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Drug Interactions between citric acid / simethicone / sodium bicarbonate and methenamine / sodium acid phosphate

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

methenamine sodium bicarbonate

Applies to: methenamine / sodium acid phosphate and citric acid / simethicone / sodium bicarbonate

GENERALLY AVOID: Agents that can alkalinize the urine such as thiazide diuretics, carbonic anhydrase inhibitors, and antacids may decrease the antibacterial effectiveness of methenamine by inhibiting its conversion to formaldehyde. Methenamine is most effectively converted in an acidic milieu of pH less than 5.5.

MANAGEMENT: Concomitant use of methenamine-containing preparations with thiazide diuretics, carbonic anhydrase inhibitors, or large doses of antacids should be avoided if possible. Otherwise, frequent urine pH testing may be considered. Some methenamine products may be used with antacids if dosing times are separated by at least one hour. Consult the manufacturer's product labeling for specific recommendations.

References

  1. Musher D, Griffith D "Generation of formaldehyde from methenamine: effect of pH and concentration, and antibacterial effect." Antimicrob Agents Chemother 6 (1974): 708-11
  2. Kevorkian C, Merritt J, Ilstrup D "Methenamine mandelate with acidification: an effective urinary antiseptic in patients with neurogenic bladder." Mayo Clin Proc 59 (1984): 523
  3. "Product Information. Hiprex (methenamine)." Hoechst Marion Roussel PROD (2002):
  4. Sand TE, Jacobsen S "Effect of urine pH and flow on renal clearance of methotrexate." Eur J Clin Pharmacol 19 (1981): 453-6
  5. "Product Information. Hyophen (benzoic acid/hyoscy/methen/mblue/phenylsal)." BioComp Pharma (2016):
View all 5 references

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Drug and food interactions

No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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