SupplementModerate evidenceImmunity

Uva ursi (Arctostaphylos uva-ursi)

EMA-monograph leaf extract for acute uncomplicated UTI, antibiotic-sparing option in early presentation.

Why

Uva ursi (Arctostaphylos uva-ursi) leaf holds an EMA HMPC monograph at Traditional Use for relief of symptoms of recurrent mild lower urinary tract infections such as burning sensation during urination and frequent micturition in women, after serious conditions have been excluded by a clinician. The Moore 2019 REGATTA trial directly compared uva ursi with fosfomycin in acute UTI and found non-inferiority on symptom-relief endpoints. Limited to short courses due to hydroquinone metabolite concerns.

How it works

Arbutin and methylarbutin are hydrolysed in alkaline urine to hydroquinone, which has direct antibacterial activity against uropathogens. Alkalisation of urine (e.g. with sodium bicarbonate) was historically combined with uva ursi to optimise hydroquinone release.

Expected onset · Symptom reduction within 1–3 days

How to take

Dosage

Standardised extract delivering 400–800 mg arbutin/day, divided. Limit course to 7 days; no more than 5 episodes per year.

Timing

Three or four times daily during acute episode

On the label

Standardised extract with stated arbutin content (10–12% in leaf). Avoid leaf extracts without standardisation.

Ideal for

Adult women with early symptoms of acute uncomplicated lower UTI seeking antibiotic-sparing first-line option.

Safety

Limit to 7 days per course and no more than 5 courses per year. Hydroquinone is potentially genotoxic at high cumulative exposure. Not for chronic prevention. Avoid in pregnancy, breastfeeding, kidney disease, and children under 12. Caution with NSAIDs (uricosuric interaction). Worsens symptoms if there is haematuria, fever, flank pain or systemic illness. These need standard medical care, not herbal treatment.

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Evidence

At a glance

Moore 2019 BMJ REGATTA trial (n=382 women with uncomplicated UTI): uva ursi + ibuprofen showed similar symptom resolution to fosfomycin at day 7, with 64% of the herbal-arm participants avoiding antibiotic use. EMA classifies uva ursi at Traditional Use for early UTI symptoms in women.

Where to get it

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