URNEVA (methenamine/methylene blue/sod phos/p.salicylate/hyoscyamine)

Moderate

• A-hydrocort

• A-methapred

• abciximab

• acebutolol

• Adasuve

• Amaryl

• Angeliq

• Anucort-hc

• Anusol-hc

• Aristospan Intra-articular

• Aristospan Intralesional

• Arixtra

• Astagraf Xl

• atenolol

• betamethasone acet & sod phos

• Betapace

• Betapace Af

• betaxolol

• Beyaz

• bisoprolol fumarate

• Brevibloc

• Brevibloc In Nacl (iso-osm)

• Brilinta

• budesonide

• Bystolic

• Celestone Soluspan

• chlorpromazine

• cilostazol

• cisplatin

• clopidogrel

• colchicine-probenecid

• Colocort

• Compazine

• Compro

• Corgard

• Cortef

• Cortenema

• Cortifoam

• cortisone

• cyclosporine

• cyclosporine modified

• dalteparin (porcine)

• Depacon

• Depakene

• Depakote

• Depakote Er

• Depakote Sprinkles

• Depo-medrol

• dexamethasone

• Dexamethasone Intensol

• dexamethasone sodium phos (PF)

• dexamethasone sodium phosphate

• Dexpak 10 Day

• Dexpak 13 Day

• Dexpak 6 Day

• Diabeta

• divalproex

• drospirenone-e.estradiol-lm.FA

• drospirenone-estradiol

• drospirenone-ethinyl estradiol

• Duetact

• Elmiron

• enoxaparin

• Entocort Ec

• eptifibatide

• esmolol

• esmolol in NaCl (iso-osm)

• Ez Use Joint-tunnel-trigger

• First-duke's

• First-mary's Mouthwash

• Flo-pred

• fludrocortisone

• fluphenazine decanoate

• fluphenazine HCl

• fondaparinux

• Fragmin

• Gengraf

• Gianvi (28)

• glimepiride

• glipizide

• glipizide-metformin

• Glucotrol

• Glucotrol Xl

• Glucovance

• glyburide

• glyburide micronized

• glyburide-metformin

• Glynase

• Grx Hicort 25

• Haldol

• Haldol Decanoate

• haloperidol

• haloperidol decanoate

• haloperidol lactate

• Hecoria

• Hemril-30

• heparin (porcine)

• heparin (porcine) in D5W

• heparin(porcine) in 0.45% NaCl

• heparin, porcine (PF)

• hydrocortisone

• hydrocortisone acetate

• hydrocortisone sod succ (PF)

• hydrocortisone sod succinate

• Inderal La

• Inderal Xl

• Innopran Xl

• Integrilin

• itraconazole

• Kenalog

• ketoconazole

• Levatol

• lithium carbonate

• lithium citrate

• Lithobid

• Lopressor

• Loryna (28)

• Lovenox

• loxapine

• loxapine succinate

• Loxitane

• Medrol

• Medrol (pak)

• methylprednisolone

• methylprednisolone acetate

• methylprednisolone sod suc(PF)

• methylprednisolone sodium succ

• methylprednisolone-bupivacaine

• metoprolol succinate

• metoprolol tartrate

• Millipred

• Millipred Dp

• nadolol

• nateglinide

• nebivolol

• Neoral

• nystatin-hydrocortisone-diphen

• nystatin-TCN-HC-diphenhydramin

• Ocella

• Onmel

• Orapred

• Orapred Odt

• Pediapred

• penbutolol

• pentosan polysulfate sodium

• perphenazine

• perphenazine-amitriptyline

• Phenadoz

• Phenergan

• Physicians Ez Use M-pred

• pindolol

• pioglitazone-glimepiride

• Plavix

• Pletal

• prednisolone

• prednisolone acetate

• prednisolone sodium phosphate

• prednisone

• Prednisone Intensol

• probenecid

• prochlorperazine

• prochlorperazine Edisylate

• prochlorperazine maleate

• Proctocort

• Prograf

• promethazine

• Promethazine Vc

• Promethazine Vc-codeine

• promethazine-codeine

• promethazine-DM

• promethazine-phenyleph-codeine

• promethazine-phenylephrine

• Promethegan

• propranolol

• Rapamune

• Rayos

• Rectacort-hc

• Reopro

• Safyral

• Sandimmune

• Sectral

• sirolimus

• Solu-cortef

• Solu-cortef (pf)

• Solu-medrol

• Solu-medrol (pf)

