those in the gastrointestinal and urinary tracts.
2. Methenamine:
   • Function: Methenamine is an antibacterial agent that is converted to formaldehyde in an acidic environment, such as the urine. Formaldehyde has antibacterial properties and helps prevent the growth of bacteria in the urinary tract.
   • Medical Uses: Methenamine is used as a urinary antiseptic to prevent and treat urinary tract infections (UTIs). It is often combined with other medications to enhance its effectiveness.
3. Methylene Blue:
   • Function: Methylene blue is a dye with various applications. It has antimicrobial and antiparasitic properties. In medicine, it acts as a redox indicator and can be used to treat methemoglobinemia (a condition where there is an abnormal amount of methemoglobin in the blood).
   • Medical Uses: Methylene blue is used in different medical scenarios, such as treating methemoglobinemia, guiding certain surgical procedures, and as a urinary antiseptic. It has also been studied for its potential use in treating conditions like Alzheimer's disease.
4. Sodium Phosphate:
   • Function: Sodium phosphate is a salt of phosphoric acid. It has osmotic laxative properties, meaning it draws water into the intestines, softening the stool and promoting bowel movements. It is also used for other medical purposes.
   • Medical Uses: Sodium phosphate is commonly used as a laxative to relieve constipation. It is also used in certain medical procedures, such as bowel preparation for colonoscopies.

Hyoscyamine, methenamine, methylene blue, and sodium phosphate are all ingredients in urogesic blue. Following urologic operations, a combination of medications is used to reduce bladder spasms and discomfort when voiding.

Urogesic-Blue (Hyoscyamine, methenamine, methylene blue, and sodium phosphate) Uses:

• Urinary tract symptoms:
  • It is used for the treatment of symptoms of irritative voiding.
  • It is also used as an antispasmodic for the relief of urinary tract symptoms caused by diagnostic procedures and for the relief of local symptoms of lower urinary tract infections like hypermotility.

Urogesic-Blue Dose in Adults

Urogesic-Blue Dose in the treatment of Urinary tract symptoms:

• You would take one tablet four times a day.
• The tablets contain four different substances: Hyoscyamine, methenamine, methylene blue, and sodium phosphate. These substances work together to help with urinary issues.

Urogesic-Blue Dose in Children

Urogesic-Blue Dose in the treatment of Urinary tract symptoms:

• Children >6 years:
  • Oral: Dosage must be individualized.

Pregnancy Risk Factor C

• We don't have information about how this combination affects animals when it comes to having babies.
• However, both hyoscyamine and methenamine can pass through the placenta to the baby during pregnancy.
• There's not much information about using methylene blue by mouth during pregnancy.
• This is based on what we know from studies done in the past.

Use of hyoscyamine and methenamine during breastfeeding.

• Hyoscyamine and methenamine can be found in breast milk.
• If a nursing mother is considering taking medication containing these substances, caution is recommended.

Dose in Kidney Disease:

• The information from the company that makes this medication doesn't mention any changes in the recommended dose for people with kidney problems.

Dose in Liver disease:

• The instructions from the company that makes this medication don't include any changes in the recommended dose for people with liver issues.

Side effects of Urogesic-Blue:

• Also see hyoscyamine, methenamine, and methylene blue monographs.
• Cardiovascular:
  • Flushing
  • Rapid Pulse
• Central Nervous System:
  • Dizziness
  • Drowsiness
• Gastrointestinal:
  • Vomiting
  • Xerostomia
  • Fecal Discoloration (Blue To Blue-Green)
  • Nausea
• Hypersensitivity:
  • Hypersensitivity Reaction (Rare)
• Genitourinary:
  • Acute Urinary Retention.
  • Difficulty In Micturition.
  • Urine Discoloration (Blue To Blue-Green).
• Ophthalmic:
  • Blurred Vision.
• Respiratory:
  • Dyspnea.

Contraindications to Urogesic-Blue (Hyoscyamine, methenamine, methylene blue, and sodium phosphate):

• If someone is allergic or highly sensitive to hyoscyamine, methenamine, methylene blue, sodium phosphate monobasic, or any other ingredient in the medication, they should avoid using it.
• This is because they may have an allergic reaction to one or more components in the formulation.

Warnings and precautions

Belladonna alkaloid allergy:

• If someone has had problems with medicines containing belladonna alkaloids in the past, they should be careful when using this medication.

Blurred vision

• If you experience blurred vision while using this medication, stop taking it right away.
• Blurred vision is a serious side effect, and discontinuing the medication is important to prevent further complications.

Dizziness:

• If you start feeling dizzy while using this medication, it's crucial to stop taking it immediately.
• Dizziness is a significant side effect that may affect your safety and well-being.
• Discontinuing the use of the medication is important to prevent any potential accidents or complications associated with dizziness.

Salicylate allergy

• If someone has had issues with medicines containing salicylates in the past, they should be cautious when using this medication.

Tachycardia

• If you experience a rapid heartbeat (tachycardia) while using this medication, it's important to discontinue its use immediately.
• Tachycardia can be a serious side effect, and stopping the medication promptly is crucial to avoid potential complications.

Cardiovascular disease

• If you have heart problems like irregular heartbeats, heart failure, or issues with the coronary arteries or mitral valve, you should be careful when using this medication.

Gastrointestinal Disease:

• If you have problems with your stomach or intestines, like a blockage in the digestive tract or ulcers in your stomach, be cautious when using this medication.

Glaucoma:

• If you have glaucoma, you should be cautious when using this medication.
• Glaucoma is a condition characterized by increased pressure within the eye, and certain medications can potentially affect eye health.

Myasthenia gravis:

• If you have myasthenia gravis, you should use this medication with caution.
• Myasthenia gravis is a neuromuscular disorder that can affect muscle strength and control.

Obstructive Uropathy:

• If you have a condition called obstructive uropathy, which involves blockages in the urinary system like bladder neck obstruction or prostatic hyperplasia, be careful when using this medication.

Monitoring parameters:

• Monitor Urinary tract symptoms.

How to administer Urogesic-Blue (Hyoscyamine, methenamine, methylene blue, and sodium phosphate)?

• Take with Water: Swallow the medication by mouth.
• Drink Plenty of Water: After taking the medication, make sure to drink a good amount of water.

Mechanism of action of Hyoscyamine, methenamine, methylene blue, and sodium phosphate (Urogesic-Blue):

Hyoscyamine:

• Function: Hyoscyamine relaxes smooth muscles.
• Effect: Produces an antispasmodic effect.
• Purpose: Used to alleviate muscle spasms.

Methenamine:

• Function: Hydrolyzed in acidic urine to produce formaldehyde.
• Action: Provides local bactericidal or bacteriostatic effects.
• Purpose: Used for urinary tract infections.

Methylene Blue:

• Properties: Has weak antiseptic properties.
• Purpose: Used for various medical applications, including in combination with other medications.

Sodium Phosphate Monobasic:

• Role: Maintains an acidic pH in the urine.
• Significance: Necessary for the breakdown of methenamine.
• Purpose: Used in combination with other substances for specific therapeutic effects in the urinary system.Top of Form

See individual agents.

International Brand Names of Hyoscyamine, methenamine, methylene blue, and sodium phosphate:

• Indiomin MB
• ME/NaPhos/MB/Hyo1
• Uro-BLUE
• Urogesic-Blue
• Urolet MB
• UTA

Hyoscyamine, methenamine, methylene blue, and sodium phosphate Brand Names in Pakistan:

Not available.