Antibiotic treatments are very effective in treating bladder infections. A three-day course of the antibiotics Macrobid or Trimethoprim is the standard treatment for cystitis.
To order a prescription for cystitis treatment, fill in our brief questionnaire.
One of our online doctors will review your information and check whether an antibiotic course is the right treatment for you. This service is for women only.
Prescriptions can be delivered to your home address or local pharmacy in Ireland.
A consultation for cystitis treatment prescription costs €20.
Please note: many pharmacies currently have a shortage of Macrobid. We recommend Trimethoprim treatment instead.
Nitrofurantoin (Macrobid) is the medical treatment recommended first for cystitis.
Buy cystitis treatment online
Placing an order for A cystitis treatment prescription from Zava is simple and convenient. You just need to take the following steps:
- Fill out a short online assessment about your health and lifestyle
- Place an order for treatment prescription
- One of the doctors at Zava will check your assessment answers to see if your order is right for you
- If your order is right for you, then your prescription can be posted to your preferred address or you can collect it from your local pharmacy
Common side effects of cystitis treatment
Side effects of Nitrofurantoin (Macrobid) include:
- feeling dizzy
- feeling sick (nausea) or being sick (vomiting)
- dark urine
Trimethoprim is another antibiotic, like nitrofurantoin, used to treat urinary tract infections (UTIs). Trimethoprim is no longer recommended as the first line for treating cystitis.
Cystitis is the name for an inflamed bladder. Normally, this is caused by a urine infection, but it can also be caused by damage or irritation, from having sex, for example. It is very common in women. Cystitis in men and children can be a sign of other underlying conditions, so for them, treatment should always be sought from a doctor.
Antibiotics help your body's immune system fight the infection. Trimethoprim and nitrofurantoin are antibiotics commonly used to treat cystitis. Whichever antibiotic your doctor prescribes, take the dose exactly as your doctor instructs and complete the course, unless you are told to stop.
You should consider taking antibiotics for cystitis (also known as a water infection) when the problem does not improve after a couple of days and when self-care methods have failed. Most women who suffer from recurrent cystitis already know which treatment works best for them. The first line antibiotic treatment suitable for most cystitis is either Trimethoprim or Nitrofurantoin (often sold as Macrobid).
Men and children who have cystitis should see a doctor to get treated. They should not be treated with over-the-counter remedies. Women who have cystitis for the first time should also see a doctor. The same goes for women who have recurrent bouts of cystitis, cystitis that does not clear up within a week or who experience severe symptoms.
Cystitis is characterised by needing to urinate frequently and a stinging or burning pain when you urinate. You might have lower abdominal pain, pass blood in your urine or get a high temperature too. You might also notice your urine is cloudier than normal and smells bad. If you drink plenty of water, cystitis will sometimes go by itself in a few days, but you might need a short course of antibiotics to get rid of it completely. If you have an infection in your bladder and do not treat it, it can cause the infection to spread to your kidneys.
Common symptoms of cystitis include:
- a strong, lasting need to pass urine more often than normal
- a painful or burning sensation when you pass urine
- passing urine more often and only passing small amounts
- blood in your urine
- cloudy and/or strong-smelling urine
- pain in your stomach or lower back
- feeling pressure in the lower abdomen (below the stomach)
Some other symptoms can be signs of a more serious infection, so if you have any of these you should see a doctor as soon as possible:
- a fever or high temperature
- shivering or shaking
- pain in the sides of the back (the flank areas)
Keep in mind that some of the symptoms of cystitis are similar to other conditions, such as:
- sexually transmitted infections (STIs)
- inflammation of the urethra (the tube that carries urine from the bladder)
- vaginal thrush (in women)
- prostatitis (inflammation of the prostate gland in men)
You should see your doctor if you have any of these symptoms. To check if you have cystitis, instead of another condition, your doctor may recommend taking a test.
If this is the first time you have had cystitis, you should see your doctor to investigate the cause of your symptoms.
If you have symptoms of mild cystitis, you can treat this at home by drinking lots of water before you contact a doctor as it may clear up on its own. But if your cystitis lasts for more than a few days, it is important to get medical treatment.
If you are getting cystitis on a regular basis, you should speak to a doctor who can tell you whether you should continue to use antibiotics, or if there may be a better treatment for you.
If your cystitis comes back repeatedly over a long period of time, you may have interstitial cystitis (also known as ‘bladder pain syndrome’ or 'chronic cystitis') which is long-term inflammation of the bladder. This is not usually caused by infection and it is treated in a different way.
If you get a high fever or severe pain, or if your symptoms get worse, then you should see a doctor straight away.
Treating cystitis at home
If you have mild cystitis, you do not always need medical treatment. In a lot of cases, it may clear up on its own after a few days. Ways to treat cystitis yourself include:
- drinking lots of water
- not having sex
- taking painkillers
- getting lots of vitamin C
- trying some herbal supplements, like D-mannose, cranberry extract, or garlic extract
If your cystitis lasts for more than a few days, you should think about getting medical treatment.
Your doctor will usually suggest a short course of antibiotics, like nitrofurantoin. Nitrofurantoin is the active ingredient in Macrobid.
