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Hyophen (Methenamine, Phenyl salicylate, Methylene Blue, Benzoic acid, and Hyoscyamine)

Hyophen (Methenamine, phenyl salicylate, methylene blue, benzoic acid, and hyoscyamine) is used for the treatment of patients with urinary tract discomfort as a result of infection or certain diagnostic procedures.

Methenamine, phenyl salicylate, methylene blue, benzoic acid, and hyoscyamine Uses:

It is used for the treatment of urinary tract discomfort caused by hypermotility as a result of infection or diagnostic procedures.

Hyophen Dose in Adults:

Hyophen Dose in the treatment of Urinary tract symptoms:

Oral: One tablet four times a day.

Hyophen Dose in Childrens:

Hyophen Dose in the treatment of Urinary tract symptoms:

Children >6 years:
- Oral: Dosage must be individualized

Pregnancy Risk Factor C

Reproduction studies with this combination have not been done, so data is very limited.
The placental barrier can be crossed by methenamine and/or hyoscyamine.

Use of methenamine, phenyl salticylate, methyleneblue, benzoic acid and hyoscyamine during breastfeeding

Breastmilk contains hyoscyamine and methenamine.
It is recommended that you use it with caution if you are lactating.

Hyophen Dose in Kidney Disease:

No dosage adjustments have been provided in the manufacturer's labeling.
Use it with caution in patients with kidney disease.
Methenamine is contraindicated in patients with kidney impairment (although very less amounts of the drug are present in the combination products).

Hyophen Dose in Liver disease:

No dosage adjustments have been provided in the manufacturer's labeling.
Use it with caution in patients with liver disease.
Methenamine is contraindicated in severe liver disease (although very less amounts of the drug are present in the combination products).

Side effects of Hyophen:

Cardiovascular:
- Flushing
- Tachycardia
Central nervous system:
- Dizziness
Gastrointestinal:
- Fecal discoloration (blue)
- Nausea
- Vomiting
- Xerostomia
Genitourinary:
- Difficulty in micturition Urinary retention (acute)
- Urine discoloration (blue)
Ophthalmic:
- Blurred vision
Respiratory:
- Dyspnea

Contraindication to Hyophen (Methenamine, phenyl salicylate, methylene blue, benzoic acid, and hyoscyamine):

Hypersensitivity to methenamines, hyoscyamines, methyleneblue, phenyl salicylates, benzoic acids, or any other component of the formulation
Notification:
- Check out contraindications for individual drugs.

Warnings and precautions

Belladonna alkaloid allergy:
- Patients who have a history of intolerance or hypersensitivity to belladonna alkaloids are advised to avoid the drug.
Blurred vision
- Stop the treatment if the patient has blurred vision.
Cardiac disease
- Patients who have a history of heart disease, heart attack, or mitral stenosis should not take the drug.
Dizziness:
- Stop the treatment if the patient experiences dizziness.
Salicylate allergy
- Patients who have a history of intolerance should not use the drug.
Tachycardia
- Patients with tachycardia must stop taking the medication immediately.
Gastrointestinal Disease:
- Patients with a pyloric obstruction or duodenal obstruction, or with gastric ulcers, should not use this drug.
Glaucoma:
- Patients with elevated intraocular pressure or glaucoma need to be cautious.
Myasthenia gravis:
- Patients suffering from myasthenia gravis need to be cautious.
Obstructive Uropathy:
- Patients suffering from obstructive symptoms like prostatic hyperplasia or bladder outlet obstruction should not take this drug.

Methenamine, phenyl salicylate, methylene blue, benzoic acid, and hyoscyamine: Drug Interaction