• Sorine

• sotalol

• Sotalol Af

• Sporanox

• Sporanox Pulsepak

• Starlix

• Stavzor

• Syeda

• tacrolimus

• Tenormin

• thioridazine

• ticagrelor

• timolol maleate

• tolazamide

• tolbutamide

• Toprol Xl

• triamcinolone acetonide

• triamcinolone hexacetonide

• triamcinolone-lidocaine

• trifluoperazine

• Uceris

• valproate sodium

• valproic acid

• valproic acid (as sodium salt)

• Veripred 20

• Vestura (28)

• Yasmin (28)

• Yaz 28

• Zarah

• Zebeta

Moderate

• Abnormal hepatic function tests

• Autonomic neuropathy

• Cardiac arrhythmia

• Child-pugh class A hepatic impairment

• Child-pugh class B hepatic impairment

• Child-pugh class C hepatic impairment

• Chronic heart failure

• Coronary artery disease

• Disease of liver

• Gastroesophageal reflux disease

• Hepatic cirrhosis

• Hiatal hernia

• High fever >101 degrees fahrenheit

• Hypertension

• Hyperthyroidism

• Kidney disease with likely reduction in GFR

• Kidney disease with reduction in GFR

• Severe hepatic disease

Hyoscyamine

• Severity Level:

  2

• Additional Notes: Limited data suggest an increased risk of congenital malformations

Methenamine

• Severity Level:

  2

• Additional Notes: Insuff human data avail; consider maternal benefit vs neonatal risk

Methylene Blue

• Severity Level:

  D

• Additional Notes: Serious fetal/neonatal adverse effects with intra-amniotic admin

Salicylate(low Dose In Combo Prod)

• Severity Level:

  C

• Additional Notes: Insuff human data avail; consider risk vs benefit

Contraindicated

Methylene Blue

Manufacturer does not rec during treatment and for 8 days after last dose

One report of metabol acidosis w/asa;Risk of reye's syn w/viral illness/fever

General	Excretion Potential	Effect on Infant	Notes
Drug should not be given to breast feeding mothers	Unknown	Not known; no or inclusive data	Manufacturer does not rec during treatment and for 8 days after last dose

Salicylates

Manufacturer does not rec during treatment and for 8 days after last dose

One report of metabol acidosis w/asa;Risk of reye's syn w/viral illness/fever

General	Excretion Potential	Effect on Infant	Notes
Drug should not be given to breast feeding mothers	Excreted	Not known; no or inclusive data	One report of metabol acidosis w/asa;Risk of reye's syn w/viral illness/fever

Precaution Exists

Hyoscyamine

Limited data suggest minimal amounts excreted into breastmilk.

Limited data suggest low excretion with no known infant adverse effects

General	Excretion Potential	Effect on Infant	Notes
Evaluate use carefully	Excreted	Not known; no or inclusive data	Limited data suggest minimal amounts excreted into breastmilk.

Methenamine

Limited data suggest minimal amounts excreted into breastmilk.

Limited data suggest low excretion with no known infant adverse effects

General	Excretion Potential	Effect on Infant	Notes
Evaluate use carefully	Excreted	Not known; no or inclusive data	Limited data suggest low excretion with no known infant adverse effects

No Known Risk

None

General	Excretion Potential	Effect on Infant	Notes
			None

Contraindicated

None

Precaution Exists

Hyoscyamine

Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Non-sedating agents preferred. Gastrointestinal-Avoid with gastrointestinal ileus. May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.

General-Elderly have a higher incidence of systemic toxicities. Dose reduction may be needed.

Organ / System	HEP	REN	CARD	ENDO	NEURO / PSYCH	PULM
Increased Risk / Adverse Effects	Y	N	N	Y	N	N

BEERS: Y     HEDIS: Y     STOPP: Y

Phenyl Salicylate (salol)

Neuro/Psych-Anticholinergic effects may cause sedation, worsen cognitive impairment and increase fall risk. Non-sedating agents preferred. Gastrointestinal-Avoid with gastrointestinal ileus. May cause or worsen pre-existing constipation. Genitourinary-Best avoided in patients with urinary retention from any cause.

General-Elderly have a higher incidence of systemic toxicities. Dose reduction may be needed.

Organ / System	HEP	REN	CARD	ENDO	NEURO / PSYCH	PULM
Increased Risk / Adverse Effects	Y	N	N	Y	N	N

BEERS: N     HEDIS: N     STOPP: N

No Known Risk

None

0-9	A-Z