Over The Counter (OTC) UTI Medicine: What Are the Best Options?

It is a feeling that is, unfortunately, quite common. You go to use the bathroom and notice pain when urinating, or maybe you constantly feel like you really need to pee, only to get to the toilet and have very little come out. If you have had this happen before, a defeated sigh may come out as you recognize the signs of a UTI.

For those with a UTI, the idea of going to a doctor and taking antibiotics may seem unappealing, which can leave many wondering if they can get by with just OTC medications.

Table of Contents

What Is A UTI?

A urinary tract infection (UTI) occurs when any foreign invader, such as bacteria, viruses, or fungi, enters the urinary tract and begins multiplying. The urinary tract consists of multiple parts, including the urethra, bladder, ureters, and kidneys.

In most cases, bacteria are the cause of UTIs, and they enter the urinary tract through the urethra. From there, they travel through the urinary tract until they get to the bladder, where they can multiply, causing an infection.

Some common symptoms of a UTI include burning pain when urinating and a strong and frequent urge to urinate. When you notice these symptoms, it is time to consider treatment for a UTI.

How is a UTI treated?

UTIs are most commonly (and most successfully) treated with antibiotics. As explained previously, most UTIs result from bacteria, which is why antibiotics, and their ability to kill bacteria or prevent them from multiplying, are some of the most effective treatments.

Some antibiotics often used to treat UTIs include:

  • Ciprofloxacin
  • Nitrofurantoin
  • Fosfomycin
  • Levofloxacin
  • Cephalexin
  • Amoxicillin

A significant problem with antibiotic treatment of UTIs, though, is increasing antibiotic resistance and high recurrence rates. This means that you may experience multiple bouts of UTIs per year, or the antibiotics may no longer be able to attack the bacteria causing your infection.

Treating a UTI is essential, as when left untreated, the infection can spread to the kidneys, where it may then cause sepsis (whole-body infection). By treating the infection while it is still contained within your bladder, you can prevent this more severe infection from occurring.

Because of the increasing rates of antibiotic resistance, many are turning toward over-the-counter (OTC) treatment options that do not use antibiotics to remedy their UTI.

Can You Treat a UTI With Over-The-Counter Medicine?

Antibiotics are the only true way to destroy the bacteria causing a UTI, and antibiotics are only available with a doctor’s prescription. Knowing this, it is not possible to directly treat a UTI with OTC medicine. However, different OTC medications can help reduce symptoms as the body fights the infection, with their greatest benefit in regard to reducing pain.

Additionally, some OTC medications and supplements help to slow the progression of the infection or make it easier for the body to remove the harmful bacteria, which may speed up your recovery.

That being said, OTC UTI medicines cannot cure your UTI, only antibiotics can do that. As such, it is crucial for those who are older, pregnant, or at a higher risk of serious illness from a UTI to immediately begin antibiotics as soon as they notice the symptoms of a UTI.

What Is the Best Over-The-Counter Medicine for UTIs?

The following OTC medications offer a range of benefits for those experiencing a UTI, primarily focusing on relieving pain or other UTI symptoms.

Phenazopyridine

Phenazopyridine helps to numb the lining of the urinary tract, reducing pain that is felt when urinating. It is a type of dye medicine that builds up in the bladder.

This medication can be taken up to 3 times a day for 3 days, and it often begins providing relief in just 20 minutes to an hour after taking it. However, it is important not to take it for more than 3 days as it can mask ongoing UTI symptoms and keep you from seeking medical attention.

An important note about phenazopyridine is that it turns urine orange, and the dye can also stain your clothes permanently.

Ibuprofen/Acetaminophen

Ibuprofen and acetaminophen are both general pain relievers that can help with stomach pain or other forms of general discomfort resulting from a UTI. Since both of these medications come in a liquid form, they may be a good alternative to phenazopyridine in those who cannot swallow pills.

Ibuprofen and acetaminophen work by reducing inflammation in the urinary tract, which then reduces pain. Additionally, by lowering inflammation, the urge to urinate frequently may also be reduced, relieving yet another UTI symptom.

Cystex

Cystex is a common OTC treatment for UTIs that contains methenamine, benzoic acid, and sodium salicylate. The primary intention of Cystex is to ease pain from a UTI, but the ingredient methenamine can also help slow the progress of the infection.

When methenamine comes into contact with acidic urine, it becomes formaldehyde, which is able to kill the bacteria, but not completely. So, while methenamine cannot completely eradicate a UTI, it can slow down its progression and help your body heal faster.

Of note, though, is that methenamine requires acidic urine in order to work in this fashion, so it is important to take vitamin C with this drug to increase the acidity of your urine and allow the medicine to meet its maximum potential.

Azo

Yet another common UTI treatment is AZO, which contains many different varieties. One such type is the AZO Urinary Tract Defense which, like Cystex, has methenamine. There are also AZO varieties that only focus on pain relief with ingredients that include phenazopyridine. Some come with a higher dose of phenazopyridine than others, offering maximum strength pain relief.

When taking these maximum-strength pain relief tablets, it is essential to remember that this can mask the symptoms of the infection, which is why taking it for more than 3 days is not recommended. Additionally, it is not recommended for those with liver problems.