Risk Factor C (Monitor therapy)
Acetylcholinesterase Inhibitors	May diminish the therapeutic effect of Anticholinergic Agents. Anticholinergic Agents may diminish the therapeutic effect of Acetylcholinesterase Inhibitors.
Alosetron	May enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined.
Amantadine	May enhance the anticholinergic effect of Anticholinergic Agents.
Amantadine	Urinary Acidifying Agents may decrease the serum concentration of Amantadine.
Anticholinergic Agents	May enhance the adverse/toxic effect of other Anticholinergic Agents.
Antiemetics (5HT3 Antagonists)	May enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined. Exceptions: Alosetron; Ondansetron; Ramosetron.
Antipsychotic Agents	Serotonergic Agents (High Risk) may enhance the adverse/toxic effect of Antipsychotic Agents. Specifically, serotonergic agents may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotic Agents may enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome.
BCG Vaccine (Immunization)	Antibiotics may diminish the therapeutic effect of BCG Vaccine (Immunization).
Beta2-Agonists	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Beta2Agonists.
Betahistine	Monoamine Oxidase Inhibitors may increase the serum concentration of Betahistine.
Blood Glucose Lowering Agents	Monoamine Oxidase Inhibitors may enhance the hypoglycemic effect of Blood Glucose Lowering Agents.
Botulinum Toxin-Containing Products	May enhance the anticholinergic effect of Anticholinergic Agents.
Brimonidine (Ophthalmic)	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Brimonidine (Ophthalmic). Monoamine Oxidase Inhibitors may increase the serum concentration of Brimonidine (Ophthalmic).
Brimonidine (Topical)	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Brimonidine (Topical). Monoamine Oxidase Inhibitors may increase the serum concentration of Brimonidine (Topical).
Cannabinoid-Containing Products	Anticholinergic Agents may enhance the tachycardic effect of Cannabinoid-Containing Products. Exceptions: Cannabidiol.
Cerebrolysin	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors.
Chloral Betaine	May enhance the adverse/toxic effect of Anticholinergic Agents.
Chlorphenesin Carbamate	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors.
ChlorproPAMIDE	Urinary Acidifying Agents may increase the serum concentration of ChlorproPAMIDE.
Clemastine	Monoamine Oxidase Inhibitors may enhance the anticholinergic effect of Clemastine.
Dihydrocodeine	May enhance the serotonergic effect of Monoamine Oxidase Inhibitors. This could result in serotonin syndrome.
Domperidone	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Domperidone. Monoamine Oxidase Inhibitors may diminish the therapeutic effect of Domperidone. Domperidone may diminish the therapeutic effect of Monoamine Oxidase Inhibitors.
Doxapram	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of Doxapram.
Doxylamine	Monoamine Oxidase Inhibitors may enhance the anticholinergic effect of Doxylamine. Management: The US manufacturer of Diclegis (doxylamine/pyridoxine) and the manufacturers of Canadian doxylamine products specifically lists use with monoamine oxidase inhibitors as contraindicated.
EPINEPHrine (Nasal)	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of EPINEPHrine (Nasal).
Epinephrine (Racemic)	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of Epinephrine (Racemic).
EPINEPHrine (Systemic)	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of EPINEPHrine (Systemic).
Ergot Derivatives	May enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined. Exceptions: Nicergoline.
Esketamine	May enhance the hypertensive effect of Monoamine Oxidase Inhibitors.
Gastrointestinal Agents (Prokinetic)	Anticholinergic Agents may diminish the therapeutic effect of Gastrointestinal Agents (Prokinetic).
Glucagon	Anticholinergic Agents may enhance the adverse/toxic effect of Glucagon. Specifically, the risk of gastrointestinal adverse effects may be increased.
Itopride	Anticholinergic Agents may diminish the therapeutic effect of Itopride.
Lactobacillus and Estriol	Antibiotics may diminish the therapeutic effect of Lactobacillus and Estriol.
Lasmiditan	May enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined.
Lorcaserin	May enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined.
Mecamylamine	Urinary Acidifying Agents may decrease the serum concentration of Mecamylamine.
Metaraminol	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of Metaraminol.
Metaxalone	May enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined.
Mirabegron	Anticholinergic Agents may enhance the adverse/toxic effect of Mirabegron.
Nitroglycerin	Anticholinergic Agents may decrease the absorption of Nitroglycerin. Specifically, anticholinergic agents may decrease the dissolution of sublingual nitroglycerin tablets, possibly impairing or slowing nitroglycerin absorption.
Norepinephrine	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of Norepinephrine.
Ondansetron	May enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined.
Opioid Agonists	Anticholinergic Agents may enhance the adverse/toxic effect of Opioid Agonists. Specifically, the risk for constipation and urinary retention may be increased with this combination.
Opioid Agonists	May enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined. Exceptions: FentaNYL; Meperidine; TraMADol.
Oxitriptan	Serotonergic Agents (High Risk) may enhance the serotonergic effect of Oxitriptan. This could result in serotonin syndrome. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined.
