Where to get Hiprex alternatives

Author: Jessica Lloyd
Senior Naturopath | BHSc(N) | ISSVD, ISSWSH, BSSM, ATMS

Last reviewed: October 22, 2025

On 1 October 2025, the Australian Therapeutic Goods Administration (TGA) scheduled methenamine hippurate, the active ingredient in Hiprex, as a restricted pharmacy-only medicine. Hiprex can now only be obtained by prescription or in person at the pharmacy counter.

This will be distressing news for many of you, who have relied on My Vagina for your Hiprex supplies over many years. We were one of the only international online suppliers, and our supply was unexpectedly cut off, and we are unable to obtain more stock. We are also unable to fulfil prescriptions.

While this may be sending some of you into a tailspin, don’t despair! We’ve put together key information on how to find Hiprex, but also to help you understand how Hiprex works, so you can navigate Hiprex alternatives.

Remember, we’re specialist naturopaths and successfully treat people with chronic infections, including embedded UTI, every day. We know a lot about it. And, here’s a secret: we have never used Hiprex to treat UTIs, because we have much more effective tools for the job.

We’ll share what we know so you have all the information.

First, you’ll learn why Hiprex was restricted, then buckle up for the sad tale of why you had no warning of your supply ending. Once that’s out of the way, you’ll be taken on a rollicking ride into the bladder to see what Hiprex does, where to find it, and what other options are on offer.

Hand holds Hiprex, to treat chronic or embedded UTI

Why was Hiprex rescheduled and restricted?

Hiprex has been widely available in Australia for over 50 years and has a sound public safety record. The active ingredient, methenamine hippurate, is considered a low-risk alternative to antibiotics for preventing recurrent urinary tract infections (UTIs) and serves as a much-needed, non-resistance-forming UTI preventative.

The TGA decided to restrict Hiprex due to the potential lack of medical oversight for some users and the subsequent risk of harm.

The reasons given for the scheduling change include that Hiprex could mask the symptoms of or delay the diagnosis of a serious medical condition.

The committee that made this decision acknowledged that people medically diagnosed with recurrent UTI are unlikely to inappropriately self-medicate with Hiprex. However, the restriction of Hiprex is designed to protect those who do not yet have a medical diagnosis of recurrent UTI but are self-treating with Hiprex. This could include you.

The Schedule 3 Pharmacy Only classification requires a chat with a pharmacist, who can ask basic screening questions and provide instructions for proper use. Alternatively, a doctor can provide a prescription.

Why was there no warning so you could stock up?

The news of the change was delivered to us by Pharmacist Terry from our local Hiprex shop as we were trying to place a new order just a few days ago.

He explained it was a sudden move by the TGA, and seemed as surprised as we were, saying it was incredibly rare for the TGA to issue an overnight scheduling change like this. In fact, he couldn’t remember the last time it had happened. Pharmacies were given 24 hours to clear the shelves of Hiprex.

Terry’s right not to remember — because it has probably never happened before. In reality, the TGA had been debating this change to the status of Hiprex since 2023.

A final decision to classify Hiprex as Schedule 3 was agreed upon, with an implementation date of 1 October 2024, with a year’s grace period to allow everyone to prepare. That brings us to 1 October 2025, three weeks ago.

Unfortunately, it appears the change slipped quietly under the radar, and by the time it became official, there was no opportunity for pharmacists or customers to react. Like you, we were blindsided.

We know this is incredibly frustrating, and we’re genuinely sorry. We wish we’d had the chance to warn you or help you prepare, but the decision was finalised and implementation quiet. We’re doing everything we can now to help you transition smoothly with safe, effective alternatives.

Where is Hiprex available?

Because Hiprex was first developed in the UK, Australia, and New Zealand, these countries are major users with broad access.

The new restrictions bring Australia into line with the UK, Canada, USA, and New Zealand. New Zealand reclassified it in 2023, and the UK did the same back in 2019.

