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methenamine / sodium phosphate / methylene blue / hyoscyamine

Generic Urogesic Blue
Used for Urinary Tract Infection
Used for Urinary Tract Infection

Urogesic Blue is a combination of 4 medications used to help ease urinary tract discomfort from conditions such as lower urinary tract infections (UTIs) or medical procedures. Methenamine, sodium phosphate, and methylene blue work to reduce bacteria in the urine, while hyoscyamine is an antispasmodic used to relieve bladder spasms. Urogesic Blue is usually taken by mouth 4 times a day in adults and children. This medication can make your urine blue as a side effect, but this is harmless and will go away. ME/NaPhos/MB/Hyo 1 is a generic alternative to Urogesic Blue.

Last reviewed on September 3, 2024
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What is Urogesic Blue?

What is Urogesic Blue used for?

  • Pain, discomfort, difficulty emptying the bladder, or other symptoms of irritative voiding (irritation while urinating)

  • Muscle spasms of the bladder from conditions such as lower urinary tract infections (UTIs)

  • Pain and discomfort of the urinary tract during some medical procedures

How Urogesic Blue works

Urogesic Blue is a combination of 4 medications:

  • Methenamine is broken down to formaldehyde in acidic urine, which stops the growth of bacteria.

  • Monobasic sodium phosphate is a type of salt that makes the urine acidic to help methenamine break down into formaldehyde.

  • Methylene blue is a mild antiseptic that kills or stops the growth of bacteria in the urine and bladder.

  • Hyoscyamine is an antispasmodic. It relaxes the smooth muscles in the bladder to help relieve muscle spasms and the urge to urinate.

Drug Facts

Drug ClassUrinary antispasmodic / Antiseptic
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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Avg retail price
$87.60(save 68.94%)
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$27.21
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What are the side effects of Urogesic Blue?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Dry mouth
  • Nausea
  • Vomiting
  • Blue urine or discolored stool

Other Side Effects

  • Drowsiness
  • Redness of your skin (flushing)
  • Difficult urination
  • Cannot empty your bladder fully

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Serious allergic reactions: itching, rash, severe dizziness, swelling, or trouble breathing
  • Symptoms of too much medication: fast heart rate, dizziness, blurry vision
When do Urogesic Blue possible side effects begin and end?
Time passed since treatment started:
HOURS
DAYS
WEEKS
MONTHS
Possible blue urine or discolored stool
If a line continues to the right, you'll likely keep experiencing this side effect once it starts.

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

pros-and-cons

Pros and cons of Urogesic Blue

thumbs-up

Pros

Taken by mouth

Treats various urinary symptoms

Combines four medications into one tablet for convenience

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Cons

Typically taken 4 times a day

Might not work as well if taking antacids at same time

Can cause bothersome side effects, such as dry mouth and nausea

pharmacist-tips

Pharmacist tips for Urogesic Blue

pharmacist
  • The methylene blue in Urogesic Blue can cause your urine to turn a blue or blue green color. This side effect isn't harmful and should go away about a day or so after you stop taking this medication.

    • Urogesic Blue works best in acidic environment. Avoid taking antacids, such as calcium carbonate, at the same time as Urogesic Blue. Doing so will make the urine less acidic and cause Urogesic Blue to not work as well. If you need to take an antacid, separate it from Urogesic Blue by at least an hour.

      • Urogesic Blue can cause serious harm if you or your child take more than what your prescriber has directed. If you or your child have symptoms of fast heartbeat, dizziness, blurry vision, slowed breathing, or seizures, stop taking this medication and get medical help right away.

