Uro-Mp Capsules
It is used to ease pain from a bladder infection.It is used to treat muscle spasms of the urinary system.It is used to treat signs of urinary problems.
Drug Class
Urinary antiseptic, urinary analgesic, antispasmodic
Pharmacologic Class
Urinary anti-infective (Methenamine), anticholinergic (Hyoscyamine), salicylate analgesic (Phenyl Salicylate), urinary acidifier (Sodium Phosphate Monobasic), dye (Methylene Blue)
Pregnancy Category
Category C (due to Methenamine, Hyoscyamine, and Salicylate components; Salicylate is D in 3rd trimester)
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Uro-Mp Capsules are a combination medicine used to relieve discomfort and symptoms like pain, burning, urgency, and frequent urination associated with urinary tract infections or other bladder irritations. It works by making your urine more acidic to help fight bacteria, relaxing bladder muscles, and providing mild pain relief.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. Take your medication as directed, with or without food, and swallow it with a full glass of water. It's also important to drink plenty of non-caffeinated liquids, unless your doctor advises you to limit your fluid intake.
If you take other oral medications, be aware that this drug may interfere with their absorption. You may need to take your other medications at a different time than this one. Consult with your doctor to determine the best schedule for your medications.
Storing and Disposing of Your Medication
To maintain the quality and safety of your medication, store it at room temperature with the lid tightly closed. Keep it in a dry place, away from the bathroom, and out of reach of children and pets. Ensure that all medications are stored in a secure location to prevent accidental ingestion or misuse.
Missing a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for a missed one.
To use this medication correctly, follow your doctor's instructions and read all the information provided. Take your medication as directed, with or without food, and swallow it with a full glass of water. It's also important to drink plenty of non-caffeinated liquids, unless your doctor advises you to limit your fluid intake.
If you take other oral medications, be aware that this drug may interfere with their absorption. You may need to take your other medications at a different time than this one. Consult with your doctor to determine the best schedule for your medications.
Storing and Disposing of Your Medication
To maintain the quality and safety of your medication, store it at room temperature with the lid tightly closed. Keep it in a dry place, away from the bathroom, and out of reach of children and pets. Ensure that all medications are stored in a secure location to prevent accidental ingestion or misuse.
Missing a Dose
If you miss a dose, take it as soon as you remember. However, if it's close to the time for your next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not take two doses at the same time or take extra doses to make up for a missed one.
Lifestyle & Tips
- Drink plenty of fluids to help flush the urinary tract.
- Maintain good hydration.
- Avoid foods or medications that make your urine less acidic (e.g., citrus fruits, milk products, antacids) as this can reduce the effectiveness of methenamine.
- This medication may cause your urine to turn blue or green. This is a normal and harmless effect of the methylene blue component.
- Avoid driving or operating machinery if you experience blurred vision, dizziness, or drowsiness.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
1 to 2 capsules orally, 3 to 4 times daily, or as directed by physician
Dose Range:
1 - 2 mg
Condition-Specific Dosing:
Urinary Tract Irritation:
1 to 2 capsules 3 to 4 times daily
Pediatric Dosing
Neonatal:
Not established
Infant:
Not established
Child:
Not established (Use generally not recommended or specific dosing not well-established for this combination)
Adolescent:
Dosing may be similar to adult, but caution advised and physician consultation required.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; monitor for anticholinergic effects and salicylate accumulation.
Moderate:
Use with caution; consider dose reduction or avoidance due to Methenamine (contraindicated in severe), Hyoscyamine, and Salicylate accumulation.
Severe:
Contraindicated (due to Methenamine and risk of accumulation of other components).
Dialysis:
Contraindicated (due to Methenamine and lack of data for other components).
Hepatic Impairment:
Mild:
Use with caution.
Moderate:
Use with caution; monitor for increased anticholinergic effects and salicylate toxicity.
Severe:
Use with caution; consider avoidance due to potential for increased adverse effects and altered metabolism of Hyoscyamine and Salicylates.
