progesterone + tamsulosin + propantheline bromide + nifedipine

This is not a confirmed fixed-dose pharmaceutical product. The exact four-drug string appears as a consolidated intervention entry in **NCT01010048**, a Phase 4 study of medical treatment following extracorporeal shock-wave lithotripsy for urinary calculus. However, the study description identifies separate treatment groups receiving ESWL alone, ESWL plus tamsulosin, ESWL plus progesterone, or ESWL plus propantheline bromide and nifedipine; it does not establish simultaneous administration of all four drugs as one regimen or product. The individual agents have distinct smooth-muscle-related pharmacology: progesterone activates progesterone receptors, tamsulosin antagonizes alpha-1A adrenergic receptors, propantheline bromide antagonizes muscarinic acetylcholine receptors, and nifedipine blocks L-type calcium channels.