The antibiotics work by killing bacteria and stopping them from growing and spreading. This helps your body’s immune system to fight off the infection.
Once you have started taking the antibiotics, you should start to feel better after 2 to 3 doses, which is usually within 24–48 hours of starting treatment.
Trimethoprim is another antibiotic, like Macrobid, also used to treat urinary tract infections but is no longer recommended as a first line treatment.
Women are eight times more likely than men to get cystitis (because a woman’s urethra is shorter and closer to the anus than a man’s). Up to 15% of women get cystitis each year, and 50 % of all women have cystitis at least once in their life.
If your cystitis does not improve within a day or two (despite the use of home remedies), you should consult a doctor, so that he can prescribe you the right antibiotics. Additionally, you should seek medical help if you experience the symptoms of severe or acute cystitis:
- Fever and chills
- Blood in the urine
- Pain or discomfort in your lower back
People who have a history of kidney infections, heart problems or recurrent bladder infections should consult their doctor if they have cystitis.
This is also necessary for patients with diabetes because bacteria thrive in sugar. There might be an increased risk that the infection spreads to the kidneys. Pregnant women who have a bladder infection also need close medical attention.
Most urine infections are caused by germs from the bowel being transferred from your anus (back passage) to your urethra (the tube that your bladder sends urine through when you urinate). Certain types of bacteria thrive in urine and rapidly multiply, spreading the infection.
Most of the time, this happens when people do not go to the toilet often enough. This results in “left-overs” of urine and bacteria in the bladder that lead to an infection. So, remember to empty your bladder regularly and as completely as possible. This problem may also occur in people who do not drink enough. This can cause the urine to become more concentrated in the bladder, until it can be flushed out. This can also result in bacterial infections. It is possible that a blockage somewhere in your kidneys, bladder or urethra can cause cystitis as well, for example because of kidney stones or prostate problems in men.
Sometimes your GP might want to diagnose cystitis by detecting the presence of bacteria in urine as well as asking you about your symptoms. In this case, your doctor will ask you for a sample of your urine, then examine it with a dipstick or take a urine culture to identify which bacteria is the cause of your infection. This way they can prescribe the most suitable treatment to you. Since E. coli bacteria is the cause of most cases, your doctor may prescribe you trimethoprim or Macrobid to begin with. If other bacteria have caused the infection, or the E. coli are resistant to these antibiotics, your doctor will contact you to prescribe a more suitable treatment.
It is estimated that 30-50% of women will have cystitis at some time in their lives. Here is a list of the most common risk factors that contribute:
- Pregnancy – hormonal and physical changes can contribute to the infection
- Menopause – due to hormonal changes
- Using the contraceptive diaphragm
- Sexual activity - increases the chances of having bacteria pushed in the urethra. Having unprotected sex with new partners also increases the risk of infection due to the body's unfamiliarity to new bacteria carried by the new partner
- Diabetes – excess sugar facilitates the reproduction of bacteria
- Impaired immune system – i.e. when natural defences are down (e.g. because of an illness or a cancer treatment)
- Foreign bodies in or near the bladder (tubes, kidney stones)
- Strong allergies to vaginal creams and other hygiene products
- Vaginal infections, such as thrush
- Sexually transmitted infections (STIs), such as chlamydia, can increase the risks of getting cystitis
There is also some evidence that using a spermicide destroys the normal vaginal flora, including its bacteria, which can lead to an increase in the number of foreign bacteria which will then become the source of bladder infection.
Male bladder infection is usually a symptom of a more severe disease. It therefore requires a visit to the doctor. It is sometimes the sign of an obstruction somewhere within the urinary tract. STIs can also cause bladder infections in men.
Most cases of cystitis pass within a few days. However, if they last for more than a few days, you should seriously consider a medical treatment for the bladder infection. There is a risk that cystitis could turn into a kidney infection, which is much more dangerous if left untreated.
It is worth considering whether you have other conditions as well or instead of cystitis – vaginal thrush comes with many of the same symptoms of cystitis, as some STI’s. Soap, deodorant and scented bath products can irritate your genitals and result in pain when you urinate.
Most women find that their cystitis improves within a few days of treatment. If your symptoms have not cleared or come back within two weeks, consult your doctor. Some of the bacteria that can cause cystitis are resistant to different types of antibiotics. You may need to try a different course of treatment.
Cystitis occurs much less frequently in men. Sexually active gay men are more likely to get it than other men. Cystitis can be serious because it can be a sign of:
- an infection of the bladder or prostate (the gland between the penis and the bladder)
- a blockage/obstruction in the urinary tract (e.g. from a tumour or an enlarged prostate)
Men who get cystitis should therefore see a doctor as soon as possible.
This page covers bacterial cystitis. However, there are other types of cystitis:
Interstitial cystitis – causes recurring discomfort in the bladder and pelvic area. It comes with a frequent and urgent need to urinate. The pain that it causes, along with other symptoms, vary from person to person. Women may find it even more painful when they are menstruating. Interstitial cystitis is normally diagnosed around age 40 and 90% of people who have it are women. It is treated with painkillers, bladder distension (increasing the bladder’s size by filling it), bladder instillation (filling the bladder with a solution to soothe irritation) or surgery.
