Urotropine

UROTROPINE (syn. hexamine, formin, aminoform, metramine), hexamethylenetetramine, (CH₂)₆N₄. It is obtained from formaldehyde (para-formaldehyde) by the action of ammonia on it. A colorless crystalline powder, of a sweetish taste, odorless. It evaporates upon heating. Soluble in 1.5 parts of water, yielding a solution that is slightly alkaline to litmus. In an acidic environment, it splits, releasing formaldehyde. Its therapeutic use is based on this. It is used: a) for urinary tract infections in a dose of up to 2-3 g pro die. Since the action of urotropine manifests itself only in an acidic environment, a large number of preparations containing a urine-acidifying component have been proposed abroad; b) for biliary tract infections. Finally, urotropine finds wide application (intravenously) in all kinds of general infections of the body: influenza, encephalitis, meningitis, typhoid fever, sepsis, etc. In these cases, it is of course possible to assume the presence in urotropine of a certain antiseptic action due to the acidic reaction of inflammatory foci. However, much more probable is Gantzdijk's noted "colloidoclastic" action of urotropine solutions upon its intravenous administration. The shifts occurring during this both in the composition of blood ions and in its colloidal state are probably activators of the body's defense reactions. This colloidoclastic action probably also explains the success of intravenous infusions of urotropine in a number of neurasthenic conditions and arteriosclerotic symptoms. In addition, urotropine is a favorite remedy in the treatment of gout due to the fact that formaldehyde forms a relatively soluble compound—diformaldehyde-uric acid—with uric acid. Therefore, urotropine is one of the main components of a number of patented remedies for gout, including urodon. The use of urotropine (especially in large doses) is often accompanied by a number of side effects. On the one hand, phenomena of local irritation of the urinary tract, burning in the canal, dysuric phenomena, and hematuria are observed; on the other hand, allergic reactions: skin rashes, urticaria, etc. With regard to symptoms of the first order, the concentration at which the drug is excreted by the kidney is of course not indifferent (dependence on the drinking regimen); however, simultaneously with a decrease in concentration and a mitigation of the irritating effect, the therapeutic (disinfectant) effect naturally weakens as well. By virtue of this, it is recommended in cases of increased reaction of the urinary tract not to increase the amount of drinking, 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 urotropine in an acidic environment, when administered internally, it is recommended to take it before meals. Dosage: 0.5-1.0 internally several times a day (up to 4 g). For children, according to Finkelstein, up to 1.0 per day. Intravenously, 5-10 cm³ of a 40% solution. Urotropine preparations: allotropin—phosphoric acid urotropine; amphotropin—camphoric acid urotropine; borovertin—metaboric acid urotropine; chinotropin—quinic acid urotropine; helmitol—anhydromethylenecitric acid urotropine; hexal—sulfosalicylic acid urotropine; cystoitrin—urotropine with sodium acetate.

I. Itsikeon.