Me NaPhos MB Hyo 1 (methenamine 81.6 mg sodium phosphate, monobasic, monohydrate 40.8 mg methylene blue anhydrous 10.8 mg hyoscyamine sulfate anhydrous 0.12 mg) Dailymed
Generic: urinary antiseptic antispasmodic is used for the treatment of Abnormalities, Drug-Induced Urinary Bladder, Neurogenic Colic Colitis, Ulcerative Glaucoma Hyperhidrosis Ileal Diseases Intestinal Obstruction Intraoperative Complications Megacolon, Toxic Muscle Rigidity Myasthenia Gravis Peptic Ulcer Rhinitis Shock, Hemorrhagic Sialorrhea Spasm Tremor Urethral Obstruction Xerostomia Myocardial Ischemia Gastroparesis Irritable Bowel Syndrome Alkalosis Constipation Edema Hypernatremia Hypocalcemia Pulmonary Edema Hypophosphatemia Urological Manifestations Renal Insufficiency Bacteriuria Cystitis Dehydration Escherichia coli Infections Hypersensitivity Kidney Diseases Staphylococcal Infections Urinary Tract Infections Hepatic Insufficiency Cyanosis Herpes Simplex Methemoglobinemia Poisoning Pregnancy Lithiasis
IMPRINT: M455
SHAPE: oval
COLOR: blue
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Description
Each tablet contains:
Methenamine, USP ................................. 81.6 mg Monobasic Sodium Phosphate, USP ......... 40.8 mg Methylene Blue ....................................... 10.8 mg Hyoscyamine Sulfate ............................... 0.12 mg
Inactive Ingredients Include:
Microcrystalline Cellulose, Mannitol, Croscarmellose Sodium, Magnesium Stearate, FD&C Blue #1
HYOSCYAMINE SULFATE is an alkaloid of belladonna. Exists as a white crystalline powder. Affected by light It is very soluble in water; freely soluble in alcohol; practically insoluble in ether. METHENAMINE exists as colorless, lustrous crystals or white crystalline powder. Its solutions are alkaline to litmus. Freely soluble in water; soluble in alcohol and in chloroform.
METHYLENE BLUE exists as dark green crystals. It is soluble in water and in chloroform; sparingly soluble in alcohol.
MONOBASIC SODIUM PHOSPHATE exists as a white crystalline powder. Its solutions are acidic to litmus. It is freely soluble in water and practically insoluble in alcohol.
This product is not an Orange Book (OB) rated product, therefore all prescriptions using this product shall be pursuant to state statutes as applicable. There are no claims of bioequivalence or therapeutic equivalence.
Clinical Pharmacology
HYOSCYAMINE is a parasympatholytic which relaxes smooth muscles and thus produces an antispasmodic effect. It is well absorbed from the gastrointestinal tract and is rapidly distributed throughout body tissues. Most is excreted in the urine within 12 hours, 13% to 50% being unchanged.
Its biotransformation is hepatic. Its protein binding is moderate.
METHENAMINE degrades in an acidic urine environment releasing formaldehyde which provides bactericidal or bacteriostatic action. It is well absorbed from the gastrointestinal tract. 70% to 90% reaches the urine unchanged at which point it is hydrolyzed if the urine is acidic. Within 24 hours it is almost completely (90%) excreted; of this amount at pH 5, approximately 20% is formaldehyde. Protein binding: some formaldehyde is bound to substances in the urine and surrounding tissues. Methenamine is freely distributed to body tissue and fluids but is not clinically significant as it does not hydrolyze at pH greater than 6.8.
METHYLENE BLUE possesses weak antiseptic properties. It is well absorbed in the gastrointestinal tract and is rapidly reduced to leukomethylene blue which is stabilized in some combination form in the urine. 75% is excreted unchanged.
MONOBASIC SODIUM PHOSPHATE helps to maintain an acid pH in the urine necessary for the degradation of methenamine.
Indication And Usage
ME/NaPhos/MB/Hyo 1 Tablets is indicated for the treatment of symptoms of irritative voiding. Indicated for the relief of local symptoms, such as hypermotility which accompany lower urinary tract infections and as antispasmodic. Indicated for the relief of urinary tract symptoms caused by diagnostic procedures.
Warnings
Do not exceed recommended dosage. If rapid pulse, dizziness, or blurring of vision occurs discontinue use immediately.
Precautions
(Pregnancy Category C) hyoscyamine and methenamine cross the placenta. Studies have not been done in animals or humans. It is not known whether ME/NaPhos/MB/Hyo 1 Tablets cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. ME/NaPhos/MB/Hyo 1 Tablets should be given to a pregnant woman only if clearly needed.
