Description

Simple

A medication used to relieve pain and discomfort caused by irritation in the urinary tract.

Clinical

A local anesthetic used for the symptomatic relief of pain, burning, urgency, frequency, and general discomfort caused by lower urinary tract irritations that are a result of infection, trauma, surgery, endoscopic procedures, or the passage of equipment or catheters.

Overview

Phenazopyridine, also known as Pyridium, is a urinary tract analgesic used for the short-term management of urinary tract irritation and its associated unpleasant symptoms such as burning and pain during urination. In the USA, this drug was previously marked by Roche but has been discontinued by the FDA.[16] It is still used in various parts of the world. Ingestion of phenazopyridine is found to change the appearance of the urine by imparting an orange or red color, as it is considered an azo dye.[15]

Pharmacology

Indication

Phenazopyridine hydrochloride is indicated to relieve uncomfortable symptoms that occur as a consequence of mucosal irritation of the lower urinary tract in adults. The irritation may be a result of trauma, surgery, endoscopic procedures, infection, or the insertion of instruments or urinary cathet... Read more

Pharmacodynamic

Phenazopyridine acts as a local anesthetic offering relief from irritating conditions of the urinary tract. It relieves urinary urgency frequency, burning, pain, and discomfort.[14, Read more

Mechanism of action

The full mechanism of action of phenazopyridine is not fully elucidated[18], however, it is reported to exert a direct topical analgesic effect on the mucosal lining of the urinary tract via the inhibition of volta... Read more

Absorption

Phenazopyridine is absorbed in the gastrointestinal tract.[ Read more

Protein binding

Information currently not available.

Volume of distribution

Small, trace quantities of phenazopyridine are thought to cross the placenta and the blood-brain barrier, reaching cerebrospinal fluid.[15] A pharmacokinetic study in rats determined that phenazopyridine metab... Read more

Clearance

This drug is rapidly excreted by the kidneys, up to 65% of a dose administered orally may be excreted as unchanged drug in the urine. The clearance of phenazopyridine may be decreased with impaired renal or hepatic function and is contraindicated in these conditions.[ Read more

Half life

The mean elimination half-life of phenazopyridine is 7.35 hours in rats with healthy renal function.[1... Read more

Route of elimination

Up to 65% of an oral phenazopyridine dose is quickly excreted by the kidneys as unchanged drug measured in the urine.[15]
The pharmacokinetics of this drug have not been evaluated in depth in man. In a small... Read more

Toxicity

The oral LD50 of phenazopyridine in rats is 472 mg/kg.[19]

Overdose information

Administering excess phenazopyridine above the daily recommended dose in those with healthy or impaired kidney function may increas... Read more

Adverse Effects

Contraindications

  • Regions: US
  • Patient Conditions:
      • Name: G6PD Deficiency
      • Drugbank Id: DBCOND0077795
  • Regions: Canada
  • Patient Conditions:
      • Name: Liver Diseases
      • Drugbank Id: DBCOND0027940
  • Regions: US
  • Patient Conditions:
      • Name: Renal Insufficiency
      • Drugbank Id: DBCOND0031387

Food Interactions

  • Take with food. Food reduces irritation.

