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Methenamine is a medication primarily used to prevent recurrent urinary tract infections (UTIs). Unlike traditional antibiotics, it functions as a urinary antiseptic by converting into formaldehyde in acidic urine, which effectively inhibits bacterial growth. This mechanism reduces the risk of developing antibiotic resistance. Methenamine is available in two salt forms: methenamine hippurate, typically taken twice daily, and methenamine mandelate, usually taken four times daily. Common side effects are generally mild and may include nausea, vomiting, diarrhea, and stomach cramps. To enhance its effectiveness, maintaining an acidic urine pH is important, which can be achieved through dietary adjustments or supplements like vitamin C. However, combining methenamine with sulfonamide antibiotics is not recommended due to potential interactions. Methenamine is not suitable for individuals with severe kidney or liver disease. Its use has gained renewed interest as a non-antibiotic option for UTI prevention, especially in the context of increasing antibiotic resistance.