D-Mannose

D-mannose is a naturally occurring sugar that works by adhering to E-coli bacteria, the most common cause of UTIs. When D-mannose sticks to the bacteria, it then becomes easier for the body to eliminate them when urinating.

However, D-mannose is only effective in cases where a UTI is caused by E. coli. While this is the most common cause, there is no guarantee it will be effective in every case.

How can DrHouse Help You?

While the above OTC UTI treatments are available to help manage pain and assist the body as it fights the infection, sometimes they are not enough.

If your symptoms have not improved within 3 days, they are getting worse or more severe, or if you experience recurrent UTIs, it is recommended to seek help from a medical professional. By getting help when in these stages, you can help prevent the infection from becoming a kidney infection, which requires even stronger antibiotics and greater medical interventions.

DrHouse offers a convenient and highly accessible way to receive an antibiotic prescription for your UTI. After creating an account using the DrHouse app, you can meet with a doctor in just 15 minutes to discuss your symptoms and receive an online antibiotic prescription, if needed.

For those experiencing severe pain from the UTI, your online doctor may also choose to prescribe pain-relieving medication to help ease your symptoms and make you more comfortable while waiting for your antibiotics to begin working.

Key Takeaways

A UTI is often a bacterial infection of the bladder that causes pain when urinating and frequent urges to urinate, despite little urine leaving the body. Antibiotics are the most common and effective treatment for UTIs. Still, many may choose to seek alternative treatments, whether because of growing concerns of antibiotic resistance or to avoid unpleasant side effects.

While antibiotics are the only medicine that can destroy the bacteria and treat a UTI, particular OTC medicine can help relieve symptoms as the body fights the infection. Medications such as ibuprofen, acetaminophen, and phenazopyridine help to alleviate pain when urinating.

Methenamine helps to kill some of the bacteria in the urinary tract, slowing the progression of the infection and aiding the body’s immune system. Many of these medications are then combined with certain OTC treatments, such as AZO or Cystex.

In many cases, antibiotics are still needed to treat the infection and avoid a more severe infection, but using these OTC medications along with antibiotics can help relieve symptoms and boost the power of the antibiotics, potentially clearing the infection faster. For those needing antibiotics for the UTI, online doctors such as DrHouse can help get you a prescription fast.

Sources:

  • Eastham jH, Patel P. Phenazopyridine. [Updated 2022 Nov 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK580545/ 
  • Nordt, S. (2017). Pyelonephritis following phenazopyridine use. The American Journal Of Emergency Medicine, 35(5), 805.e3-805.e4. doi: https://www.doi.org/10.1016/j.ajem.2016.11.058 
  • Bleidorn, J., Gágyor, I., Kochen, M., Wegscheider, K., & Hummers-Pradier, E. (2010). Symptomatic treatment (ibuprofen) or antibiotics (ciprofloxacin) for uncomplicated urinary tract infection? – Results of a randomized controlled pilot trial. BMC Medicine, 8(1). doi: https://www.doi.org/10.1186/1741-7015-8-30 
  • Aloush, S., Al-Awamreh, K., Abu Sumaqa, Y., Halabi, M., Al Bashtawy, M., & Salama, F. (2019). Effectiveness of antibiotics versus ibuprofen in relieving symptoms of nosocomial urinary tract infection: A comparative study. Journal Of The American Association Of Nurse Practitioners, 31(1), 60-64. doi: https://www.doi.org/10.1097/jxx.0000000000000101 
  • Chwa, A., Kavanagh, K., Linnebur, S. A., & Fixen, D. R. (2019). Evaluation of methenamine for urinary tract infection prevention in older adults: a review of the evidence. Therapeutic advances in drug safety, 10, 2042098619876749. https://doi.org/10.1177/2042098619876749 
  • Lenger, S., Bradley, M., Thomas, D., Bertolet, M., Lowder, J., & Sutcliffe, S. (2020). D-mannose vs other agents for recurrent urinary tract infection prevention in adult women: a systematic review and meta-analysis. American Journal Of Obstetrics And Gynecology, 223(2), 265.e1-265.e13. doi: https://www.doi.org/10.1016/j.ajog.2020.05.048 
  • Domenici, L., Monti, M., Bracchi, C., Giorgini, M., Colagiovanni, V., Muzii, L., & Benedetti Panici, P. (2016). D-mannose: a promising support for acute urinary tract infections in women. A pilot study. European review for medical and pharmacological sciences, 20(13), 2920–2925.

DrHouse articles are written by MDs, NPs, nutritionists and other healthcare professionals. The contents of the DrHouse site are for informational purposes only and are not a substitute for professional medical advice, diagnosis, or treatment. If you are experiencing high fever (>103F/39.4C), shortness of breath, difficulty breathing, chest pain, heart palpitations, abnormal bruising, abnormal bleeding, extreme fatigue, dizziness, new weakness or paralysis, difficulty with speech, confusion, extreme pain in any body part, or inability to remain hydrated or keep down fluids or feel you may have any other life-threatening condition, please go to the emergency department or call 911 immediately.

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