        faqs

        Frequently asked questions about Urogesic Blue

        How long can you take Urogesic Blue?
        Only take Urogesic Blue for as long as your urologist or healthcare professional (HCP) has prescribed to you. They might recommend that you take it until your urinary symptoms get better. There haven't been enough studies to understand whether it's safe to take Urogesic Blue long-term.
        How often can you take Urogesic Blue?
        Adults can take Urogesic Blue four times a day, but the dose in children might be different. Follow the instructions provided by your prescriber carefully so you take the appropriate dose. Taking too much medication can lead to serious side effects, such as fast heart rate, dizziness, and blurry vision.
        How long does it take for Urogesic Blue to work?
        More research is needed to better understand the timing of when each ingredient of Urogesic Blue starts working. The four ingredients in Urogesic Blue are absorbed from your stomach and get into your urine within 24 hours. Make sure to drink plenty of fluids after each dose. Contact your care team if you aren't experiencing symptom relief after taking Urogesic Blue.
        How long does Urogesic Blue stay in your system?
        Urogesic Blue can stay in your system for around one day. However, it can take a little longer for your urine to return to its normal color since methylene blue can turn urine blue or blue-green.
        Is Urogesic Blue over the counter?
        No, Urogesic Blue isn't available over the counter. It requires a prescription from a healthcare professional.
        Is there a chemical in Urogesic Blue that turns urine blue?
        Yes. Urogesic Blue contains a medication called methylene blue that can cause your urine to turn blue or blue-green. It can also discolor your stool. This effect is harmless and temporary.
        Is Urogesic Blue an antibiotic?
        One ingredient in Urogesic Blue, methenamine, is considered to be an antibiotic. But Urogesic Blue shouldn’t be used to treat an active UTI because it most likely isn't enough to help you fight off an infection. It's only meant to help with some of the symptoms from a UTI, such as urinating often, difficulty emptying the bladder, and pain or discomfort while urinating. Don't use Urogesic Blue to treat UTI even if you already have it at home. Doing so can make your infection worse since it can prevent you from receiving the right medication in the meantime. If you have symptoms of a UTI, such as pain or burning while urinating, urinating more often than usual, or bloody urine, please talk with your primary care provider.
        Is Urogesic Blue the same as Uribel?
        No. Both Urogesic Blue and Uribel contain similar ingredients, but some are different. Urogesic Blue contains methenamine, sodium phosphate, hyoscyamine, and methylene blue. Uribel contains hyoscyamine, methenamine, phenyl salicylate (a pain reliever), benzoic acid (a urine acidifier), and methylene blue. Both medications can be taken to relieve urinary tract symptoms. Follow up with your healthcare professional to learn about more differences between these medications.
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        What are the risks and warnings for Urogesic Blue?

        Urogesic Blue can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

        risk-warning

        Fast heart rate

        • Risk factors: Irregular heartbeat | Heart failure | Heart problems

          Taking Urogesic Blue might make your heart problems worse since hyoscyamine can raise your heart rate. These problems are more common in people with heart problems, such as heart failure and irregular heartbeat. Please let your prescriber know if you have any history of heart problems or if you have signs and symptoms of fast heart rate, such as dizziness, shortness of breath, or chest palpitations.

          risk-warning

          Risk of serious side effects in older adults

          • Risk factor: Over 65 years of age

            Urogesic Blue contains hyoscyamine, which is an anticholinergic medication. It can cause confusion, dry mouth, and constipation. The symptoms are typically worse for older adults. Some studies have also showed that anticholinergic medications are related to higher risk of dementia. If you're over the age of 65, please talk with your prescriber about the benefits and risks of taking Urogesic Blue.

            risk-warning

            Risk of serious blood problem

            • Risk factor: People with low levels of glucose-6-phosphodiesterase (G6PD)

              Urogesic Blue contains methylene blue. In people with low levels of G6PD (a genetic condition), this medication can lead to the break down of red blood cells. If you have low G6PD, please talk with your prescriber before taking Urogesic Blue. Please seek medical attention right away if you notice symptoms such as gray or blue-colored skin, headache, fast heart beat, shortness of breath, dizziness and lack of energy.

              risk-warning

              Risk of higher serotonin levels

              • Risk factor: People who take medications that raise serotonin levels

                Methylene blue can raise the levels of serotonin (a chemical in the body that boosts your mood) in your brain. If you take multiple medications that raise your serotonin levels, such as fluoxetine (Prozac) or selegiline (Zelapar), then you're more likely to build up serotonin in the brain. Too much serotonin can cause serotonin syndrome, a serious and life-threatening condition. Get medical attention right away if you have signs and symptoms, such as confusion, muscle twitching, excessive sweating, shaking, dizziness, or fever. If you take any medications for your mental health, please talk with your prescriber before taking Urogesic Blue.

                risk-warning

                Reaction to belladonna plants

                • Risk factors: Children

                  Urogesic Blue contains hyoscyamine, which is a medication made from belladonna plants and can be dangerous if you take too much. Infants and toddlers can be particularly sensitive to belladonna toxins. Don't give Urogesic Blue to any children younger than 6 years old. If you notice your child has dry mouth, confusion, and memory loss after taking this medication, talk with your child's pediatrician right away.

