Pyridium (phenazopyridine hydrochloride) is a well-established urinary analgesic indicated for the symptomatic relief of pain, burning, urgency, frequency, and other discomforts arising from irritation of the lower urinary tract mucosa. It is not an antibiotic and does not treat the underlying infection causing the symptoms; rather, it provides local, topical analgesia to the urinary tract lining, offering patients significant comfort while definitive antibacterial therapy takes effect. Its mechanism of action is exerted locally on the mucosa, providing a soothing effect that begins to work within one hour of administration. This medication is a valuable adjunctive therapy in the management of conditions such as cystitis, urethritis, and prostatitis, and is also used for relief of discomfort following urological procedures.

Features

• Active Ingredient: Phenazopyridine Hydrochloride
• Available Strengths: 95 mg, 97.2 mg, 100 mg, 200 mg (tablets and film-coated tablets)
• Mechanism of Action: Exerts a local analgesic or anesthetic effect on the mucosal lining of the urinary tract.
• Onset of Action: Symptomatic relief is typically experienced within one hour of oral administration.
• Duration of Action: Provides relief for several hours per dose.
• Excretion: Primarily renally excreted, imparting a characteristic reddish-orange discoloration to urine.

Benefits

• Provides rapid, targeted relief from the burning sensation and pain associated with urinary tract infections and irritations.
• Reduces the feelings of urgency and frequency, allowing for more normalized bladder function and improved comfort.
• Serves as an effective adjunct therapy, managing painful symptoms while antibiotics address the underlying bacterial cause.
• Helps improve patient quality of life and compliance with primary treatment regimens by alleviating acute discomfort.
• Can be used for short-term symptomatic relief following diagnostic or surgical procedures involving the urinary tract.

Common use

Pyridium is primarily used for the symptomatic relief of pain, burning, itching, urgency, and frequency associated with:

• Cystitis: Inflammation of the bladder, most commonly due to bacterial infection.
• Urethritis: Inflammation of the urethra.
• Prostatitis: Inflammation of the prostate gland.
• Post-procedural comfort: Following cystoscopy, catheterization, or other urological instrumentation. It is crucial to understand that Pyridium is a symptomatic treatment only. It does not possess any antibacterial properties. Therefore, it must always be used in conjunction with an appropriate antimicrobial agent when an infection is present. Failure to treat the underlying infection can lead to severe complications, including pyelonephritis (kidney infection) and sepsis.

Dosage and direction

Pyridium is intended for short-term use, typically not exceeding two days, as a supplement to specific antibacterial therapy.

• Adults: The usual dosage is one 200 mg tablet taken orally three times per day after meals.
• Administration: Tablets should be swallowed whole with a full glass of water. Taking the medication with or after meals can help minimize potential stomach upset.
• Duration of Therapy: Treatment should be discontinued after 2 days for UTI-associated symptoms, as the antibacterial therapy should have taken effect by that time. For post-procedural use, follow the specific duration prescribed by the urologist.
• Pediatric Use: The safety and efficacy in children under the age of 6 have not been established. For children 6-12 years old, dosage is based on weight and must be determined by a physician. It is imperative to follow the specific dosage instructions provided by the prescribing healthcare professional.

Precautions

• Underlying Cause: A physician must be consulted to diagnose the cause of the urinary symptoms before initiating therapy with Pyridium. This is not a substitute for medical diagnosis.
• Renal Impairment: Use with caution in patients with renal impairment. Impaired kidney function can lead to increased systemic absorption and accumulation of the drug, raising the risk of toxicity.
• Hepatic Impairment: Use with caution in patients with pre-existing liver disease.
• Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency: Individuals with this genetic condition are at an increased risk of hemolytic anemia while taking Pyridium.
• Urine Discoloration: Patients must be warned that Pyridium will cause a reddish-orange discoloration of urine. This is a harmless and expected effect. It may also stain clothing.
• Other Discoloration: The drug may also cause a yellow discoloration of the skin or sclerae (the whites of the eyes), which could be indicative of accumulation and potential toxicity and should be reported to a doctor immediately.

Contraindications

Pyridium is contraindicated in patients with:

• Known hypersensitivity to phenazopyridine hydrochloride or any component of the formulation.
• Renal insufficiency (significantly reduced kidney function), as the drug may accumulate and cause toxicity.
• Glomerulonephritis (inflammation of the kidney’s filtering units) or severe hepatitis.
• A history of methemoglobinemia induced by phenazopyridine or other agents.

Possible side effect

While many patients tolerate Pyridium well, some side effects may occur:

• Common: Headache, dizziness, mild gastrointestinal upset (e.g., stomach cramps, nausea).
• Dermatological: Itching, skin rash.
• Hematological: In rare cases, particularly in patients with G6PD deficiency, methemoglobinemia (a blood disorder that reduces oxygen delivery to tissues) or hemolytic anemia (destruction of red blood cells) can occur. Signs include cyanosis (bluish skin), shortness of breath, fatigue, and rapid heart rate, which require immediate medical attention.
• Hepatic: Yellowing of the skin or eyes (scleral icterus), which suggests possible hepatotoxicity and requires discontinuation and medical evaluation.
• Renal: Although rare, acute renal failure and renal tubule obstruction have been reported with misuse or overdose.

Drug interaction

Formal drug interaction studies are limited, but the following should be considered:

• Sulfonamides: Concomitant use with sulfa antibiotics may increase the risk of crystalluria (crystals in the urine).
• Other Methemoglobinemia-Inducing Agents: Concurrent use with drugs like dapsone, chloroquine, nitrates, or nitrites may increase the risk of methemoglobinemia.
• Urine Acidifiers/Aikalizers: The pH of the urine can affect the rate of excretion of phenazopyridine. Always provide your doctor and pharmacist with a complete list of all medications you are taking, including prescription, over-the-counter, vitamins, and herbal supplements.

Missed dose

If a dose is missed, it should be taken as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped, and the regular dosing schedule resumed. Do not double the dose to make up for a missed one.

Overdose

Overdose of Pyridium is serious and can be fatal. Symptoms of overdose are primarily related to methemoglobinemia and hemolysis (red blood cell destruction) and may include:

• Cyanosis (bluish/gray skin coloration due to lack of oxygen)
• Hemolytic anemia
• Jaundice (yellowing of skin/eyes)
• Hepatic toxicity
• Renal failure (anuria, oliguria)
• Metabolic acidosis
• Tachycardia, shortness of breath, dizziness, weakness, stupor In case of suspected overdose, seek immediate emergency medical attention or contact a Poison Control Center. Treatment is supportive and may include methylene blue for methemoglobinemia.

Storage

• Store at room temperature between 20°C to 25°C (68°F to 77°F).
• Protect from light and moisture. Keep the bottle tightly closed.
• Keep out of reach of children and pets.
• Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed.

Disclaimer

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The information provided is not exhaustive and may not cover all possible uses, directions, precautions, interactions, or adverse effects.

Reviews

• Clinical Efficacy: “Phenazopyridine remains a cornerstone of symptomatic management in acute cystitis. Its rapid onset provides crucial patient comfort, improving adherence to the primary antibiotic regimen.” – Journal of Urology
• Patient Feedback: Many patients report significant and rapid relief from the intense pain and burning of UTIs, often stating it “makes the infection bearable” while antibiotics work. The most common noted downside is the alarming but harmless urine discoloration.
• Expert Consensus: Urologists and primary care providers widely regard Pyridium as a safe and effective short-term analgesic for urinary tract discomfort when used appropriately under medical supervision and in conjunction with definitive therapy.