Breast-feeding
problems in humans have not been documented; however, methenamine and traces of hyoscyamine are excreted in breast milk.
Prolonged Use
there have been no studies to establish the safety of prolonged use in humans. No known long-term animal studies have been performed to evaluate carcinogenic potential.
Pediatric
infants and young children are especially susceptible to the toxic effect of the belladonna alkaloids.
Geriatric
use with caution in elderly patients as they may respond to usual doses of hyoscyamine with exclient, agitation, drowsiness, or confusion.
Drug Interactions
because of this product's effect on gastrointestinal
motility and gastric emptying, it may decrease the absorption of other oral medications during concurrent use such as: urinary alkalizers; thiazide diuretics (may cause the urine to become alkaline reducing the effectiveness of methenamine by inhibiting its conversion to formaldehyde); antimuscarinics (concurrent use may intensify antimuscarinic effects of hyoscyamine because of secondary antimuscarinic activities of these medications); antacids/antidiarrheals (may reduce absorption of hyoscyamine, concurrent use with antacids may cause urine to become alkaline reducing effectiveness of methenamine by inhibiting its conversion to formaldehyde) doses of these medications should be spaced 1 hour apart from doses of hyoscyamine; antimyasthenics (concurrent use with hyoscyamine may further reduce intestinal motility); ketoconazole (patients should be advised to take this combination at least 2 hours after ketoconazole); monoamine oxidase (MAO) Inhibitors (concurrent use may intensify antimuscarinic side effects, opioid (narcotic) analgesics may result in increased risk of severe constipation); sulfonamides (these drugs may precipitate with formaldehyde in the urine, increasing the danger of crystalluria). Patients should be advised that the urine may become blue to blue green and the feces may be discolored as a result of the excretion of methylene blue.
Adverse Reactions
Cardiovascular – rapid pulse, flushing
Central Nervous System – blurred vision, dizziness
Respiratory – shortness of breath or troubled breathing
Genitourinary – difficulty micturition, acute urinary retention
Gastrointestinal – dry mouth, nausea/vomiting
Drug Abuse And Dependence
A dependence on the use of ME/NaPhos/MB/Hyo 1 Tablets has not been reported and due to the nature of its ingredients, abuse of ME/NaPhos/MB/Hyo 1 Tablets is not expected.
Overdosage
Emesis or gastric lavage. Slow intravenous administration of physostigmine in doses of 1 mg to 4 mg (0.5 mg to 1 mg in children), repeated as needed in one to two hours to reverse severe antimuscarinic symptoms. Administration of small doses of diazepam to control exclient and seizures. Artificial respiration with oxygen if needed for respiratory depression. Adequate hydration. Symptomatic treatment as necessary.
Dosage And Administration
Adults
One tablet orally 4 times per day followed by liberal fluid intake.
Older Children
Dosage must be individualized by physician. Not recommended for use in children up to 6 years of age.
How Supplied
ME/NaPhos/MB/Hyo 1 Tablets are light blue to blue, oval, biconvex tablets debossed with "M455" with scoreline on one side and plain on the other side. Supplied in bottles of 100 tablets (NDC 58657-454-01).
Other Safety Information
CAUTION
RX ONLY
STORAGE
Store at 25° C (77° F); excursions permitted to 15° C to 30° C (59° F to 86° F) [See USP Controlled Room Temperature]. Keep container tightly closed.
Distributed By: Method Pharmaceuticals, LLC Arlington, TX 76006
Rev. Date: 01/2016
General Precautions Section
DIRECTIONS: 1 Tablet 4 times daily followed by liberal fluid intake, or as directed by a physician.
FOR FULL PRODUCT INFORMATION SEE ATTACHED BOOKLET. Store at 25° C (77° F); excursions permitted to 15° C to 30° C (59° F to 86° F) [See USP Controlled Room Temperature]. Protect from moisture or direct sunlight.
NOTE: Patient should be advised that urine will be colored blue while taking this medication.
PHARMACIST: Preserve and dispense in tight-light resistant container as defined in the USP.
KEEP THIS AND ALL MEDICINES OUT OF THE REACH OF
CHILDREN.
Tamper evident by heat seal under cap. Do not use if there is evidence of tampering.
To report an adverse event, please contact Method Pharmaceuticals, LLC at (877) 250-3427.
Package Label.principal Display Panel
Distributed by: Method Pharmaceuticals, LLC Arlington, TX 76006 Rev. Date: 01/2016
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Booklet
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