Uva ursi (bearberry)
Summary
Uva ursi (bearberry leaf) contains arbutin, which is converted to hydroquinone. In a 398-woman German trial, it cut antibiotic courses by 64% versus fosfomycin but gave more symptoms and more kidney infections (8 vs 2). A 382-woman UK trial found no symptom or antibiotic benefit. Because of hydroquinone, the EU limits use to one week in adult women.
Key facts
- Dried leaf of bearberry (Arctostaphylos uva-ursi), standardised to hydroquinone derivatives calculated as arbutin[4]
- 398 women with bladder infections: 63.6% fewer antibiotic courses than with fosfomycin, but higher symptom burden and 8 vs 2 kidney infections[1]
- 382 women: no difference in urinary frequency symptoms or antibiotic use[2]
- Adult women only, no more than one week; contraindicated in kidney disorders and not recommended in pregnancy or breastfeeding[4]
- 2 graded human outcomes on this page
- October 13, 2026
How it works
ProposedBearberry leaf is rich in arbutin, a hydroquinone glycoside; hydroquinone derivatives are proposed to act as a urinary antiseptic. Clinical trials have not shown that this translates into reliable symptom relief.[3][4]
What the human research says
Human trials only, one row per outcome. The form column shows what each trial actually tested. Grades follow our evidence-grading policy.
| Outcome | Effect | Grade | Best evidence | PMID |
|---|---|---|---|---|
| Antibiotic use and symptom burden in uncomplicated UTI vs fosfomycin | Mixed | Grade B | RCT · n = 398 · 2021 Adult women with suspected uncomplicated urinary tract infection in 42 German family practices Form: Uva ursi tablets (105 mg arbutin each) · Dose: 2 tablets three times daily (630 mg arbutin/day) · Duration: 5 days Antibiotic courses were 63.6% lower than with fosfomycin, but total symptom burden was 136.5% of the fosfomycin group (failing non-inferiority), and 8 women developed pyelonephritis versus 2 (p=0.067). | 34111592 (opens PubMed)Source [1] |
| Urinary frequency symptoms and antibiotic use vs placebo | No effect | No effect | RCT · n = 382 · 2019 Women aged 18–70 with suspected lower UTI in UK primary care, all given a delayed antibiotic prescription Form: Uva ursi extract · Dose: Not stated in the abstract · Duration: Not stated in the abstract No difference in frequency symptoms on days 2–4 (−0.06, p=0.661) and no significant reduction in antibiotic use (39.9% vs 47.4%, p=0.293); no safety concerns. | 30685500 (opens PubMed)Source [2] |
Forms
| Form | Elemental % | Absorption (human data) | GI tolerance | Studied for |
|---|---|---|---|---|
| Uva ursi dry extract (tablets) | Varies[1][3] | No human absorption data in the cited trials.[1] | Adverse events were similar to fosfomycin, but kidney infections were more frequent (8 vs 2).[1] | Uncomplicated UTI trials (630 mg arbutin/day for 5 days) |
| Bearberry leaf tea | Varies[4] | No human absorption data.[4] | Nausea, vomiting and stomach-ache have been reported; urine may turn greenish-brown.[4] | EU traditional use: 1.5–4 g leaf, 2–4 times daily, maximum 8 g/day |
Studied doses
Doses studied in human trials ranged from 630 mg/day of arbutin (two 105 mg tablets three times daily) for 5 days in the German trial; the UK trial does not state its dose in the abstract. The EU monograph lists dry-extract doses equal to 200–840 mg/day of hydroquinone derivatives, for no more than one week.[1][3][4]
Interactions
Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.
Who should be careful
- Kidney disorders
- The EU monograph lists kidney disorders as a contraindication.[4]
- Long-term or repeated use
- Arbutin breaks down to hydroquinone, which showed genotoxic and carcinogenic effects in lab and animal tests. The EU assessment judges the risk minimal only for short courses, warns that prolonged use may impair the liver, and describes eye (macular) damage in a woman who drank bearberry tea regularly for 3 years.[5][4]
- Pregnancy and breastfeeding
- Safety is not established and use is not recommended.[4]
- Men, children and adolescents
- The EU monograph does not recommend use in men or anyone under 18 without medical supervision.[4]
Talk to your pharmacist or clinician before starting a supplement, especially if you take prescription medicines.
How to read the label
- One week maximumThe EU monograph limits use to no more than one week; several national monographs cited in the EU assessment also cap use at about 5 courses a year. Trials used 5 days.[4][5]
- Check the arbutin contentDoses are expressed as hydroquinone derivatives calculated as arbutin; the trial tablets each contained 105 mg.[1][4]
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Frequently asked questions
Does uva ursi work for bladder infections?
Not convincingly. In 382 women it did not ease symptoms versus placebo, and against fosfomycin it caused more symptoms and more kidney infections, though fewer antibiotic courses.[1][2]
Can uva ursi replace antibiotics?
The trials do not support that: 8 of 207 women starting on uva ursi developed kidney infections, versus 2 of 191 on fosfomycin.[1]
How long can it be used?
The EU monograph says no more than one week, in adult women only. The limit reflects concern about hydroquinone, which is genotoxic in lab tests, and reports of liver strain with prolonged use.[4][5]
Why does it turn urine green-brown?
The EU monograph notes that bearberry leaf may colour urine greenish-brown.[4]
Who should not use uva ursi?
People with kidney disorders, pregnant or breastfeeding women, men and under-18s, per the EU monograph.[4]
Sources
- [1]Herbal treatment with uva ursi extract versus fosfomycin in women with uncomplicated urinary tract infection in primary care: a randomized controlled trial.. Clin Microbiol Infect, 2021. RCT
- [2]Uva-ursi extract and ibuprofen as alternative treatments for uncomplicated urinary tract infection in women (ATAFUTI): a factorial randomized trial.. Clin Microbiol Infect, 2019. RCT
- [3]Reducing antibiotic use for uncomplicated urinary tract infection in general practice by treatment with uva-ursi (REGATTA) - a double-blind, randomized, controlled comparative effectiveness trial.. BMC Complement Altern Med, 2018. RCT
- [4]European Union herbal monograph on Arctostaphylos uva-ursi (L.) Spreng., folium (Revision 2). European Medicines Agency (HMPC), 2018. guideline
- [5]Assessment report on Arctostaphylos uva-ursi (L.) Spreng., folium (EMA/HMPC/750266/2016). European Medicines Agency (HMPC), 2018. guideline
What changed
- Independent adversarial review: added the EMA assessment report to explain the one-week limit (hydroquinone genotoxicity and carcinogenicity in lab and animal tests, possible liver impairment with prolonged use, a maculopathy case after 3 years of tea, about 5 courses a year in national monographs). Pregnancy wording corrected to "not recommended" (the EU contraindication is kidney disorders). Studied-dose sentence repaired. All PMIDs re-verified; evidence rows match their abstracts.
- Adversarial second pass: every PMID re-checked against NCBI esummary (title, year, no retraction, erratum or expression-of-concern flags) and every number in each evidence row re-read against its PubMed abstract (PMC full text where the abstract lacked dose or duration). Countries and funding notes kept only where the abstract or full text states them; interactions listed only where a source supports them, otherwise stated as unstudied.
- First draft. Every PMID checked against NCBI E-utilities esummary (title and year taken from the record) and abstracts read for the cited rows.