Is Hiprex an Antibiotic? (Facts)

Mahshid Moghei, PhD Medically reviewed by Mahshid M. on

Doctor  explains Hiprex treatment to mature woman

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. Your provider will only prescribe Methenamine Hippurate (Hiprex) after the UTI has been treated with an appropriate antibiotic.

Key Takeaways

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

  • Methenamine Hippurate (Hiprex) helps prevent and control chronic UTIs (urinary tract infections) in people who need long-term treatment.

  • Hiprex (methenamine hippurate) is an antibacterial agent. It does not directly kill bacteria like antibiotics do.

Is Hiprex an Antibiotic?

Yes. Methenamine Hippurate (Hiprex) is an antibiotic, but not the type that treats active infections or active UTIs (urinary tract infections). In a recent study, Hiprex has been known to be as effective as antibiotics.

The study revealed that the drug methenamine (which is not an antibiotic) has been shown to potentially be as effective as antibiotics at preventing urinary tract infections (UTIs). 

The study included women who had frequent infections of the urinary tract (the organs involved in peeing). In 12 months’ treatment, they had similar reductions in these infections, whether they received methenamine or an antibiotic.

Why is Hiprex Not Considered an Antibiotic?

Hiprex (Methenamine Hippurate) is not considered an antibiotic because it functions as a urinary antiseptic, meaning it works by creating a hostile environment for bacteria in the urine rather than directly attacking the bacteria themselves. 

Its active ingredient, methenamine, breaks down into formaldehyde in acidic urine, which damages bacterial proteins and inhibits their growth, instead of directly killing them like an antibiotic would.

Is Hiprex as Effective as Antibiotics?

Hiprex (methenamine hippurate) is an antibacterial agent. It does not directly kill bacteria like antibiotics do. Instead, it works by creating an environment in the urine that prevents bacteria from growing, which is helpful for preventing recurrent UTIs but not for treating active infections. 

Studies have shown that it can be as effective as antibiotics in preventing recurrent UTIs, especially in those with chronic infections. However, it would not be used to treat an existing UTI, and antibiotics are still required for acute infections.

How Long Can Hiprex Be Taken?

The duration of Hiprex (methenamine hippurate) treatment varies depending on the individual case. For chronic UTI (urinary tract infection) prevention, it is typically used for long-term management, and the length of treatment should be determined by a healthcare provider based on the patient's specific needs. 

Some patients may need the medication indefinitely to prevent ongoing and recurrent infections.

Can Hiprex Damage the Bladder?

Hiprex is generally considered safe for bladder health, but there are potential side effects with long-term use, including the risk of kidney stones and kidney damage. 

While it is not directly harmful to the bladder, prolonged use should be carefully monitored by a healthcare professional to avoid any adverse effects. It is important to follow prescribed guidelines and monitor for signs of complications.

What Medications are Used to Treat Active UTIs (Urinary Tract Infections)?

Here are some of the common medications that are used to treat active UTIs (urinary tract infections):

  • Trimethoprim and sulfamethoxazole (Bactrim, Bactrim DS): Common medication for treating UTIs.

  • Fosfomycin (Monurol): Common medication for treating UTIs.

  • Nitrofurantoin (Macrodantin, Macrobid, Furadantin): Common medication for treating UTIs.

  • Cephalexin: Common medication for treating UTIs,

  • Ceftriaxone: Common medication for treating UTIs.

  • Ciprofloxacin (Cipro): A fluoroquinolone that inhibits bacterial growth 

  • Doxycycline: A broad-spectrum antibiotic

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Sources

  1. Harding, C., et al. "Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women: multicentre, open label, randomised, non-inferiority trial." BMJ, vol. 376, 2021, e068229. https://doi.org/10.1136/bmj-2021-0068229.

  2. 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.

  3. 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

  4. 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.