Uticure

Indications

Methenamine Hippurate is used to prevent repeated urinary tract infections (UTIs) in adults who get them often. It is a preventive medicine taken over the long term and is not used to treat an infection that is already active; an existing infection should be cleared with a suitable antibiotic first.

How It Works

In acidic urine, Methenamine slowly breaks down into formaldehyde, a substance that kills bacteria. Because this happens mainly in the bladder, it helps stop bacteria from building up in the urine without acting like a usual antibiotic, so bacteria do not become resistant to it. The hippurate part helps keep the urine acidic.

Dosage and Administration

Usual adult dose: 1 g by mouth twice daily (morning and evening). It can be taken with food to reduce stomach upset. Drink a normal amount of fluid; very large amounts dilute the urine and may reduce its effect. Your doctor will review whether you still need it every few months.

Interactions

Medicines and products that make the urine less acidic, such as antacids, Sodium bicarbonate, Potassium citrate and Acetazolamide, reduce its effect. Do not take with Sulfonamide antibiotics (such as Sulfamethoxazole), as they can form crystals in the urine. Avoid large amounts of milk products or citrus that make urine alkaline, unless advised.

Contraindications

Do not use if you have severe kidney failure, severe liver disease, severe dehydration, metabolic acidosis (too much acid in the blood) or gout, or if you are allergic to Methenamine.

Side Effects

Side effects are usually mild and include nausea, stomach upset, rash, itching and headache. Rarely, high doses may irritate the bladder, causing painful or frequent urination or blood in the urine.

Get urgent medical help if you have signs of a severe allergic reaction (swelling of the face or throat, difficulty breathing, widespread rash), blood in your urine, or fever with back pain, which may mean a kidney infection.

Pregnancy and Lactation

It is sometimes used in pregnancy, but only when a doctor decides it is needed. Small amounts pass into breast milk; ask your doctor before using it while breastfeeding.

Precautions and Warnings

Tell your doctor if you have kidney or liver problems. Liver tests may be checked during long-term use. If you develop UTI symptoms such as burning, fever or cloudy urine while taking it, see a doctor, as you may need an antibiotic.

Overdose

Overdose may cause stomach upset and bladder irritation with painful urination or blood in the urine. Seek medical advice if a large amount has been taken.

Therapeutic Class

Urinary antiseptic (urinary tract infection prophylaxis).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.