Radiation cystitis – this is damage caused to the bladder by radiation therapy (such as when used to treat cancer in the pelvic organs). Symptoms include blood in the urine and pain. Treatments include painkillers, Hyaluronic Acid, Elmiron and Botox injections.
Chemotherapy Induced cystitis – caused by chemotherapy given directly to the bladder. Treatments include Hyaluronic Acid and Elmiron.
Cystitis Glandularis/Cystitis Cystica – In cystitis cystica, the lining of the bladder comes out in tiny blisters. In cystitis glandularis the lining is thicker over the blisters, giving a cobblestone appearance. Both are usually the result of a chronic urine infection. Treatment is usually long-term antibiotics.
As long as it is not your first cystitis infection, you can order a prescription for nitrofurantoin from Zava. We offer a quick and easy service. Just follow these steps:
- Fill in a quick 3-minute questionnaire about your health and medications you are already taking
- Place an order for treatment prescription
- A Zava doctor will check your order, and based on your answers, they will be able to see if treatment is right for you
- If treatment is right for you then your prescription can be delivered straight to you, or you can collect it from a local pharmacy in Ireland
If you do not want to order a prescription online, you can go to a doctor and they may give you a prescription which you can take to a local pharmacy.
If this is the first time you have cystitis, or you are having really strong symptoms, you should go straight to your GP. They can make sure you are not having any other serious health problems, and they can give you advice on treatment.
Cystitis and kidney infections
If it is left untreated, a serious cystitis infection can spread to your kidneys. If you have a kidney infection, the symptoms usually come on quickly over a few hours or days. These include:
- a high temperature
- pain in your side, back, or the area around your penis or vulva
- feeling sick (nausea) or being sick (vomiting)
Cystitis and pregnancy
Generally, women are more likely to develop cystitis than men. During pregnancy, the urinary passage becomes relaxed and widens, so the chances of bacteria getting into it are higher than usual.
If a pregnant woman gets cystitis, she should see her doctor for treatment. There is a chance that she could develop a kidney infection or give birth too early. A doctor will be able to recommend a safe treatment to take in pregnancy.
Cystitis and sex
Cystitis is not a sexually transmitted infection (STI), but women can often get cystitis after sex. This is because when you have sex, the bacteria that cause cystitis can get pushed into the urethra. Also, friction and irritation during sex can cause damage to your urethra and bladder, which makes it easier for bacteria to spread.
Passing urine as soon as possible after sex helps to flush any bacteria which could causes cystitis out of your system.
If you have cystitis, it is best to avoid having sex until you have completed your treatment and are not having symptoms any more. If you do have sex while you have cystitis it could be uncomfortable or painful.
- Wipe your bottom from front to back after you use the toilet
- Regularly wash the skin around your penis or vulva, using a mild soap
- Wear cotton underwear
- Stay hydrated by drinking plenty of water
- Pass urine as soon as you feel the need to go – do not hold it in
- Always empty your bladder completely when you use the toilet
- Pass urine as soon as possible after you have had sex
- Avoid using any products that will irritate the skin around the vulva, like feminine hygiene sprays, bubble baths, and spermicides. If you avoid using spermicides, make sure you have an effective backup method of contraception to avoid STIs and unwanted pregnancies
Trimethoprim and nitrofurantoin are antibiotics that are commonly used to treat cystitis. Whichever antibiotic your doctor prescribes, take the doses exactly as your doctor instructs and complete the course, unless you are told to stop.
The most common side effects of trimethoprim are feeling or being sick, itching or a skin rash.
The most common side effects of nitrofurantoin are feeling or being sick, feeling dizzy, having diarrhoea. Nitrofurantoin might darken the colour of your urine, but this is a normal effect of the medicine.
Tell your doctor, before taking these antibiotics, if you:
- are pregnant, breastfeeding or trying for a baby
- think you might have glandular fever
- have problems with your liver or kidneys or your breathing
- are diabetic
- are anaemic or have low levels of vitamin B or folic acid
- have peripheral neuropathy
- have porphyria or glucose 6-phosphate dehydrogenase (G6PD) deficiency
- are taking other medicines
- have ever been allergic to a medicine
- are taking a contraceptive pill (you may need to use additional methods of contraception)
Always read the patient information leaflet supplied with your medicine for full details on side effects, cautions and drug interactions.
Dr Simran Deo Doctor
Dr Simran Deo qualified from St George’s, University of London in medicine in 2006 with a distinction in her written finals. She went on to specialise in general practice, obtaining the MRCGP certification in 2012. In 2014 she received a merit for the Diploma in Dermatology from Cardiff University.Meet our doctors
Last reviewed: 08 Jan 2021
NHS (2018). Cystitis. [online] Available at: https://www.nhs.uk/conditions/cystitis/ [accessed 15th July 2019].
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NHS Inform (2019). Cystitis. [online] Available at: https://www.nhsinform.scot/illnesses-and-conditions/kidneys-bladder-and-prostate/cystitis [accessed 15th July 2019].