It is derived from cranberries BUT it is not d-mannose.The owner of Utiva told me that in their clinical trials done in the US, d-mannose combined with Utiva actually diminished the effect of Utiva. I was also told that if I felt a UTI coming on, to just double up on the Utiva...which I did for 2 days at one point.The day before the onset of UTI symptoms, I had eaten a lot of carbs at a party and as always that is a UTI trigger. I still continue to shower morning and night to be sure I am 'clean' and I take the vaginal estrogen which is absorbed almost totally locally I am told and the Utiva. The most important thing to understand is that Utiva is to be used preventatively; in other words right after antibiotics when one has NO infection in the bladder. That is key.