However, for those in North America, access can still be difficult. Many doctors are unfamiliar with Hiprex and hesitant to prescribe it, despite its long history of safe and effective use.

Countries using Hiprex (or equivalent)

USA
Canada
UK – no prescription needed
Australia – no prescription needed
New Zealand – no prescription needed
France
Norway
Sweden
Turkey

Hiprex availability in Europe is expanding

In Europe, methenamine hippurate is slowly gaining traction. France introduced its first prescription-only product, Altaromin, earlier in 2025, and Germany is expected to have products on pharmacy shelves within the next two years. Norway and Sweden remain the outliers — they’ve offered methenamine hippurate products for more than five decades.

I rely on Hiprex – what should I do now?

If you’re in a country where Hiprex or an equivalent product is still available by prescription, the first step is to visit your GP. Most doctors will prescribe it once they understand what it’s used for and how it works.

If your doctor seems hesitant, share some of the research with them — there’s plenty out there — and explain how Hiprex has helped you. Sometimes it’s simply a matter of awareness. If that doesn’t get you anywhere, you may need to find another doctor who’s familiar with chronic or recurrent UTI care.

Are there Hiprex alternatives?

Yes! We know that Hiprex suddenly disappearing from our store without notice is scary, so we’ve put some solid information together to help you understand first, how Hiprex works in the bladder, then show you how our Hiprex alternative treatment, Phyprex, works.

There is no direct switch for Hiprex; it’s unique, but there are many effective strategies for tackling chronic UTIs without Hiprex. As infection and microbiome specialist naturopaths, this is squarely in our wheelhouse.

Skip to Hiprex Alternatives

How Hiprex works in the bladder

Hiprex is taken orally. Once absorbed, the methenamine travels unchanged into the kidneys and bladder. In the bladder’s naturally acidic environment, it slowly converts into formaldehyde — the active antiseptic component. This chemical shift only happens in the urine.

Formaldehyde may sound alarming (it’s the same compound used in embalming fluid), but it’s also a potent antimicrobial agent, produced in trace amounts by your own body.

With regular dosing, the urine becomes infused with formaldehyde, killing free-floating (planktonic) bacteria on contact — eliminating all good, bad, or inconsequential bacteria. It works much faster than antibiotics or herbs, which rely on slower biological pathways. This is why Hiprex is unique.

But this antibacterial power has limits. Formaldehyde can’t reach the bladder’s cells or the embedded bacteria that hide beneath the mucosal barrier.

The mucosal barrier: who is it really protecting?

The bladder is built like a fortress. A protective mucus layer coats the inner wall, shielding cells from urine and ideally, blocking pathogens. It also blocks formaldehyde.

The bladder has its own microbiome. While researchers are still defining what “healthy” looks like, we know what unhealthy looks like: an overgrowth of species like E. coli, Enterococcus faecalis, Klebsiella, and Ureaplasma.

Some of these bacteria settle under the mucosal layer, while others float around the bladder and trigger inflammation — these are the ones that cause UTI symptoms.

Hiprex: playing the long game

Formaldehyde in urine can’t reach the bacteria hiding beneath the mucosal barrier or break through biofilms — and neither can antibiotics. But it’s ruthless against planktonic bacteria, wiping them out fast.

With those free-floating troublemakers gone, the bladder lining finally gets some peace and symptoms settle down.

But the real culprits are still lounging under the mucous, smoking cigarettes and playing cards, waiting it out. They aren’t scared of a little pee. Have you met these guys? They’re in for the long haul.

With their planktonic friends dead, embedded bacteria can’t reseed – that would entail going into the deadly urine. But, a dormant bacteria can’t live forever, right? Nutrients deplete, and every so often, linings shed, dropping them into the formaldehyde pee like a frog’s leg into the cauldron.

