Can Medications Cause UTIs? Yes, and Here’s 9 Possible Culprits

Urinary tract infections (UTIs) happen when bacteria or other germs grow in the urinary tract. They usually come with uncomfortable or painful symptoms, such as urgency or burning during urination. Typically, you’ll need to take an antibiotic to help clear the infection.

There are many risk factors that can increase your likelihood of developing a UTI. Sometimes, the culprit is in your medicine cabinet. But which medications are most likely to cause UTIs?

Medication-related UTIs at a glance

There are many medications that raise your risk of developing a UTI. But the ways they contribute to UTIs vary.

Below is a table that provides a summary of nine notable types of medications that can cause UTIs. Though, keep in mind that this isn’t a comprehensive list of medications that can have this side effect.

Keep reading to find out more about these nine medications known for causing UTIs.

1. Anticholinergic medications, such as oxybutynin

Anticholinergic medications, such as oxybutynin and benztropine, have the potential to cause UTIs. Anticholinergic medications block the actions of the chemical acetylcholine in the body. This can cause several side effects — known broadly as anticholinergic side effects — including urinary retention.

Urinary retention is when the bladder is unable to fully empty. Urinary retention can allow bacteria that’s usually removed when you urinate to multiply in the bladder. If there’s enough bacteria present in the bladder, a UTI can occur.

2. Older antihistamines, such as diphenhydramine

First-generation antihistamines, such as diphenhydramine and doxylamine, are another class of medications that can cause UTIs. These older antihistamines have anticholinergic effects. This means they can cause some of the same side effects as anticholinergic medications, including urinary retention.

And as mentioned above, urinary retention raises the risk of UTIs. Your risk of urinary retention may be even higher if you’re 65 or older. That’s one reason that experts recommend older adults avoid first-generation antihistamines.

Good to know: Newer antihistamines, such as loratadine (Claritin) and fexofenadine (Allegra), are much less likely to cause urinary retention. Switching to one of these could help lower your risk of UTIs. But speak with a healthcare professional before making the switch. There are some symptoms and conditions that first-generation antihistamines work better for.

3. SGLT2 inhibitors, such as Jardiance and Farxiga

SGLT2 inhibitors, such as Jardiance and Farxiga, are another medication class that can cause UTIs. In fact, more frequent UTIs is one of the most commonly reported SGLT2 inhibitor side effects. SGLT2 inhibitors are commonly taken for Type 2 diabetes. One of the ways they work is by removing excess glucose from the bloodstream through the urine.

But bacteria and other germs love glucose, because the nutrient helps them multiply. Urinating out extra glucose can attract these germs to your genitals, which can lead to various infections in that area, including UTIs. In rare cases, UTIs from SGLT2 inhibitors can become serious and even lead to hospitalization.

EXPERT PICKS: WHAT TO READ NEXT

• Prevention first: Here, experts provide top tips to help stop urinary tract infections (UTIs) before they start.

• Get UTI relief now. Read about the best ways to get rid of a UTI — fast.

• UTIs don’t just affect women. Learn the facts about UTIs in men from physicians.

4. Calcium channel blockers, such as amlodipine and diltiazem

Calcium channel blockers, such as amlodipine and diltiazem, can also cause UTIs. This side effect isn’t common, but it’s still possible.

Calcium channel blockers can affect how the bladder muscles contract. Most often, people taking these medications experience increased urination. But in some cases, the bladder may not contract strongly enough. And this can cause urinary retention, raising the risk of UTIs.

5. Certain antidepressants, such as amitriptyline and fluoxetine

Some antidepressants can also cause UTIs. Tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) are two notable groups linked to this side effect. But the ways these medications cause UTIs are different.

TCAs, which include amitriptyline and nortriptyline, have anticholinergic effects on the body. Because of this, they can cause urinary retention. And this can lead to UTIs.

SSRIs, which include fluoxetine and sertraline, can also cause urinary retention. But this is caused by SSRIs’ effects on serotonin. Serotonin is a hormone involved in mood regulation. It also plays a role in how the bladder stores urine. SSRIs may interfere with how serotonin attaches to its receptors (chemical binding sites) in the bladder. And this may lead to urinary retention — and possibly UTIs.

6. NSAIDs, such as diclofenac

NSAIDs, such as diclofenac and ketoprofen, can also cause UTIs. NSAIDs work by blocking the actions of the prostaglandins. Prostaglandins are chemicals in the body that contribute to fever, pain, and inflammation.

Some prostaglandins help the bladder contract to empty urine. By blocking these chemicals, NSAIDs may cause the bladder to not contract as strongly as usual. And this could raise the risk of urinary retention, which may contribute to UTIs.

7. Opioid pain relievers, such as morphine

Opioid pain relievers, such as morphine and fentanyl, can cause UTIs because of how they affect the bladder. Opioids raise the risk of UTIs in a few different ways:

• They have anticholinergic effects. Similar to many of the above medications, opioids can cause urinary retention because of this.

• They affect how your bladder muscles contract. Opioids can cause your bladder muscles to contract less strongly than usual, which can cause urinary retention. This effect is seen most commonly with opioid epidurals.

• They make it harder to realize your bladder is full. Opioids affect certain nerves that send signals to your brain telling you that you need to urinate. So your bladder may become fuller than usual.

8. First-generation antipsychotics, such as chlorpromazine

First-generation, or typical, antipsychotics, such as chlorpromazine and haloperidol, are another possible cause of UTIs. They balance levels of certain chemicals in the body to help treat mental health conditions such as schizophrenia.

Because of how they work, first-generation antipsychotics can cause a variety of side effects, including anticholinergic effects. This can cause urinary retention and, in turn, UTIs.

Good to know: Second-generation, or atypical, antipsychotics are less likely overall to cause anticholinergic effects. But some, such as clozapine (Clozaril), have a higher risk of these side effects than others.

9. Immunosuppressants, such as cyclosporine

Immunosuppressants, such as prednisone and cyclosporine, are medications that suppress (weaken) your immune system. These medications are necessary to prevent rejection for people who have received an organ transplant. They’re also a mainstay in the treatment of autoimmune disorders. But taking an immunosuppressant raises your risk of infections, including UTIs.

Can antibiotics cause a UTI?

No, antibiotics don’t cause UTIs. Antibiotics are usually needed to treat UTIs. But overuse of these medications can cause antibiotic-resistant UTIs. If this happens, your next UTI may not be as easy to treat as the last one.

If you get UTIs often, antibiotic-resistance can make it harder to find a treatment that works well. In some cases, a prescriber may recommend taking an antibiotic, such as methenamine hippurate (Hiprex), daily to help prevent UTIs. But most people should limit taking antibiotics to help prevent resistance.

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Written by:

Kristine Foley, PharmD

Kristine Foley is a licensed pharmacist with over 13 years of community pharmacy experience. She earned her Doctor of Pharmacy degree from Rutgers University.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Jennifer Gershman, PharmD, CPh, PACS

Jennifer Gershman, PharmD, is a licensed pharmacist in Florida. She has worked in the pharmacy industry for more than 15 years and is currently a medical writer.

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