Confidence:
Medium
Pharmacology
Mechanism of Action
Uro-Mp is a combination product. Methenamine is hydrolyzed in acidic urine to formaldehyde, which is bactericidal. Sodium Phosphate Monobasic acidifies the urine, facilitating methenamine's action. Phenyl Salicylate is hydrolyzed to salicylic acid and phenol; salicylic acid provides mild analgesic and anti-inflammatory effects. Methylene Blue is a mild antiseptic and dye. Hyoscyamine is an anticholinergic agent that blocks muscarinic receptors, providing antispasmodic effects on smooth muscle of the urinary tract, reducing bladder spasms, urgency, and frequency.
Pharmacokinetics
Absorption:
Bioavailability:
Methenamine: Well absorbed orally. Hyoscyamine: Rapidly absorbed. Phenyl Salicylate: Hydrolyzed to salicylic acid, which is well absorbed. Methylene Blue: Well absorbed.
Tmax:
Methenamine: ~1-2 hours. Hyoscyamine: ~0.5-2 hours. Salicylic acid (from Phenyl Salicylate): ~1-2 hours.
FoodEffect:
Food may delay absorption but generally does not significantly affect overall bioavailability for most components. Acidic foods/drinks may enhance methenamine hydrolysis.
Distribution:
Vd:
Hyoscyamine: ~2-4 L/kg. Salicylic acid: ~0.1-0.2 L/kg.
ProteinBinding:
Hyoscyamine: ~50%. Salicylic acid: Highly protein bound (~90%). Methenamine: Not significantly protein bound.
CnssPenetration:
Hyoscyamine: Yes (can cross BBB, especially at higher doses). Salicylic acid: Yes. Methenamine: Limited.
Elimination:
HalfLife:
Methenamine: ~3-6 hours. Hyoscyamine: ~3.5 hours. Salicylic acid: Dose-dependent, ~2-4.5 hours (therapeutic doses), longer with higher doses.
Clearance:
Not specifically quantified for the combination.
ExcretionRoute:
Primarily renal (Methenamine, Hyoscyamine, Salicylic acid, Methylene Blue).
Unchanged:
Methenamine: ~10-25% (as methenamine), significant portion as formaldehyde. Hyoscyamine: ~30-50%. Methylene Blue: Significant portion unchanged.
Pharmacodynamics
OnsetOfAction:
Hyoscyamine: 20-30 minutes (oral). Methenamine: Formaldehyde production begins rapidly in acidic urine.
PeakEffect:
Hyoscyamine: 1-2 hours. Methenamine: Sustained formaldehyde release as long as urine is acidic.
DurationOfAction:
Hyoscyamine: 4-6 hours. Methenamine: As long as urine remains acidic and drug is present (typically 6-8 hours per dose).