Ramosetron	Anticholinergic Agents may enhance the constipating effect of Ramosetron.
Ramosetron	May enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined.
St John's Wort	May enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. St John's Wort may decrease the serum concentration of Serotonergic Agents (High Risk). Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined.
Syrian Rue	May enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. Management: Monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes) when these agents are combined.
Thiazide and Thiazide-Like Diuretics	May diminish the therapeutic effect of Methenamine.
Risk Factor D (Consider therapy modification)
Amifampridine	Agents With Seizure Threshold Lowering Potential may enhance the neuroexcitatory and/or seizure-potentiating effect of Amifampridine.
Antacids	May diminish the therapeutic effect of Methenamine.
Antacids	May decrease the serum concentration of Hyoscyamine. Management: Administer immediate release hyoscyamine before meals and antacids after meals when these agents are given in combination.
Benzhydrocodone	May enhance the serotonergic effect of Monoamine Oxidase Inhibitors. This could result in serotonin syndrome. Management: The use of benzhydrocodone is not recommended for patients taking monoamine oxidase inhibitors (MAOIs) or within 14 days of MAOI discontinuation.
Carbonic Anhydrase Inhibitors	May diminish the therapeutic effect of Methenamine. Management: Consider avoiding this combination. Monitor for decreased therapeutic effects of methenamine if used concomitant with a carbonic anhydrase inhibitor. Exceptions: Brinzolamide; Dorzolamide.
COMT Inhibitors	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors.
DOPamine	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of DOPamine. Management: Initiate dopamine at no greater than one-tenth (1/10) of the usual dose in patients who are taking (or have taken within the last 2 to 3 weeks) monoamine oxidase inhibitors. Monitor for an exaggerated hypertensive response to dopamine.
HYDROcodone	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of HYDROcodone. Management: Consider alternatives to this combination when possible.
Iohexol	Agents With Seizure Threshold Lowering Potential may enhance the adverse/toxic effect of Iohexol. Specifically, the risk for seizures may be increased. Management: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iohexol. Wait at least 24 hours after the procedure to resume such agents. In nonelective procedures, consider use of prophylactic anticonvulsants.
Iomeprol	Agents With Seizure Threshold Lowering Potential may enhance the adverse/toxic effect of Iomeprol. Specifically, the risk for seizures may be increased. Management: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iomeprol. Wait at least 24 hours after the procedure to resume such agents. In nonelective procedures, consider use of prophylactic anticonvulsants.
Iopamidol	Agents With Seizure Threshold Lowering Potential may enhance the adverse/toxic effect of Iopamidol. Specifically, the risk for seizures may be increased. Management: Discontinue agents that may lower the seizure threshold 48 hours prior to intrathecal use of iopamidol. Wait at least 24 hours after the procedure to resume such agents. In nonelective procedures, consider use of prophylactic anticonvulsants.
Ketoconazole (Systemic)	Hyoscyamine may decrease the serum concentration of Ketoconazole (Systemic). Management: Take hyoscyamine at least 2 hours after ingestion of ketoconazole. Monitor for decreased therapeutic effects of ketoconazole if used together with hyoscyamine.
Lithium	Methylene Blue may enhance the serotonergic effect of Lithium. This could result in serotonin syndrome. Management: Consider alternatives to this drug combination. If combined, monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes).
Pramlintide	May enhance the anticholinergic effect of Anticholinergic Agents. These effects are specific to the GI tract.
Remifentanil	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Remifentanil. Specifically, the risk for opioid toxicity (eg, respiratory depression) may be increased. Remifentanil may enhance the serotonergic effect of Monoamine Oxidase Inhibitors. This could result in serotonin syndrome. Management: The use of remifentanil is not recommended for patients taking monoamine oxidase inhibitors (MAOIs) or within 14 days of MAOI discontinuation.
Reserpine	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Reserpine. Existing MAOI therapy can result in paradoxical effects of added reserpine (e.g., excitation, hypertension). Management: Monoamine oxidase inhibitors (MAOIs) should be avoided or used with great caution in patients who are also receiving reserpine.
Secretin	Anticholinergic Agents may diminish the therapeutic effect of Secretin. Management: Avoid concomitant use of anticholinergic agents and secretin. Discontinue anticholinergic agents at least 5 half-lives prior to administration of secretin.
Serotonergic Opioids (High Risk)	Methylene Blue may enhance the serotonergic effect of Serotonergic Opioids (High Risk). This could result in serotonin syndrome. Management: Consider alternatives to this drug combination. If combined, monitor for signs and symptoms of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, mental status changes).
