Urotropin

UROTROPIN (syn. hexamine, formin, aminoform, metramine), hexamethylenetetramine, (CH₂)₆N₄. It is obtained from formaldehyde (paraformaldehyde) by the action of ammonia on it. It is a colorless crystalline powder, with a sweetish taste and no odor. It evaporates upon heating. It is soluble in 1.5 parts of water, yielding a solution that is slightly alkaline to litmus. In an acidic environment, it decomposes, releasing formaldehyde. Its therapeutic application is based on this. It is used: a) for infections of the urinary tract in a dose of up to 2–3 g per day. Since the action of Urotropin manifests only in an acidic environment, a large number of preparations containing a component that acidifies the urine have been proposed abroad; b) for infections of the biliary tract. Finally, Urotropin finds wide application (intravenously) in all kinds of general infections of the organism: influenza, encephalitis, meningitis, typhoid fever, sepsis, etc. In these cases, it is, of course, possible to assume that Urotropin possesses some antiseptic action due to the acidic reaction of inflammatory foci. However, the “colloidoclastic” action of Urotropin solutions upon intravenous administration, noted by Ganzdik, is much more likely. The shifts that occur in this process, both in the composition of blood ions and in its colloidal state, are likely activators of the body's protective reactions. This colloidoclastic action likely also explains the success of intravenous infusions of Urotropin in a number of neurasthenic states and for arteriosclerotic symptoms. Furthermore, Urotropin is a preferred remedy in the treatment of gout due to the fact that formaldehyde forms a relatively soluble compound with uric acid—diformyl-uric acid. Therefore, Urotropin is one of the main components of a number of patented remedies for gout, including Urodonal. The use of Urotropin (especially in large doses) is often accompanied by a number of side effects. On one hand, phenomena of local irritation of the urinary tract are observed: burning in the canal, dysuric phenomena, hematuria; on the other hand, reactions of an allergic nature: skin rashes, urticaria, etc. Regarding symptoms of the first order, the concentration at which the medicine is excreted by the kidney (dependence on the drinking regimen) is, of course, not indifferent; however, simultaneously with a decrease in concentration and a softening of the irritating effect, the therapeutic (disinfecting) effect is naturally weakened. By virtue of this, it is recommended in cases of increased reaction of the urinary tract not to increase the amount of fluid intake, but to prescribe calcium chloride simultaneously. This not only weakens the phenomena of local irritation but can also prevent a general allergic reaction. In addition, calcium chloride acidifies the urine, thereby creating favorable conditions for the cleavage of formaldehyde. Due to the decomposition of Urotropin in an acidic environment, it is recommended to take it before meals when prescribed orally. Dosage: 0.5–1.0 g orally several times a day (up to 4 g). For children, according to Finkelstein, up to 1.0 g per day. Intravenously, 5–10 cm³ of a 40% solution. Urotropin preparations: allotropin—Urotropin phosphate; amphotropin—Urotropin camphorate; borovertin—Urotropin metaborate; chinotropin—Urotropin quinate; helmitol—Urotropin anhydromethylenecitrate; hexal—Urotropin sulfosalicylate; cystoitrin—Urotropin with sodium acetate.