It’s eerily quiet out there in the bladder, as no bacteria can survive the potency of formaldehyde. It’s empty and peaceful, with the only disruption being the occasional shedding event that might flare up the bladder’s immune reaction and cause symptoms.

Hiprex: An ‘ecologically quiet’ bladder with hidden bombs

Hiprex maintains a peaceful bladder by keeping planktonic bacteria dead and the embedded ones dormant. But it also prevents protective microbes from returning. It’s effective at control, not at cure — which is why you losing access right now feels so scary.

UTI symptoms are caused by your body, not bacteria

UTI symptoms are your body’s immune response, not the bacteria gnawing at your cells. The bladder senses trouble and mounts an inflammatory defence. Even a small number of bacteria can cause big symptoms. This is why tests can show negative while you still feel very much infected.

That’s where the story of recovery can finally begin — and where our work with plants takes over.

Why is conventional medicine still ignoring plants?

It is still baffling that today, this 60-year-old tablet with long-term antibiotics is the most innovative treatment Western medicine has for the debilitating issue of embedded UTIs.

How can this be, when we have so many incredible, effective plant medicines at our fingertips? We are pioneering the shift to resistance-free non-antibiotic treatments. Here’s how.

What My Vagina is doing for chronic UTIs and why it’s different

At My Vagina, we treat people with chronic UTI every day, successfully, without antibiotics, and despite it being a bestseller in our store, without Hiprex.

That’s right, we don’t use Hiprex at all.

So why do we sell it? We originally included Hiprex as part of a very early male bacterial vaginosis treatment in our Killing BV Penis Treatment Guide. Once we developed better options, we tried to stop selling it, but the uproar from the chronic UTI community was so fierce that we kept it.

Our smart strategy for embedded UTI

Here, I’ll explain our approach to treating chronic UTIs and show off our unique product suite developed just for you: Phyprex UTI Prevent and Phyprex UTI Acute.

Yes, we called it Phyprex, cute huh! Phy for phyto, plants, and prex because we’re angling to replace your use of Hiprex with treatments that genuinely improve your bladder health and protect you from infections.

Importantly, we use herbal formulas that don’t block your capacity to rebuild a healthy microbiome, unlike those that produce formaldehyde. Hiprex might seem like a lifesaver if all you have are antibiotics, but there are other great options.

Meet Phyprex UTI Prevent — your gentle, intelligent Hiprex alternative

We know how devastating it feels to lose something that worked. Hiprex held the line for many people — keeping infections quiet and life manageable. But while Hiprex controlled bacteria, it didn’t heal your bladder.

That’s where Phyprex UTI Prevent steps in.

The plant-based Hiprex alternative, Phyprex UTI Prevent for effective treatment of UTI

Phyprex is our naturopath-designed, evidence-informed herbal formula that works with your body rather than against it. Instead of flooding your bladder with formaldehyde, Phyprex nourishes and strengthens your bladder’s natural defences — so it can stay calm, resilient, and infection-resistant on its own.

Each 2.5 mL dose delivers a precise balance of six high-strength herbal extracts — burr marigold, gotu kola, calendula, echinacea, rosehips, and couch grass — in a potent 1:2 extract ratio. These herbs don’t simply “kill bugs”; they restore the bladder’s barrier, cool inflammation, and help re-establish a healthy urinary microbiome.

Think of Hiprex as a disinfectant, and Phyprex UTI Defend as a restorer.

Why people love Phyprex UTI Prevent

Supports bladder healing as gotu kola and calendula repair delicate bladder tissue from the inside out and help the mucosal barrier rebuild and seal properly.
Reduces irritation and urgency, with couch grass and rosehips soothing inflamed tissue and calming the oxidative stress that drives pain and sensitivity.
Balances immune response as echinacea and burr marigold gently recalibrate immune activity so the body can recognise and quietly manage any lingering bacteria rather than over-reacting.
Protects the bladder’s friendly flora, since unlike Hiprex, Phyprex doesn’t wipe out protective microbes but instead supports the internal conditions they need to thrive.

