Atropine, Hyoscyamine, Methenamine, Methylene Blue, Phenyl Salicylate, and Benzoic Acid (Systemic)

Brand Names : Atrosept, Dolsed, Hexalol, Prosed/DS, Trac Tabs 2X, UAA, Uridon Modified, Urimed, Urinary Antiseptic No. 2, Urised, Uriseptic, Uritab, Uritin, Uro-Ves

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this combination medicine, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to any of the belladonna alkaloids such as atropine, hyoscyamine, and scopolamine, or to aspirin or other salicylates. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Diet - While you are taking this combination medicine, it is important for your urine to be acidic. To do this, your doctor may recommend that you eat more protein and such foods as cranberries (especially cranberry juice with vitamin C added), plums, or prunes. You should avoid foods that make the urine more alkaline, such as most fruits (especially citrus fruits and juices), milk, and other dairy products.

Pregnancy - Studies have not been done in either humans or animals.

Breast-feeding - Although methenamine and very small amounts of atropine and hyoscyamine (contained in this combination medicine) pass into the breast milk, this medicine has not been reported to cause problems in nursing babies.

Children - Unusual excitement, nervousness, restlessness or irritability, and unusual warmth, dryness, and flushing of skin are more likely to occur in children, who are usually more sensitive to the effects of atropine and hyoscyamine (contained in this combination medicine). Also, when atropine and hyoscyamine are given to children during hot weather, a rapid increase in body temperature may occur. In infants and children, especially those with spastic paralysis or brain damage, this medicine may be more likely to cause severe side effects.

Older adults - Confusion or memory loss, constipation, difficult urination, excitement, agitation, drowsiness, or dryness of mouth may be more likely to occur in elderly patients, who are usually more sensitive than younger adults to the effects of atropine and hyoscyamine. Also, this combination medicine may cause eye pain in patients who have untreated glaucoma.

Other medicines - Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this combination medicine, it is especially important that your health care professional know if you are taking any of the following:

• Antacids or
• Diarrhea medicine containing kaolin or attapulgite or
• Thiazide diuretics (water pills) or
• Urinary alkalizers (medicine that makes the urine less acid, such as acetazolamide [e.g., Diamox], calcium- and/or magnesium-containing antacids, dichlorphenamide [e.g., Daranide], methazolamide [e.g., Neptazone], potassium or sodium citrate and/or citric acid, sodium bicarbonate [baking soda]) - Use with these medicines may decrease the effects of this combination medicine

• Ketoconazole (e.g., Nizoral) - Use with this combination medicine may reduce the effects of ketoconazole

• Other anticholinergics (medicine for abdominal or stomach spasms or cramps) - Use with these medicines may increase the effects of atropine and hyoscyamine

• Potassium chloride (e.g., Slow K or K-Dur) - May worsen or cause an increase in lesions (sores) of the stomach or intestine

• Sulfonamides (sulfa medicine) - Use with this combination medicine may increase the risk of crystals forming in the urine

Other medical problems - The presence of other medical problems may affect the use of this combination medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Bleeding problems (severe) - This combination medicine may increase heart rate, which would make bleeding problems worse

• Brain damage (in children) - May increase the central nervous system (CNS) effects of this combination medicine

• Colitis (severe) or
• Dryness of mouth (severe or continuing) or
• Enlarged prostate or
• Fever or
• Glaucoma or
• Heart disease or
• Hernia (hiatal) or
• High blood pressure or
• Intestinal blockage or other intestinal or stomach problems or
• Lung disease or
• Myasthenia gravis or
• Toxemia of pregnancy or
• Urinary tract blockage or difficult urination - This combination medicine may make these conditions worse

• Dehydration or
• Kidney disease or
• Liver disease - Higher levels of medicine may result and increase the risk of side effects

• Overactive thyroid - May increase the heart rate