Methenamine hippurate

Class
Urinary antiseptics
Subclass
Formaldehyde-releasing agents
Substance name
Methenamine hippurate, hexamethylenetetramine, hexamine
Brand names
Hiprex®
Common formulations
Tablet
Safety risks
Contraindications
Gout
Pre-existing renal impairment, renal failure, or severe dehydration
Warnings and precautions
Allergic reactions
Use caution with a tartrazine dye hypersensitivity.
Specific populations
Renal impairment
eGFR 20-50 mL/min/1.73 m²
Use acceptable. No dose adjustment required.
eGFR 10-20 mL/min/1.73 m²
Use acceptable. No dose adjustment required.
eGFR < 10 mL/min/1.73 m²
Do not use. Avoid hippurate salt in renal impairment due to the risk of hippurate crystalluria Methenamine is not recommended in severe renal impairment as urinary concentrations are too low for it to be effective.
Renal replacement therapy
Continuous renal replacement
Use acceptable. No dose adjustment required.
Intermittent hemodialysis
Do not use.
Peritoneal dialysis
Do not use.
Hepatic impairment
Child-Pugh A (mild)
No guidance available.
Child-Pugh B (moderate)
No guidance available.
Child-Pugh C (severe)
Do not use.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: A
Use only if benefits outweigh potential risks. Animal studies using the hippurate salt have failed to reveal evidence of fetal harm.
The safe use of methenamine hippurate in early pregnancy is not established. In the last trimester, the safety of methenamine hippurate is suggested but not definitively proven.
Breastfeeding
Acceptable for use during breastfeeding.
Unknown drug levels in breastfed infants.
No overt adverse effects reported in breastfed infants.
Adverse reactions
Common 1-10%
↑ liver enzymes, dysuria, nausea, skin rash
Unknown frequency
↑ urine protein, pneumonia, abdominal cramps, diarrhea, generalized pruritus, hematuria, vomiting, stomatitis, urticaria
Interactions
Drug(s)
Check Interactions
Reset

What did you think about this content?

Create free account

Sign up for free to access the full drug resource