methenamine / sodium phosphate / methylene blue / hyoscyamine
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.
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
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
Less Common Side Effects
- Drowsiness
- Redness of your skin (flushing)
- Difficult urination
- Cannot empty your bladder fully
Urogesic Blue 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
The following Urogesic Blue side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Blue or blue-green urine or stools
- Blurry vision
- Dizziness
- Dry mouth
- Nausea
- Upset stomach
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Pros and cons of Urogesic Blue
Pros
- Taken by mouth
- Treats various urinary symptoms
- Combines four medications into one tablet for convenience
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 for Urogesic Blue
- Take Urogesic Blue with plenty of water to clear the bacteria out of your urinary tract.
- 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.
- Let your healthcare team know you're taking Urogesic Blue, especially if they prescribe an antibiotic to treat your UTI. The formaldehyde produced from methenamine can interact with sulfa antibiotics used to treat UTI, such as trimethoprim/sulfamethoxazole (Bactrim), and cause crystals to form in the urine.
- Hyoscyamine in Urogesic Blue can cause constipation as a side effect. It's best to avoid taking Urogesic Blue with opioid pain medications because doing so can worsen constipation.
- Let your healthcare team know if you're taking a monoamine oxidase inhibitors (MAOIs), such as rasagiline (Azilect). Taking Urogesic Blue with an MAOI raises your risk for a serious side effect called serotonin syndrome.
- 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.
Common questions about 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.
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.
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.
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.
No, Urogesic Blue isn't available over the counter. It requires a prescription from a healthcare professional.
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.
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.
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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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.
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 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 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 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.
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.
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.
Urogesic Blue dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 81.6mg/40.8mg/10.8mg/0.12mg | 30 tablets | $54.60 | $1.82 |
Typical dosage 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.
How much does Urogesic Blue cost?
$54.60
