Hiprex Side Effects: What to Know (2025)

Mahshid Moghei, PhD Medically reviewed by Mahshid M. on

Understanding the Side Effects of Hiprex: A Closer Look

The most common side effects of Methenamine Hippurate (Hiprex) are nausea, upset stomach, dysuria, rash, and bladder irritation. Methenamine Hippurate (Hiprex) is an antibiotic, but not the type that treats active infections or active UTIs (urinary tract infections). Instead, Methenamine Hippurate (Hiprex) helps prevent and control chronic UTIs (urinary tract infections) in people who need long-term treatment.

Key Takeaways

  • Methenamine Hippurate (Hiprex) is an antibiotic, but not the type that treats active infections or active UTIs (urinary tract infections).

  • The most common side effects of Methenamine Hippurate (Hiprex) are nausea, upset stomach, dysuria, rash, and bladder irritation.

Hiprex (Methenamine Hippurate) Side Effects

According to the FDA label, here are the common Hiprex (Methenamine Hippurate) side effects. According to the FDA label, “Minor adverse reactions have been reported in less than 3.5% of patients treated. These reactions have included nausea, upset stomach, dysuria, and rash.”

This can be broken down into the following data table:

Side Effect

Frequency

Nausea

< 3.5% of patients

Upset stomach

< 3.5% of patients

Dysuria (painful urination)

< 3.5% of patients

Rash

< 3.5% of patients

Bladder irritation (with large doses)

Occasional, with higher doses (up to 8 grams daily)​.

Preventing Common Side Effects of Hiprex (Methenamine Hippurate)

Hiprex (Methenamine Hippurate) thankfully doesn’t have a long list of side effects. However, here are the most common side effects and how to prevent them for occurring: 

  • Nausea and Upset Stomach: These symptoms may occur, particularly when the medication is taken on an empty stomach. Taking Hiprex with food or at bedtime can help reduce these side effects​.

  • Dysuria (Painful Urination): Some patients experience painful urination, especially when starting treatment. Maintaining adequate hydration and ensuring the urine stays acidic (as required for Hiprex to work properly) can help prevent or reduce discomfort​.

  • Rash: A mild rash may develop in some individuals. If this occurs, consult with a healthcare provider for further guidance. Discontinuation or dosage adjustments may be required​.

  • Bladder Irritation (with higher doses): High doses (such as those exceeding 8 grams per day) can lead to bladder irritation. This can cause symptoms like painful urination and blood in the urine (hematuria). To prevent this, it’s important to follow the prescribed dose carefully and avoid self-adjusting the dosage.

Hair Loss and Hiprex (Methenamine Hippurate)

There are no clinical studies that suggest hair loss is a side effect of taking the medication Hiprex (methenamine hippurate). If you’re experiencing signs of hair loss, contact your PCP (primary care physician) to learn why you may be having these unexpected results.

Weight Gain and Hiprex (Methenamine Hippurate)

There are no clinical studies that suggest weight gain is a side effect of taking the medication Hiprex (Methenamine Hippurate). If you’re experiencing issues with your body mass index increasing, contact your PCP (primary care physician) to learn why you may be having these unexpected results.

Additionally, loss of appetite can be considered a negative side effect of Hiprex (Methenamine Hippurate), which would potentially cause weight loss rather than weight gain.

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Sources

  1. Ingenus Pharmaceuticals, LLC. (2023). Methenamine hippurate tablet [package insert]. DailyMed. Retrieved from https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4412d667-63f6-427e-a5c6-376a0e1e172d.

  2. Noureldin, Y. A., Elkoushy, M. A., Andonian, S. (2017). Is it safe to prescribe ascorbic acid for urinary acidification in stone-forming patients with alkaline urine? Turkish Journal of Urology, 43(4), 444-450. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5503439/#!po=81.2500

  3. Ovung, A., & Bhattacharyya, J. (2021). Sulfonamide drugs: Structure, antibacterial property, toxicity, and biophysical interactions. Biophysical Reviews, 13(2), 259-272. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8046889/


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The content on this page is for informational and educational purposes only and does not constitute professional medical advice. Patients should not use the information presented on this page for diagnosing a health-related issue or disease. Before taking any medication or supplements, patients should always consult a physician or qualified healthcare professional for medical advice or information about whether a drug is safe, appropriate or effective.