It’s a calm, clever formula — one that doesn’t rely on harsh chemistry but still delivers real-world relief. It’s suitable for long-term use, gentle enough for daily prevention, and created by practitioners who’ve spent decades treating complex, chronic bladder infections.

Phyprex UTI Prevent isn’t just a stopgap until you find more Hiprex. It’s the beginning of a more complete recovery — one that restores your bladder’s health and resilience, naturally.

When prevention isn’t enough and a flare is already underway, you need rapid control without wrecking your bladder’s defences — that’s where Phyprex UTI Acute comes in.

A comparison chart of Phyprex and Hiprex explaining some of the dangers of Hiprex compared with Phyprex.

Meet Phyprex UTI Acute — for flare-ups and sudden UTI symptoms

Sometimes, despite your best efforts, symptoms surge — urgency, burning, that deep unease that tells you something’s kicking off again. Phyprex UTI Acute is built for these moments.

This formula is our rapid-response herbal blend, designed to quiet acute urinary symptoms fast while protecting your bladder tissue from further irritation. It’s a combination we often use in our clinic when someone calls in desperate for relief, and it consistently performs.

Each 1 mL dose delivers a precise 1:2 extract ratio of seven potent herbs: burr marigold, buchu, uva ursi, juniper, sida, rosehips, and cryptolepis. Together, they cover every angle of a flare — antimicrobial, anti-inflammatory, diuretic, and tissue-protective — without wiping out your bladder’s healthy flora.

The plant-based Hiprex alternative, Phyprex UTI Gentle for effective treatment of UTI during pregnancy and breastfeeding with safe herbs

Why people love Phyprex UTI Acute

Targets bacterial activity quickly — Uva ursi, buchu, and juniper flood the urine with natural antiseptic compounds that lower microbial load in the bladder lumen within hours.
Reaches deeper layers — Sida and cryptolepis are broad-spectrum antimicrobials with evidence of tissue penetration and activity against intracellular or stubborn infections, particularly effective against UTI bacteria.
Cools inflammation and discomfort — Burr marigold and rosehips calm the burning, redness, and oxidative stress that drive pain and urgency.
Supports bladder resilience — While Hiprex simply sterilises urine, Phyprex UTI Acute protects the delicate mucosal barrier, allowing tissue to heal, helping restore resilience.

Unlike antibiotics or formaldehyde-producing drugs, our Phyprex approach doesn’t strip away your body’s natural defence systems. It works with them — strengthening immune recognition, clearing biofilm fragments, and allowing your bladder to recover with each flare rather than taking another hit.

How to use Phyprex UTI Acute

Phyprex UTI Acute is designed for short-term use: small, frequent doses (1 mL hourly for up to 15 hours) during active symptoms, or 2–3 times per day as things settle. Most people feel a difference within the first day or two.

See dosing and safety guidance below. If stinging occurs, dilute each dose further or space them every two hours, and maintain good hydration.

Once symptoms ease, continue with or transition to Phyprex UTI Prevent to maintain calm and continue rebuilding your bladder barrier.

If Hiprex was your security blanket, Phyprex UTI Prevent and Phyprex UTI Acute are your shield — strong enough to settle a flare rapidly, gentle enough to use when you need it most.

But I’ve used herbs in the past, and they didn’t do anything

You haven’t tried our herbs! We have been treating UTIs for decades using potent, highest-quality herbal extracts you won’t find anywhere else in the world.

We develop specialised formulas based on years of experience, and know they work. Our formulas are tried and tested in our own clinic and on ourselves. Yes, we still get UTIs sometimes, too! These blends are the first port of call.

There are thousands of herbal UTI products out there of varying quality and ingredients, but there’s only one Phyprex. Phyprex was developed specifically to be an alternative to Hiprex.