Sodium Picosulfate	Antibiotics may diminish the therapeutic effect of Sodium Picosulfate. Management: Consider using an alternative product for bowel cleansing prior to a colonoscopy in patients who have recently used or are concurrently using an antibiotic.
Typhoid Vaccine	Antibiotics may diminish the therapeutic effect of Typhoid Vaccine. Only the live attenuated Ty21a strain is affected. Management: Vaccination with live attenuated typhoid vaccine (Ty21a) should be avoided in patients being treated with systemic antibacterial agents. Use of this vaccine should be postponed until at least 3 days after cessation of antibacterial agents.
Risk Factor X (Avoid combination)
Aclidinium	May enhance the anticholinergic effect of Anticholinergic Agents.
Alcohol (Ethyl)	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors.
Alpha-/Beta-Agonists (Indirect-Acting)	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of Alpha-/Beta-Agonists (Indirect-Acting). While linezolid is expected to interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to linezolid specific monographs for details.
Alpha1-Agonists	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of Alpha1Agonists. While linezolid is expected to interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to linezolid specific monographs for details.
Amphetamines	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of Amphetamines. While linezolid and tedizolid may interact via this mechanism, management recommendations differ from other monoamine oxidase inhibitors. Refer to monographs specific to those agents for details.
Apraclonidine	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Apraclonidine. Monoamine Oxidase Inhibitors may increase the serum concentration of Apraclonidine.
AtoMOXetine	Monoamine Oxidase Inhibitors may enhance the neurotoxic (central) effect of AtoMOXetine.
Atropine (Ophthalmic)	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of Atropine (Ophthalmic).
BCG (Intravesical)	Antibiotics may diminish the therapeutic effect of BCG (Intravesical).
Bezafibrate	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Bezafibrate.
Buprenorphine	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors.
BuPROPion	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of BuPROPion.
BusPIRone	May enhance the serotonergic effect of Methylene Blue. This could result in serotonin syndrome.
CarBAMazepine	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors. Management: Avoid concurrent use of carbamazepine during, or within 14 days of discontinuing, treatment with a monoamine oxidase inhibitor.
Cholera Vaccine	Antibiotics may diminish the therapeutic effect of Cholera Vaccine. Management: Avoid cholera vaccine in patients receiving systemic antibiotics, and within 14 days following the use of oral or parenteral antibiotics.
Cimetropium	Anticholinergic Agents may enhance the anticholinergic effect of Cimetropium.
Codeine	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Codeine.
Cyclobenzaprine	May enhance the serotonergic effect of Monoamine Oxidase Inhibitors. This could result in serotonin syndrome.
Cyproheptadine	Monoamine Oxidase Inhibitors may enhance the anticholinergic effect of Cyproheptadine. Cyproheptadine may diminish the serotonergic effect of Monoamine Oxidase Inhibitors.
Dapoxetine	May enhance the serotonergic effect of Serotonergic Agents (High Risk). This could result in serotonin syndrome. Management: Do not use serotonergic agents (high risk) with dapoxetine or within 7 days of serotonergic agent discontinuation. Do not use dapoxetine within 14 days of monoamine oxidase inhibitor use. Dapoxetine labeling lists this combination as contraindicated.
Deutetrabenazine	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Deutetrabenazine.
Dexmethylphenidate	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of Dexmethylphenidate.
Dextromethorphan	Monoamine Oxidase Inhibitors may enhance the serotonergic effect of Dextromethorphan. This may cause serotonin syndrome.
Diethylpropion	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of Diethylpropion.
Diphenoxylate	May enhance the hypertensive effect of Monoamine Oxidase Inhibitors.
Droxidopa	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of Droxidopa.
Eluxadoline	Anticholinergic Agents may enhance the constipating effect of Eluxadoline.
EPINEPHrine (Oral Inhalation)	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of EPINEPHrine (Oral Inhalation).
Glycopyrrolate (Oral Inhalation)	Anticholinergic Agents may enhance the anticholinergic effect of Glycopyrrolate (Oral Inhalation).
Glycopyrronium (Topical)	May enhance the anticholinergic effect of Anticholinergic Agents.
Guanethidine	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors.
Heroin	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Heroin.
HYDROmorphone	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of HYDROmorphone.
Indoramin	Monoamine Oxidase Inhibitors may enhance the hypotensive effect of Indoramin.
Iobenguane Radiopharmaceutical Products	Monoamine Oxidase Inhibitors may diminish the therapeutic effect of Iobenguane Radiopharmaceutical Products. Management: Discontinue all drugs that may inhibit or interfere with catecholamine transport or uptake for at least 5 biological half-lives before iobenguane administration. Do not administer these drugs until at least 7 days after each iobenguane dose.
Ipratropium (Oral Inhalation	May enhance the anticholinergic effect of Anticholinergic Agents.
