Adult
Methenamine Hippurate
Warning
General Information
Restricted Formulary antimicrobial: Use in accordance with Trust guidelines
AWaRe antibiotic classification: 'Other'. Use as per guidelines.
Can be prescribed by Primary care: See Oxfordshire Clinical Commissioning Group formulary for more details
For all information regarding contra-indications, interactions, contraception, pregnancy and breastfeeding and additional information, see BNF and Summary of Product Characteristics (SPC).
Dosage
Renal impairment
| eGFR ml/min/1.73m2 | oral dose |
| 10 or more | 1g BD |
| Less than 10 | AVOID - contra-indicated |
Hepatic impairment
AVOID - manufacturers advise that use is contraindicated in hepatic dysfunction
Additional information
- Perform urine cultures and urinalysis prior to initiating and ensure pH is acidic.
- 6 monthly reviews of use are required.
- Methenamine may affect the determination of steroids, catecholamines, 5-hydroxyindole acetic acid from urine, giving false results.
References
- Summary of Product Characteristics (SPC). Hiprex 1g tablets. Mylan. Last revision of the text January 2024 Available from: https://www.medicines.org.uk/emc/product/1530/smpc [Accessed 23/4/25].
- NICE guideline [NG112]. Urinary tract infection (recurrent):antimicrobial prescribing. NICE. Published October 2018 and updated December 2024. Available from: https://www.nice.org.uk/guidance/ng112 [Accessed 23/4/25].
- 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. 2022. Available from: https://www.bmj.com/content/bmj/376/bmj-2021-0068229.full.pdf