                  Also, avoid taking Urogesic Blue if you're allergic to medications made from belladonna plants, such as atropine (Isopto Atropine) and scopolamine (Transderm Scop). Watch out for signs and symptoms of allergic reactions, such as hives, shortness of breath, swelling of your face, lips, or throat. Please get medical attention right away if you have these signs and symptoms.

                  risk-warning

                  Blockage in the intestines or bladder

                  Urogesic Blue contains hyoscyamine, which relaxes the muscles in the intestines and bladder. If you have any condition that prevents food from passing through your intestines, or if you have trouble emptying your bladder, this medication can make these conditions worse. Before starting Urogesic Blue, please talk with your prescriber about benefits and risks of taking this medication. Get medical attention right away if you have severe belly pain, nausea or vomiting, trouble urinating or blood in the urine.

                  dosage

                  Urogesic Blue dosage forms

                  The average cost for 30 tablets of 81.6mg/40.8mg/10.8mg/0.12mg of Urogesic Blue is $27.21 with a free GoodRx coupon. This is 68.94% off the average retail price of $87.60.
                  tablet
                  Tablet
                  DosageQuantityPrice as low asPrice per unit
                  81.6mg/40.8mg/10.8mg/0.12mg30 tablets$27.21$0.91

                  Typical dosing for Urogesic Blue

                  • Adults: The typical dose is 1 tablet by mouth 4 times daily with plenty of fluids.

                  • Children older than 6 years old: The dose will depend on the child's individual needs. Ask your child’s pediatrician about dosing and directions.

                  • Children younger than 6 years old: Not recommended. Talk to your child's pediatrician about safer options.

                  alternatives

                  What are alternatives to Urogesic Blue?

                  There are a number of medications that your doctor can prescribe in place of Urogesic Blue. Compare a few possible alternatives below.
                  Urogesic Blue
                  Used for:
                  • Pain, discomfort, difficulty emptying the bladder, or other symptoms of irritative voiding (irritation while urinating)

                  • Muscle spasms of the bladder from conditions such as lower urinary tract infections (UTIs)

                  • Pain and discomfort of the urinary tract during some medical procedures

                  $27.21 Lowest GoodRx priceView Prices
                  Used for:
                  • Symptoms of irritative urination such as frequency, urgency, painful urination, and loss of bladder control

                  • Urinary symptoms related to urinary tract infections (UTIs)

                  • Urinary symptoms caused by medical procedures

                  $84.00 Lowest GoodRx priceView Prices
                  Used for:
                  • Symptoms of irritative urination such as frequency, urgency, painful urination, and loss of bladder control

                  • Urinary symptoms related to urinary tract infections (UTIs)

                  • Urinary symptoms caused by medical procedures

                  $59.55 Lowest GoodRx priceView Prices

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                  References

                  Best studies we found

                  Berdai, M. A., et al. (2012). Atropa belladonna intoxication: A case report. The Pan African Medical Journal.

                  Coupland, C. A. C., et al. (2019). Anticholinergic drug exposure and the risk of dementia: A nested case-control study. Journal of the American Medical Association Internal Medicine.

                  Edwards Pharmaceuticals, Inc. (2023). Urogesic Blue- methenamine, sodium phosphate, monobasic, methylene blue, and hyoscyamine sulfate tablet, coated [package insert]. DailyMed.

                  View All References (5)

                  Guralnick, M. L., et al. (2011). Assessment and management of irritative voiding symptoms. Medical Clinics of North America.

                  Method Pharmaceuticals. (2024). Me Naphos MB Hyo 1- urinary antiseptic antispasmodic tablet [package insert]. DailyMed.

                  National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Treatments for bladder control problems (urinary incontinence).

                  Prakash, S., et al. (2017). Green urine: A cause for concern? Journal of Anaesthesiology, Clinical Pharmacology.

                  U.S. Food and Drug Administration. (2017). FDA Drug Safety Communication: Serious CNS reactions possible when methylene blue is given to patients taking certain psychiatric medications.

                  GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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