hyoscyamine, methenamine, methylene blue, and sodium biphosphate

What is the most important information I should know about this medicine?

If you have an eye exam and your pupils are dilated with eye drops, tell the eye doctor ahead of time that you are using hyoscyamine, methenamine, methylene blue, and sodium biphosphate.

What is hyoscyamine, methenamine, methylene blue, and sodium biphosphate?

Hyoscyamine produces many effects in the body, including relief from muscle spasms.

Methenamine and methylene blue work as mild antiseptics that fight bacteria in the urine and bladder.

Sodium biphosphate is a form of phosphorus, which is a naturally occurring substance that is important in every cell in the body.

Hyoscyamine, methenamine, methylene blue, and sodium biphosphate is a combination medicine used to treat bladder irritation (pain, burning, inflammation) caused by urinary tract infection. This medicine is also used to prevent bladder discomfort during a medical procedure.

Hyoscyamine, methenamine, methylene blue, and sodium biphosphate may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking this medicine?

To make sure this medicine is safe for you, tell your doctor if you have:

• heart disease;
• a heart rhythm disorder;
• congestive heart failure;
• coronary heart disease;
• a heart valve disorder;
• glaucoma;
• an enlarged prostate or bladder obstruction;
• myasthenia gravis;
• an ulcer or obstruction in your stomach; or
• if you are allergic to belladonna (Donnatal and others).

How should I take this medicine?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

If you have an eye exam and your pupils are dilated with eye drops, tell the eye doctor ahead of time that you are using hyoscyamine, methenamine, methylene blue, and sodium biphosphate.

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?

What should I avoid while taking this medicine?

Avoid taking an antacid or anti-diarrhea medicine within 1 hour before or after you take hyoscyamine, methenamine, methylene blue, and sodium biphosphate. Antacids or anti-diarrhea medicine can make it harder for your body to absorb hyoscyamine.

If you also take ketoconazole (Nizoral), wait at least 2 hours after taking it before you take hyoscyamine, methenamine, methylene blue, and sodium biphosphate.

What are the possible side effects of hyoscyamine, methenamine, methylene blue, and sodium biphosphate?

Methylene blue will most likely cause your urine or stools to appear blue or green in color. This is a normal side effect of the medication and will not cause any harm.

• severe dizziness, blurred vision, fast heart rate;
• agitation, confusion, feeling restless or excited;
• painful or difficult urination; or
• shortness of breath.

Older adults may be more likely to have side effects from this medication.

Common side effects may include:

• mild dizziness;
• dry mouth; or
• nausea, vomiting.

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 will affect hyoscyamine, methenamine, methylene blue, and sodium biphosphate?

Many drugs can interact with this medicine. Not all possible interactions are listed here. Also, hyoscyamine can make it harder for your body to absorb other medications you take by mouth. Tell your doctor about all your medications and any you start or stop using, especially:

• neostigmine or pyridostigmine;
• bladder or urinary medicines such as darifenacin, fesoterodine, oxybutynin, tolterodine, solifenacin;
• bronchodilators such as ipratropium or tiotropium;
• cold or allergy medicine that contains an antihistamine;
• a diuretic or "water pill";
• an MAO inhibitor--furazolidone, isocarboxazid, linezolid, phenelzine, rasagiline, selegiline, tranylcypromine;
• medication to treat excess stomach acid, stomach ulcer, motion sickness, or irritable bowel syndrome;
• medication to treat gout, kidney stones, or an electrolyte imbalance (such as low levels of potassium);
• medication to treat symptoms of Alzheimer's disease or Parkinson's disease;
• narcotic pain or cough medication--codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, propoxyphene, and others; or
• sulfa drugs.

This list is not complete and many other drugs can interact with hyoscyamine, methenamine, methylene blue, and sodium biphosphate. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.

Where can I get more information?

Your pharmacist can provide more information about hyoscyamine, methenamine, methylene blue, and sodium biphosphate.