Confidence:
Medium
Safety & Warnings
Side Effects
Serious Side Effects: Seek Medical Attention Immediately
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek medical help right away:
- Signs of an allergic reaction, such as rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat
- A fast heartbeat
- Blurred vision
- Dizziness
- Shortness of breath
- Difficulty urinating
Other Possible Side Effects
Like all medications, this drug can cause side effects, although not everyone will experience them. If you have any of the following side effects, or if they bother you or do not go away, contact your doctor or seek medical help:
- Upset stomach or vomiting
- Feeling sleepy
- Dry mouth
- Flushing
- A change in the color of your urine or stool to blue or green (this is a normal effect and not a cause for concern)
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, contact your doctor. For medical advice about side effects, you can also contact your doctor. Additionally, you can report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience any of the following symptoms, contact your doctor or seek medical help right away:
- Signs of an allergic reaction, such as rash, hives, itching, red, swollen, blistered, or peeling skin (with or without fever), wheezing, tightness in the chest or throat, trouble breathing, swallowing, or talking, unusual hoarseness, or swelling of the mouth, face, lips, tongue, or throat
- A fast heartbeat
- Blurred vision
- Dizziness
- Shortness of breath
- Difficulty urinating
Other Possible Side Effects
Like all medications, this drug can cause side effects, although not everyone will experience them. If you have any of the following side effects, or if they bother you or do not go away, contact your doctor or seek medical help:
- Upset stomach or vomiting
- Feeling sleepy
- Dry mouth
- Flushing
- A change in the color of your urine or stool to blue or green (this is a normal effect and not a cause for concern)
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, contact your doctor. For medical advice about side effects, you can also contact your doctor. Additionally, you can report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Severe dry mouth, difficulty swallowing or speaking
- Severe blurred vision or eye pain
- Difficulty urinating or inability to urinate
- Severe constipation or abdominal pain
- Fast or irregular heartbeat
- Confusion or hallucinations
- Ringing in the ears (tinnitus) or hearing loss (signs of salicylate toxicity)
- Unusual bleeding or bruising
- Signs of allergic reaction (rash, itching, swelling, severe dizziness, trouble breathing)
- Worsening of urinary symptoms or fever (may indicate worsening infection)
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances. Describe the allergic reactions you have experienced.
Certain health conditions, such as:
+ Bowel blockage
+ Glaucoma
+ Myasthenia gravis
+ Slow movement of the gastrointestinal (GI) tract
+ Urination difficulties
+ History of heart failure (weak heart) or other heart problems
* If you are taking specific medications, including:
+ Certain antidepressants like isocarboxazid, phenelzine, or tranylcypromine
+ Medications for Parkinson's disease, such as selegiline or rasagiline
Special Considerations for Children:
If your child is under 6 years of age, do not administer this medication. It is not recommended for children younger than 6 years old.
Additional Important Information:
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist. Verify that it is safe to take this medication with your existing medications and health conditions. Never start, stop, or change the dosage of any medication without consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances. Describe the allergic reactions you have experienced.
Certain health conditions, such as:
+ Bowel blockage
+ Glaucoma
+ Myasthenia gravis
+ Slow movement of the gastrointestinal (GI) tract
+ Urination difficulties
+ History of heart failure (weak heart) or other heart problems
* If you are taking specific medications, including:
+ Certain antidepressants like isocarboxazid, phenelzine, or tranylcypromine
+ Medications for Parkinson's disease, such as selegiline or rasagiline
Special Considerations for Children:
If your child is under 6 years of age, do not administer this medication. It is not recommended for children younger than 6 years old.
Additional Important Information:
This list is not exhaustive, and it is crucial to discuss all your medications (prescription, over-the-counter, natural products, and vitamins) and health problems with your doctor and pharmacist. Verify that it is safe to take this medication with your existing medications and health conditions. Never start, stop, or change the dosage of any medication without consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
To minimize the risk of severe side effects, do not exceed the dosage prescribed by your doctor. Taking more than the recommended amount can increase your chance of experiencing serious adverse effects.
Adhere to the prescribed treatment duration and do not take this medication for longer than specified by your doctor.
If you or someone else accidentally takes this medication, seek immediate medical attention.
If you are 65 years or older, exercise caution when using this drug, as you may be more susceptible to side effects.
When administering this medication to children, use it with caution, as some children may have a higher risk of experiencing side effects.
If you are pregnant, planning to become pregnant, or are breast-feeding, consult your doctor to discuss the potential benefits and risks to both you and the baby.
To minimize the risk of severe side effects, do not exceed the dosage prescribed by your doctor. Taking more than the recommended amount can increase your chance of experiencing serious adverse effects.
Adhere to the prescribed treatment duration and do not take this medication for longer than specified by your doctor.
If you or someone else accidentally takes this medication, seek immediate medical attention.
If you are 65 years or older, exercise caution when using this drug, as you may be more susceptible to side effects.
When administering this medication to children, use it with caution, as some children may have a higher risk of experiencing side effects.
