Uva ursi (Arctostaphylos uva-ursi)

Tier 3 — weak evidence · UTI · Urinary antiseptic

A bearberry leaf preparation whose active glycoside arbutin is hydrolysed to hydroquinone in alkaline urine, providing antimicrobial action in the bladder. Traditional European use for acute uncomplicated UTI with some supporting clinical data. Hydroquinone raises concerns about hepatotoxicity and potential carcinogenicity with prolonged use, so courses must be short (under 1 week) and infrequent (max 5 times per year). Not appropriate for chronic UTI prevention — use cranberry, D-mannose, or lactobacilli instead.

Dose: 400–800 mg standardised extract (20% arbutin) 3 times daily for max 5–7 days