Interactions

Type in a drug name to check for interaction with Phenazopyridine
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  • Paracetamol(acetaminophen)
  • Paxil(paroxetine)
  • Pamelor(nortriptyline)
  • Panadol(acetaminophen)
  • Patanol(olopatadine ophthalmic)
  • Pataday(olopatadine ophthalmic)
  • Parnate(tranylcypromine)
  • Pazeo(olopatadine ophthalmic)
Abacavir
Phenazopyridine may decrease the excretion rate of Abacavir which could result in a higher serum level.
Acarbose
Phenazopyridine may decrease the excretion rate of Acarbose which could result in a higher serum level.
Aceclofenac
The risk or severity of nephrotoxicity can be increased when Phenazopyridine is combined with Aceclofenac.
Acemetacin
The risk or severity of nephrotoxicity can be increased when Phenazopyridine is combined with Acemetacin.
Acetaminophen
The risk or severity of methemoglobinemia can be increased when Acetaminophen is combined with Phenazopyridine.
Acetazolamide
Acetazolamide may increase the excretion rate of Phenazopyridine which could result in a lower serum level and potentially a reduction in efficacy.
Acetylsalicylic acid
The risk or severity of nephrotoxicity can be increased when Acetylsalicylic acid is combined with Phenazopyridine.
Aclidinium
Phenazopyridine may decrease the excretion rate of Aclidinium which could result in a higher serum level.
Acrivastine
Phenazopyridine may decrease the excretion rate of Acrivastine which could result in a higher serum level.
Acyclovir
The risk or severity of nephrotoxicity can be increased when Acyclovir is combined with Phenazopyridine.
Adefovir
The risk or severity of nephrotoxicity can be increased when Phenazopyridine is combined with Adefovir.
Adefovir dipivoxil
The risk or severity of nephrotoxicity can be increased when Adefovir dipivoxil is combined with Phenazopyridine.
Albutrepenonacog alfa
Phenazopyridine may decrease the excretion rate of Albutrepenonacog alfa which could result in a higher serum level.
Alclofenac
The risk or severity of nephrotoxicity can be increased when Phenazopyridine is combined with Alclofenac.
Aldesleukin
Phenazopyridine may decrease the excretion rate of Aldesleukin which could result in a higher serum level.
Alendronic acid
The risk or severity of nephrotoxicity and hypocalcemia can be increased when Phenazopyridine is combined with Alendronic acid.
Allopurinol
Phenazopyridine may decrease the excretion rate of Allopurinol which could result in a higher serum level.
Allylestrenol
Phenazopyridine may decrease the excretion rate of Allylestrenol which could result in a higher serum level.
Almasilate
Phenazopyridine may decrease the excretion rate of Almasilate which could result in a higher serum level.
Alminoprofen
The risk or severity of nephrotoxicity can be increased when Phenazopyridine is combined with Alminoprofen.
23 References
  1. 1 . Shore SN, Britnell SR, Brown JN: Safety analysis of long-term phenazopyridine use for radiation cystitis. J Oncol Pharm Pract. 2019 Apr 22:1078155219842646. doi: 10.1177/1078155219842646.PubMed: 31006341
  2. 2 . Suter DM, Preynat-Seauve O, Tirefort D, Feki A, Krause KH: Phenazopyridine induces and synchronizes neuronal differentiation of embryonic stem cells. J Cell Mol Med. 2009 Sep;13(9B):3517-27. doi: 10.1111/j.1582-4934.2009.00660.x.PubMed: 20196783
  3. 3 . Rehfuss A, Mahon J, Sorokin I, Smith C, Stein BS: Phenazopyridine: A Preoperative Way to Identify Ureteral Orifices. Urology. 2018 May;115:36-38. doi: 10.1016/j.urology.2018.02.023. Epub 2018 Mar 1.PubMed: 29501712
  4. 4 . Onder AM, Espinoza V, Berho ME, Chandar J, Zilleruelo G, Abitbol C: Acute renal failure due to phenazopyridine (Pyridium) overdose: case report and review of the literature. Pediatr Nephrol. 2006 Nov;21(11):1760-4. doi: 10.1007/s00467-006-0196-1. Epub 2006 Aug 1.PubMed: 16897003
  5. 5 . Gold NA, Bithoney WG: Methemoglobinemia due to ingestion of at most three pills of pyridium in a 2-year-old: case report and review. J Emerg Med. 2003 Aug;25(2):143-8.PubMed: 12901999
  6. 6 . Murphy T, Fernandez M: Acquired methemoglobinemia from phenazopyridine use. Int J Emerg Med. 2018 Nov 12;11(1):45. doi: 10.1186/s12245-018-0208-5.PubMed: 31179913
  7. 7 . Chang LC, Kuo CW, Chau T, Lin SH: Phenazopyridine-induced hemolytic anemia in advanced kidney disease. J Am Geriatr Soc. 2014 Dec;62(12):2464-6. doi: 10.1111/jgs.13161.PubMed: 25516057
  8. 8 . Aizawa N, Wyndaele JJ: Effects of phenazopyridine on rat bladder primary afferent activity, and comparison with lidocaine and acetaminophen. Neurourol Urodyn. 2010 Nov;29(8):1445-50. doi: 10.1002/nau.20886.PubMed: 20976818
  9. 9 . Thomas BH, Whitehouse LW, Solomonraj G, Paul CJ: Excretion of phenazopyridine and its metabolites in the urine of humans, rats, mice, and guinea pigs. J Pharm Sci. 1990 Apr;79(4):321-5. doi: 10.1002/jps.2600790410.PubMed: 2352143
  10. 10 . Johnson WJ, Chartrand A: The metabolism and excretion of phenazopyridine hydrochloride in animals and man. Toxicol Appl Pharmacol. 1976 Aug;37(2):371-6. doi: 10.1016/0041-008x(76)90100-9.PubMed: 982458
  11. 11 . Li KJ, Chen QH, Zhang Z, Zhou P, Li P, Liu J, Zhu J: Determination of phenazopyridine in human plasma by GC-MS and its pharmacokinetics. J Chromatogr Sci. 2008 Sep;46(8):686-9. doi: 10.1093/chromsci/46.8.686.PubMed: 18796223
  12. 12 . Thomas BH, Whitehouse LW, Solomonraj G, Paul CJ: Metabolism and disposition of phenazopyridine in rat. Xenobiotica. 1993 Feb;23(2):99-105.PubMed: 8498084
  13. 13 . Pitre D, Maffei-Facino R: Isolation and identification of two hydroxylated metabolites of phenazopyridine in rat urine. Farmaco Sci. 1977 Jun;32(6):453-60.PubMed: 872925
  14. 14 . Phenazopyridine Hydrochloride Link
  15. 15 . Drug summary: phenazopyridine Link
  16. 16 . FDA information Phenazopyridine Link
  17. 17 . HMDB, phenazopyridine Link
  18. 18 . Phenazopyridine DailyMed Link
  19. 19 . MSDS, Phenazopyridine Link
  20. 20 . UPMC: Final Diagnosis -- Suicide Attempt with Ingestion of Pyridium Tablets Link
  21. 21 . Intracellular Drug Bioavailability: Effect of Neutral Lipids and Phospholipids Link
  22. 22 . O Factors Affecting Drug Metabolism Link
  23. 23 . Phenazopyridine hydrochloride Link