Hyoscyamine produces many effects in the body, including relief from muscle spasms.

Methenamine and methylene blue work as mild antiseptics that fight bacteria in the urine and bladder.

Phenyl salicylate is a mild pain reliever.

The combination of hyoscyamine, methenamine, methylene blue, and phenyl salicylate is used to treat bladder irritation (pain, burning, inflammation) caused by urinary tract infection. This medication is also used to prevent bladder discomfort during a medical procedure.

Hyoscyamine, methenamine, methylene blue, and phenyl salicylate may also be used for purposes not listed in this medication guide.

What is the most important information I should know about Ustell (hyoscyamine, methenamine, methylene blue, and phenyl salicylate)?

Before taking this medication, tell your doctor if you have any type of heart problem (congestive heart failure, coronary heart disease, a heart valve or heart rhythm disorder), glaucoma, an enlarged prostate, bladder obstruction, myasthenia gravis, a stomach ulcer or obstruction, or if you are allergic to belladonna (Donnatal and others).

Many drugs can interact with this medicine. Also, hyoscyamine can make it harder for your body to absorb other medications you take by mouth. Tell your doctor about all other medicines you use.

What should I discuss with my healthcare provider before taking Ustell (hyoscyamine, methenamine, methylene blue, and phenyl salicylate)?

To make sure you can safely take this medication, tell your doctor if you have any of these other conditions:

• heart disease-

• a heart rhythm disorder-

• congestive heart failure-

• coronary heart disease-

• a heart valve disorder-

• glaucoma-

• an enlarged prostate or bladder obstruction-

• myasthenia gravis-

• an ulcer or obstruction in your stomach- or

• if you are allergic to belladonna (Donnatal and others).

How should I take Ustell (hyoscyamine, methenamine, methylene blue, and phenyl salicylate)?

Take exactly as prescribed by your doctor. Do not take in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Hyoscyamine, methenamine, methylene blue, and phenyl salicylate is usually taken 4 times daily. Follow your doctor's instructions.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Overdose symptoms may include severe dizziness or rapid pulse.

What should I avoid while taking Ustell (hyoscyamine, methenamine, methylene blue, and phenyl salicylate)?

Avoid taking an antacid or anti-diarrhea medicine within 1 hour before or after you take hyoscyamine, methenamine, methylene blue, and phenyl salicylate. Antacids or anti-diarrhea medicine can make it harder for your body to absorb hyoscyamine.

If you also take ketoconazole (Nizoral), wait at least 2 hours after taking it before you take hyoscyamine, methenamine, methylene blue, and phenyl salicylate.

Ustell (hyoscyamine, methenamine, methylene blue, and phenyl salicylate) side effects

Methylene blue will most likely cause your urine or stools to appear blue or green in color. This is a normal side effect of the medication and will not cause any harm.

• severe dizziness, blurred vision, fast heart rate-

• agitation, confusion, feeling restless or excited-

• painful or difficult urination- or

• feeling short of breath.

Less serious side effects may include:

• mild dizziness-

• drowsiness- or

• flushing (warmth, redness, or tingly feeling).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Ustell (hyoscyamine, methenamine, methylene blue, and phenyl salicylate)?

Many drugs can interact with this medicine. Also, hyoscyamine can make it harder for your body to absorb other medications you take by mouth. Tell your doctor about all other medicines you use, especially:

• atropine (Atreza, Sal-Tropine), belladonna (Donnatal, and others), benztropine (Cogentin), dimenhydrinate (Dramamine), methscopolamine (Pamine), or scopolamine (Transderm Scop)-

• a diuretic (water pill)-

• bronchodilators such as ipratropium (Atrovent) or tiotropium (Spiriva)-

• glycopyrrolate (Robinul)-

• homatropine (Hycodan, Tussigon)-

• methantheline-

• neostigmine (Prostigmin) or pyridostigmine (Mestinon)-

• bladder or urinary medications such as darifenacin (Enablex), flavoxate (Urispas), oxybutynin (Ditropan, Oxytrol), tolterodine (Detrol), or solifenacin (Vesicare)- or

• an MAO inhibitor such as furazolidone (Furoxone), isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam, Zelapar), or tranylcypromine (Parnate)-

• medicines to treat symptoms of Alzheimer's disease such as donepezil (Aricept), galantamine (Razadyne), memantine (Namenda), rivastigmine (Exelon), or tacrine (Cognex)-

• narcotic pain medication such as codeine (Tylenol #3, Cheratuss, Guaiatuss), fentanyl (Actiq, Duragesic), hydrocodone (Lortab, Vicodin, Vicoprofen), hydromorphone (Dilaudid), methadone (Dolophine, Methadose), morphine (Avinza, Kadian, MS Contin, Oramorph), oxycodone (OxyContin, Endocet, Percocet), propoxyphene (Darvocet, Propacet), and others-

• sodium bicarbonate, potassium citrate (K-Lyte, Urocit-K), sodium citrate and citric acid (Bicitra, Oracit), or sodium citrate and potassium (Citrolith, Polycitra)-

• sulfa drugs (Bactrim, Septra, Sulfatrim, SMX-TMP, and others)- or

• ulcer or irritable bowel medications such as dicyclomine (Bentyl), glycopyrrolate (Robinul), hyoscyamine (Hyomax), mepenzolate (Cantil), or propantheline (Pro Banthine).

This list is not complete and there are many other drugs that can interact with hyoscyamine, methenamine, methylene blue, and phenyl salicylate. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor. Keep a list of all your medicines and show it to any healthcare provider who treats you.

Where can I get more information?

• Your pharmacist can provide more information about hyoscyamine, methenamine, methylene blue, and phenyl salicylate.

• Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.