Hiprex (Methenamine Hippurate) Drug Information: Clinical Pharmacology

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May 27, 2012

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Urinary Tract Infection (UTI In Adults) »

Urinary tract infection (UTI) facts

Urinary tract infections (UTIs) are infections of the urethra, bladder, ureters, or the kidneys, which comprise the urinary tract.
E. coli bacteria cause the majority of UTIs, but many other bacteria, fungi, and parasites may also cause UTIs.
Females have a higher risk for UTIs than most males, probably because of their anatomy; other risk factors for UTIs include any condition that may impede urine flow (e.g., enlarged prostate, congenital urinary tract abnormalities, and inflammation). Patients with catheters or those who undergo urinary surgery and men with enlarged prostates are at higher risk for UTIs.
Symptoms and signs of UTI vary somewhat depending on sex, age, and the area of the urinary tract that is infected; some unique symptoms develop depending on the infecting agent.
UTIs are diagnosed usually by isolating and identifying the urinary pathogen from the patient; there a...

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CLINICAL PHARMACOLOGY

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Microbiology: HIPREX (methenamine hippurate tablets USP) has antibacterial activity because the methenamine component is hydrolyzed to formaldehyde in acid urine. Hippuric acid, the other component, has some antibacterial activity and also acts to keep the urine acid. The drug is generally active against E. coli, enterococci and staphylococci. Enterobacter aerogenes is generally resistant. The urine must be kept sufficiently acid for urea-splitting organisms such as Proteus and Pseudomonas to be inhibited.

Human Pharmacology: Within 1/2 hour after ingestion of a single 1-gram dose of HIPREX (methenamine hippurate) , antibacterial activity is demonstrable in the urine. Urine has continuous antibacterial activity when HIPREX (methenamine hippurate) is administered at the recommended dosage schedule of 1 gram twice daily. Over 90% of methenamine moiety is excreted in the urine within 24 hours after administration of a single 1-gram dose. Similarly, the hippurate moiety is rapidly absorbed and excreted, and it reaches the urine by both tubular secretion and glomerular filtration. This action may be important in older patients or in those with some degree of renal impairment.

Last reviewed on RxList: 8/14/2008
This monograph has been modified to include the generic and brand name in many instances.