Methenamine/sodium salicylate, sold under the brand name Cystex among others, is a combination drug comprising methenamine and sodium salicylate. Methenamine serves as a urinary antiseptic and antibacterial agent, while sodium salicylate is a nonsteroidal anti-inflammatory drug (NSAID) and analgesic. The combination is used for the treatment and prevention of urinary tract infection (UTI) symptoms.[1][2][3][4]
 Chemical structure of methenamine | |
 Chemical structure of sodium salicylate | |
| Combination of | |
|---|---|
| Methenamine | Urinary antiseptic and antibacterial |
| Sodium salicylate | Nonsteroidal anti-inflammatory drug (NSAID) and analgesic |
| Clinical data | |
| Trade names | Cystex, others |
| Other names | Sodium salicylate/methenamine; Methenamine/salicylate; Methenamine/salicylic acid; Salicylate/methenamine; Salicylic acid/methenamine; Hexamine/sodium salicylate; Hexamine/salicylate |
| AHFS/Drugs.com | Multum Consumer Information |
| Routes of administration | Oral |
| ATC code | |
| Legal status | |
| Legal status |
|
Medical uses
editMethenamine, whether used alone or in combination with sodium salicylate, is considered an alternative to antibiotics for the treatment and prevention of UTIs and related symptoms.[5][1] Unlike antibiotics, methenamine does not contribute to the risk of bacterial resistance.[1][2][6]
Available forms
editThe drug is available over-the-counter (OTC), including in the United States, and is typically taken by mouth three times per day.[1][2][3][4]
Methenamine/sodium salicylate is marketed under several brand names, including Cystex Urinary Pain Relief, AZO Urinary Tract Defense, Uro-Pain Dual Action, and CVS Antibacterial Plus Urinary Pain Relief.[7][4] Some formulations also include phenazopyridine and are marketed as products like the All-In-One UTI Emergency Kit.[4]
Comparison with methenamine
editMethenamine is also available as a prescription drug and is used alone to prevent recurrent UTIs.[1][8][5] Clinical evidence supports its efficacy for this indication.[1][8][5][9] Prescription methenamine is usually administered as the hippuric acid or mandelic acid salt, while the OTC methenamine/sodium salicylate formulation uses methenamine as the free base.[1][3][10][4]
Compared to prescription methenamine, the OTC combination formulation contains lower doses of methenamine. This OTC version has been studied less extensively, and limited clinical data are available to guide its use.[2][1]
See also
editReferences
edit- ^ a b c d e f g h Li JM, Cosler LE, Harausz EP, Myers CE, Kufel WD (February 2024). "Methenamine for urinary tract infection prophylaxis: A systematic review". Pharmacotherapy. 44 (2): 197–206. doi:10.1002/phar.2895. PMID 37986168.
- ^ a b c d Chwa A, Kavanagh K, Linnebur SA, Fixen DR (2019). "Evaluation of methenamine for urinary tract infection prevention in older adults: a review of the evidence". Therapeutic Advances in Drug Safety. 10: 2042098619876749. doi:10.1177/2042098619876749. PMC 6759703. PMID 31579504.
- ^ a b c "Methenamine: Uses, Interactions, Mechanism of Action". DrugBank Online. 31 December 1993. Retrieved 11 October 2024.
- ^ a b c d e "Search Results for methenamine". DailyMed. 2 February 2016. Retrieved 11 October 2024.
- ^ a b c Lee BS, Bhuta T, Simpson JM, Craig JC (October 2012). "Methenamine hippurate for preventing urinary tract infections". The Cochrane Database of Systematic Reviews. 10 (10): CD003265. doi:10.1002/14651858.CD003265.pub3. PMC 7144741. PMID 23076896.
- ^ Lo TS, Hammer KD, Zegarra M, Cho WC (May 2014). "Methenamine: a forgotten drug for preventing recurrent urinary tract infection in a multidrug resistance era". Expert Review of Anti-Infective Therapy. 12 (5): 549–554. doi:10.1586/14787210.2014.904202. PMID 24689705.
- ^ "Methenamine and sodium salicylate Uses, Side Effects & Warnings". Drugs.com. 7 November 2023. Retrieved 14 October 2024.
- ^ a b Kale S, Somani BK (November 2023). "The resurgence of methenamine hippurate in the prevention of recurrent UTIs in women- a systematic review". Current Opinion in Urology. 33 (6): 488–496. doi:10.1097/MOU.0000000000001108. PMID 37337660.
- ^ Davidson SM, Brown JN, Nance CB, Townsend ML (March 2024). "Use of Methenamine for Urinary Tract Infection Prophylaxis: Systematic Review of Recent Evidence". International Urogynecology Journal. 35 (3): 483–489. doi:10.1007/s00192-024-05726-2. PMID 38329493.
- ^ Schweizerischer Apotheker-Verein (2004). Index Nominum: International Drug Directory. Medpharm Scientific Publishers. pp. 775–776. ISBN 978-3-88763-101-7. Retrieved 11 October 2024.