Isometheptene	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Isometheptene.
Levodopa-Containing Products	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors. Of particular concern is the development of hypertensive reactions when levodopa is used with nonselective MAOI.
Levomethadone	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors.
Levonordefrin	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of Levonordefrin.
Levosulpiride	Anticholinergic Agents may diminish the therapeutic effect of Levosulpiride.
Linezolid	Methylene Blue may enhance the serotonergic effect of Linezolid. This could result in serotonin syndrome.
Maprotiline	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors.
Meptazinol	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Meptazinol.
Mequitazine	Monoamine Oxidase Inhibitors may enhance the anticholinergic effect of Mequitazine.
Methadone	May enhance the serotonergic effect of Monoamine Oxidase Inhibitors. This could result in serotonin syndrome.
Methyldopa	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Methyldopa.
Methylphenidate	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of Methylphenidate.
Metoclopramide	May enhance the hypertensive effect of Monoamine Oxidase Inhibitors.
Mianserin	Monoamine Oxidase Inhibitors may enhance the neurotoxic effect of Mianserin.
Monoamine Oxidase Inhibitors (Antidepressant)	May enhance the serotonergic effect of Methylene Blue. This could result in serotonin syndrome.
Monoamine Oxidase Inhibitors (Type B)	May enhance the serotonergic effect of Methylene Blue. This could result in serotonin syndrome.
Morphine (Systemic)	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Morphine (Systemic).
Nefazodone	May enhance the serotonergic effect of Methylene Blue. This could result in serotonin syndrome.
Nefopam	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Nefopam.
Normethadone	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Normethadone.
Opium	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Opium.
Oxatomide	May enhance the anticholinergic effect of Anticholinergic Agents.
OxyCODONE	May enhance the serotonergic effect of Monoamine Oxidase Inhibitors. This could result in serotonin syndrome.
OxyMORphone	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors.
Pheniramine	May enhance the anticholinergic effect of Monoamine Oxidase Inhibitors.
Pholcodine	May enhance the serotonergic effect of Monoamine Oxidase Inhibitors. This could result in serotonin syndrome.
Pizotifen	Monoamine Oxidase Inhibitors may enhance the anticholinergic effect of Pizotifen.
Potassium Chloride	Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Chloride. Management: Patients on drugs with substantial anticholinergic effects should avoid using any solid oral dosage form of potassium chloride.
Potassium Citrate	Anticholinergic Agents may enhance the ulcerogenic effect of Potassium Citrate.
Reboxetine	Monoamine Oxidase Inhibitors may enhance the adverse/toxic effect of Reboxetine.
Revefenacin	Anticholinergic Agents may enhance the anticholinergic effect of Revefenacin.
Selective Serotonin Reuptake Inhibitors	May enhance the serotonergic effect of Methylene Blue. This could result in serotonin syndrome. Exceptions: Dapoxetine.
Serotonergic Non-Opioid CNS Depressants	May enhance the serotonergic effect of Methylene Blue. This could result in serotonin syndrome.
Serotonin 5-HT1D Receptor Agonists (Triptans)	May enhance the serotonergic effect of Monoamine Oxidase Inhibitors. This could result in serotonin syndrome. Monoamine Oxidase Inhibitors may increase the serum concentration of Serotonin 5-HT1D Receptor Agonists (Triptans).
Serotonin/Norepinephrine Reuptake Inhibitors	May enhance the serotonergic effect of Methylene Blue. This could result in serotonin syndrome.
Solriamfetol	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of Solriamfetol.
SUFentanil	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors. Specifically, the risk for serotonin syndrome or opioid toxicities (eg, respiratory depression, coma) may be increased. Management: Sufentanil should not be used with monoamine oxidase (MAO) inhibitors (or within 14 days of stopping an MAO inhibitor) due to the potential for serotonin syndrome and/or excessive CNS depression.
Sulfonamide Antibiotics	Methenamine may enhance the adverse/toxic effect of Sulfonamide Antibiotics. Specifically, the combination may result in the formation of an insoluble precipitate in the urine.
Tapentadol	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors. Specifically, the additive effects of norepinephrine may lead to adverse cardiovascular effects. Tapentadol may enhance the serotonergic effect of Monoamine Oxidase Inhibitors. This could result in serotonin syndrome.
Tetrabenazine	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors.
Tetrahydrozoline (Nasal)	Monoamine Oxidase Inhibitors may enhance the hypertensive effect of Tetrahydrozoline (Nasal).
Tianeptine	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors.
Tiotropium	Anticholinergic Agents may enhance the anticholinergic effect of Tiotropium.
Tricyclic Antidepressants	May enhance the serotonergic effect of Methylene Blue. This could result in serotonin syndrome.
Tryptophan	May enhance the serotonergic effect of Methylene Blue. This could result in serotonin syndrome.
Umeclidinium	May enhance the anticholinergic effect of Anticholinergic Agents.
Valbenazine	May enhance the adverse/toxic effect of Monoamine Oxidase Inhibitors.