If you are pregnant, planning to become pregnant, or are breast-feeding, consult your doctor to discuss the potential benefits and risks to both you and the baby.
Overdose Information
Overdose Symptoms:
- Severe anticholinergic effects (extreme dry mouth, dilated pupils, blurred vision, rapid heart rate, fever, flushed skin, confusion, hallucinations, seizures, coma)
- Salicylate toxicity (tinnitus, dizziness, nausea, vomiting, hyperventilation, metabolic acidosis, lethargy, seizures)
- Nausea, vomiting, abdominal pain
- Urinary retention
- Respiratory depression
What to Do:
Seek immediate medical attention or call Poison Control at 1-800-222-1222. Treatment is supportive and symptomatic, including gastric lavage, activated charcoal, and management of specific toxicities (e.g., physostigmine for severe anticholinergic effects, bicarbonate for salicylate acidosis).
Drug Interactions
Contraindicated Interactions
- Sulfonamides (with Methenamine: risk of crystalluria)
- Urinary alkalinizers (with Methenamine: reduce efficacy)
- Potassium chloride wax-matrix formulations (with anticholinergics like Hyoscyamine: increased risk of GI lesions)
- Antacids containing aluminum or magnesium (with Sodium Phosphate Monobasic: may impair phosphate absorption)
Major Interactions
- Other anticholinergics (e.g., tricyclic antidepressants, phenothiazines, antihistamines, disopyramide, quinidine): additive anticholinergic effects (Hyoscyamine)
- Opioid analgesics (with Hyoscyamine: increased risk of severe constipation and paralytic ileus)
- Warfarin and other anticoagulants (with Salicylates: increased bleeding risk)
- Methotrexate (with Salicylates: increased methotrexate toxicity)
- Oral hypoglycemics (with Salicylates: enhanced hypoglycemic effect)
- Carbonic anhydrase inhibitors (with Methenamine: may alkalinize urine, reducing efficacy)
- Serotonergic drugs (with Methylene Blue: theoretical risk of serotonin syndrome, though less common with urinary antiseptic doses)
Moderate Interactions
- Diuretics (loop and thiazide) (with Salicylates: reduced diuretic effect, increased salicylate levels)
- ACE inhibitors and ARBs (with Salicylates: reduced antihypertensive effect, increased risk of renal dysfunction)
- Corticosteroids (with Salicylates: increased risk of GI ulceration)
- Antacids (with Hyoscyamine: may reduce absorption if taken concurrently)
- Potassium-sparing diuretics (with Sodium Phosphate Monobasic: risk of hyperkalemia)
- Calcium supplements (with Sodium Phosphate Monobasic: risk of hyperphosphatemia and hypocalcemia)
Minor Interactions
- Alcohol (with Salicylates: increased GI irritation)
- Urinary acidifiers (with Methenamine: enhance efficacy)
Monitoring
Baseline Monitoring
Renal function (BUN, creatinine)
Rationale: To assess kidney function, as components are renally eliminated and Methenamine is contraindicated in severe renal impairment.
Timing: Prior to initiation of therapy.
Electrolytes (especially phosphate, calcium, potassium)
Rationale: To assess baseline electrolyte balance due to Sodium Phosphate Monobasic component and potential interactions.
Timing: Prior to initiation of therapy.
Intraocular pressure
Rationale: For patients with narrow-angle glaucoma, as Hyoscyamine can increase IOP.
Timing: Prior to initiation if history of glaucoma.
Routine Monitoring
Urine pH
Frequency: Periodically, especially if efficacy is questioned.
Target: <5.5 (for optimal Methenamine activity)
Action Threshold: If pH >6, consider dietary modifications or additional acidifiers.
Symptoms of urinary tract irritation/infection
Frequency: Daily, throughout therapy.
Target: Resolution or improvement of symptoms (dysuria, urgency, frequency).
Action Threshold: Persistent or worsening symptoms may indicate inadequate treatment or need for alternative therapy.
