Uticure

Indications

Uticure is recommended for the preventive or suppressive treatment of recurrent urinary tract infections (UTIs) when long-term management is necessary. It should only be used after the infection has been cleared with appropriate antimicrobial therapy. To minimize the risk of drug-resistant bacteria and ensure the ongoing effectiveness of Uticure and other antibiotics, it should only be used when infections are either confirmed or strongly suspected to be caused by susceptible bacteria. When available, culture and susceptibility results should guide the choice or modification of antibacterial treatment. In the absence of such data, local patterns of bacterial resistance can inform empiric therapy.

Use Uticure only as advised by a registered healthcare professional.

Pharmacology

Methenamine Hippurate exhibits antibacterial properties because the methenamine component is broken down into formaldehyde in acidic urine. The hippuric acid component also contributes to antibacterial effects and helps maintain urine acidity. This drug is particularly effective against E. coli, enterococci, and staphylococci, while Enterobacter aerogenes generally shows resistance. To inhibit urea-splitting organisms like Proteus and Pseudomonas, urine must remain sufficiently acidic.

Methenamine starts showing antibacterial activity within 30 minutes of ingesting a 1-gram dose, with continuous antibacterial effects when taken twice daily (1 gram each dose). Over 90% of the methenamine is excreted in urine within 24 hours. The hippurate component is absorbed and excreted rapidly, reaching the urine through tubular secretion and glomerular filtration, which is particularly relevant in older patients or those with mild renal impairment.

Dosage & Administration

• For adults and children over 12 years of age: 1 tablet, twice daily (morning and night).
• For children aged 6 to 12 years: ½ to 1 tablet, twice daily (morning and night).

Since the antibacterial activity of Methenamine is enhanced in acidic urine, it is advisable to avoid alkalinizing foods and medications. If necessary, urine pH should be monitored and supplemental acidification may be required. Regular urine cultures are recommended to assess the efficacy of the treatment.

Follow your healthcare provider’s guidance when using Uticure.

Contraindications

Methenamine Hippurate tablets are contraindicated in patients with renal insufficiency, severe liver impairment, or severe dehydration. It should also not be used in conjunction with sulfonamides, as they may form an insoluble precipitate with formaldehyde in the urine.

Pregnancy & Lactation

The safety of Methenamine during early pregnancy has not been established, though its use in the third trimester is generally considered safe based on animal studies. It may interfere with urine estriol testing in pregnancy, leading to unmeasurably low values when using acid hydrolysis in lab procedures. This issue can be avoided by using enzymatic hydrolysis instead of acid hydrolysis.

Precautions & Warnings

Uticure should not be prescribed for unproven or suspected bacterial infections or without a clear preventive indication, as unnecessary use may contribute to the development of drug-resistant bacteria.

Maintaining an acidic urine pH is crucial, particularly when treating infections caused by urea-splitting organisms such as Proteus and certain Pseudomonas strains.

Liver function should be monitored periodically, as there have been isolated reports of elevated serum transaminase levels that returned to normal with continued use of Uticure.

Use in Special Populations

Geriatric Use: Clinical studies for Uticure did not include sufficient participants aged 65 and older to determine whether they respond differently from younger patients. However, clinical experience suggests no significant differences between the elderly and younger patients. When prescribing for elderly patients, dosage should generally start low due to the higher likelihood of reduced hepatic, renal, or cardiac function, as well as concurrent medical conditions or other medications.

Renal & Hepatic Insufficiency: Uticure is contraindicated in patients with renal insufficiency or severe liver dysfunction.

Therapeutic Class

Other genito-urinary preparations

Storage Conditions

Store at temperatures below 30°C, away from light and moisture. Keep out of reach of children.