Our herbs are verifiably potent

Our herbal extracts are always 1:2 or 1:1 (strong) and are regularly tested for active constituent levels, toxins, and quality by manufacturers. Herbs are tightly regulated in Australia, and our patients regularly report that our herbs are indeed the strongest and most effective they’ve tried.

Quality of herbs equals effect

We feel very passionately that there are so many options for successfully treating chronic UTI without antibiotics or Hiprex. We’ve been doing it for years!

We’re dying to share our incredible formulas with you, to support you on your journey to being UTI-free.

FAQ

Can I still get Hiprex in Australia?

Yes. As of 1 October 2025, Hiprex (methenamine hippurate) has been reclassified as a Schedule 3 Pharmacy-Only medicine in Australia. But, it can no longer be purchased online and is now only available over the pharmacy counter or by prescription from a doctor.

Why was Hiprex restricted?

The Therapeutic Goods Administration (TGA) restricted Hiprex to ensure that people using it have medical oversight. Some people were self-treating without a diagnosis, which carries risks. The change was not due to any new safety concern — Hiprex remains a low-risk urinary antiseptic with a long safety record.

What can I take instead of Hiprex?

There’s no identical substitute for Hiprex, but several effective options exist. Our Phyprex UTI Prevent herbal formula offers a natural Hiprex alternative that supports bladder healing, balances immune response, and helps restore the bladder microbiome without formaldehyde. For flare support, Phyprex UTI Acute provides targeted short-term relief.

Is Phyprex safe for long-term use?

Yes. Phyprex UTI Prevent is designed for ongoing urinary tract support. It’s gentle, non-resistance-forming, and suitable for long-term prevention when taken with occasional breaks. For best results, we recommend practitioner oversight if you plan to use it continuously for more than six months.

Does Phyprex work like antibiotics or Hiprex?

No. Hiprex and antibiotics directly kill bacteria in urine. Phyprex works differently — it strengthens bladder tissue, restores protective flora, and helps your immune system maintain balance so infections are less likely to recur. It supports recovery rather than suppression.

Can I take Phyprex with Hiprex or antibiotics?

Yes. Phyprex UTI Prevent can be safely used alongside Hiprex, antibiotics, D-mannose, vaginal oestrogen, and probiotics. It complements rather than competes with these treatments by supporting tissue healing and microbial balance.

What is an embedded UTI?

An embedded UTI occurs when bacteria hide beneath the bladder’s mucosal lining, forming biofilms that protect them from antibiotics and antiseptics like Hiprex. These bacteria can remain dormant for long periods, flaring when bladder cells shed or the immune system reacts. Embedded infections require long-term, restorative care that strengthens tissue and supports microbial balance — exactly what Phyprex is designed to do.

How can I restore my bladder microbiome after using Hiprex?

Because Hiprex kills all bacteria in urine, including protective species, the bladder can struggle to rebuild its natural microbiome. Supporting recovery means nurturing the mucosal barrier, encouraging healthy flora, and calming chronic inflammation. Phyprex UTI Prevent and a Lactobacillus-dominant probiotic (oral or vaginal) can help restore the balance safely over time.

Got unique needs or need more support?

We understand that some people may need more support and advice, so if this is you, please book in for a private telehealth consultation with an expert naturopath to discuss your case, undergo a thorough assessment, and receive tailored treatment.

Get ready for a fresh perspective

Our practitioners are skilled, experienced, and very well-versed in treating chronic UTIs. We have many tricks up our sleeves, and understand the many hidden and complex underlying drivers of chronic UTI.

We treat the infection as the systemwide problem that it is, not just a local bacterial problem. You don’t end up with chronic UTI because a bacteria got out of control. You end up with chronic UTI because your body couldn’t defend itself for some reason. Let us work out why, and get you the treatment you need.

When we broaden our lens beyond bladder bacteria, it reveals many clues hiding in plain sight. You just have to know what to look for! You’re a whole functioning organism, and our incredible practitioners treat you, the person. Book here.

New