Anticholinergic side effects
Frequency: Daily, throughout therapy.
Target: Absence or mild, tolerable symptoms (dry mouth, blurred vision, constipation, urinary retention).
Action Threshold: Severe or intolerable symptoms may require dose reduction or discontinuation.
Symptom Monitoring
- Dry mouth
- Blurred vision
- Constipation
- Urinary retention
- Dizziness
- Headache
- Nausea
- Vomiting
- Rash
- Signs of salicylate toxicity (tinnitus, hearing loss, hyperventilation)
- Signs of allergic reaction (hives, swelling, difficulty breathing)
- Persistent or worsening urinary symptoms (dysuria, urgency, frequency)
Special Patient Groups
Pregnancy
Generally not recommended unless clearly needed and benefits outweigh risks. Components (Methenamine, Hyoscyamine, Salicylates) are Pregnancy Category C, with Salicylates being Category D in the third trimester due to potential for premature closure of the ductus arteriosus and increased bleeding risk.
Trimester-Specific Risks:
First Trimester:
Potential for teratogenicity with Hyoscyamine (though low risk). Salicylates generally avoided.
Second Trimester:
Generally avoided due to components, but less critical risks than first or third.
Third Trimester:
Contraindicated or strongly discouraged due to salicylate component (risk of premature closure of ductus arteriosus, prolonged labor, increased maternal/fetal bleeding).
Lactation
Not recommended. All active ingredients (Methenamine, Hyoscyamine, Salicylates, Methylene Blue) are excreted into breast milk and may cause adverse effects in the infant (e.g., anticholinergic effects, methemoglobinemia with Methylene Blue, bleeding risk with Salicylates). Consult a healthcare professional.
Infant Risk:
L3 (Moderate risk) to L4 (Potentially hazardous) depending on specific component and infant age/health. Potential for anticholinergic effects (irritability, constipation, urinary retention), methemoglobinemia (Methylene Blue, especially in G6PD deficient infants), and bleeding (Salicylates).
Pediatric Use
Use is generally not established or recommended for this combination product in children. Specific dosing and safety data are limited. Anticholinergic effects and salicylate toxicity are particular concerns in this population.
Geriatric Use
Increased susceptibility to anticholinergic side effects (e.g., dry mouth, constipation, urinary retention, confusion, falls). Renal impairment is more common, increasing risk of accumulation of renally cleared components (Methenamine, Salicylates, Methylene Blue). Use with caution, starting with lower doses and monitoring closely.
Clinical Information
Clinical Pearls
- Inform patients that their urine will turn blue or green due to the methylene blue component, which is a normal and harmless effect.
- Emphasize the importance of maintaining acidic urine (e.g., by avoiding urinary alkalinizers like antacids, citrus fruits, or milk products) for Methenamine to be effective.
- Counsel patients on anticholinergic side effects (dry mouth, blurred vision, constipation) and advise them to report severe or persistent symptoms.
- This product is for symptomatic relief and is not a substitute for antibiotic treatment of bacterial urinary tract infections if an infection is present.
- Advise patients to stay well-hydrated to help flush the urinary tract and minimize potential for crystalluria.
Alternative Therapies
- Antibiotics for bacterial UTIs (e.g., nitrofurantoin, trimethoprim/sulfamethoxazole, ciprofloxacin)
- Urinary analgesics (e.g., phenazopyridine)
- Anticholinergics/antispasmodics (e.g., oxybutynin, tolterodine for bladder overactivity)
- Urinary acidifiers (e.g., ascorbic acid, ammonium chloride)
Cost & Coverage
Average Cost:
Price varies widely, typically $30-$100+ per 30 capsules
Generic Available:
Yes
Insurance Coverage:
Tier 2 or 3 (may require prior authorization depending on plan)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it is a good idea to check with your pharmacist for more information. If you have any questions or concerns about your medication, consult with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When reporting the incident, be prepared to provide details about the medication taken, the amount, and the time it occurred.