Monitoring Parameters:

None Mentioned.

How to administer Hyophen (Methenamine, phenyl salicylate, methylene blue, benzoic acid, and hyoscyamine)?

It is administered orally with plenty of fluid.

Mechanism of action of Hyophen:

It is made up of several ingredients that are used to relieve irritative symptoms related to voiding.
You can read the pharmacology of each drug separately (Methenamine and Phenyl Salicylate, Methylene Blue, Benzoic Acid, and Hyoscyamine).

International Brand Names of Methenamine, phenyl salicylate, methylene blue, benzoic acid, and hyoscyamine:

Hyophen
Prosed/DS
Urophen MB

Methenamine, phenyl salicylate, methylene blue, benzoic acid, and hyoscyamine Brand Names in Pakistan:

No Brands Available in Pakistan.

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Hyophen (Methenamine, Phenyl salicylate, Methylene Blue, Benzoic acid, and Hyoscyamine)

Methenamine, phenyl salicylate, methylene blue, benzoic acid, and hyoscyamine Uses:

Hyophen Dose in Adults:

Hyophen Dose in the treatment of Urinary tract symptoms:

Hyophen Dose in Childrens:

Hyophen Dose in the treatment of Urinary tract symptoms:

Children >6 years:

Pregnancy Risk Factor C

Use of methenamine, phenyl salticylate, methyleneblue, benzoic acid and hyoscyamine during breastfeeding

Hyophen Dose in Kidney Disease:

Hyophen Dose in Liver disease:

Side effects of Hyophen:

Cardiovascular:

Central nervous system:

Gastrointestinal:

Genitourinary:

Ophthalmic:

Respiratory:

Contraindication to Hyophen (Methenamine, phenyl salicylate, methylene blue, benzoic acid, and hyoscyamine):

Warnings and precautions

Belladonna alkaloid allergy:

Blurred vision

Cardiac disease

Dizziness:

Salicylate allergy

Tachycardia

Gastrointestinal Disease:

Glaucoma:

Myasthenia gravis:

Obstructive Uropathy:

Monitoring Parameters:

How to administer Hyophen (Methenamine, phenyl salicylate, methylene blue, benzoic acid, and hyoscyamine)?

Mechanism of action of Hyophen:

International Brand Names of Methenamine, phenyl salicylate, methylene blue, benzoic acid, and hyoscyamine:

Methenamine, phenyl salicylate, methylene blue, benzoic acid, and hyoscyamine Brand Names in Pakistan:

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