메테나민

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금기

• Renal insufficiency (can exacerbate systemic acidosis)
• Severe hepatic disease (due to ammonia production)
• Severe dehydration
• Metabolic acidosis
• Concurrent use of sulfonamides

이상반응

• Gastrointestinal upset (nausea, vomiting, diarrhea)
• Dysuria or pollakiuria (due to formaldehyde irritation)
• Hematuria
• Crystalluria (at high doses)

약물 상호작용

• Sulfonamides · Formaldehyde forms an insoluble precipitate with sulfonamides, increasing the risk of crystalluria and renal damage. · major
• Urinary alkalinizers (e.g., Potassium citrate, Sodium bicarbonate) · Raises urine pH, preventing the conversion of methenamine to its active form (formaldehyde). · major
• Thiazide diuretics · May increase urine pH and promote diuresis, reducing formaldehyde concentration and contact time in the bladder. · moderate

모니터링

• Urine pH (target < 5.5)
• Urinalysis (monitor for crystalluria or hematuria)
• Renal function
• Hepatic function (in prolonged use)

과용량

Overdosage primarily manifests as severe gastrointestinal distress (vomiting, diarrhea) and urinary tract irritation (hematuria, dysuria, crystalluria). Treatment is supportive and symptomatic. Alkalinizing the urine can halt further conversion to formaldehyde and reduce urinary irritation.