phenazopyridine


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Related to phenazopyridine: phenazopyridine hydrochloride, Macrobid

phenazopyridine

 [fen″ah-zo-pēr´ĭ-dēn]
a urinary tract analgesic, used as the hydrochloride salt; administered orally.

phenazopyridine

(fen-az-oh-peer-i-deen) ,

Azo-Standard

(trade name),

Baridium

(trade name),

Phenazo

(trade name),

Prodium

(trade name),

Pyridium

(trade name),

Pyridium Plus

(trade name),

UTI Relief

(trade name)

Classification

Therapeutic: nonopioid analgesics
Pharmacologic: urinary tract analgesics
Pregnancy Category: B

Indications

Provides relief from the following urinary tract symptoms, which may occur in association with infection or following urologic procedures:
  • Pain,
  • Itching,
  • Burning,
  • Urgency,
  • Frequency.

Action

Acts locally on the urinary tract mucosa to produce analgesic or local anesthetic effects.
Has no antimicrobial activity.

Therapeutic effects

Diminished urinary tract discomfort.

Pharmacokinetics

Absorption: Appears to be well absorbed following oral administration.
Distribution: Unknown. Small amounts cross the placenta.
Metabolism and Excretion: Rapidly excreted unchanged in the urine.
Half-life: Unknown.

Time/action profile (urinary analgesia)

ROUTEONSETPEAKDURATION
POunknown5–6 hr6–8 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity;Glomerulonephritis;Severe hepatitis, uremia, or renal failure;Renal insufficiency;Glucose-6–phosphate dehydrogenase (G6PD) deficiency.
Use Cautiously in: Hepatitis; Obstetric / Lactation: Safety not established.

Adverse Reactions/Side Effects

Central nervous system

  • headache
  • vertigo

Gastrointestinal

  • hepatotoxicity
  • nausea

Genitourinary

  • bright-orange urine (most frequent)
  • renal failure

Dermatologic

  • rash

Hematologic

  • hemolytic anemia
  • methemoglobinemia

Interactions

Drug-Drug interaction

None significant.

Route/Dosage

Oral (Adults) 200 mg 3 times daily for 2 days.
Oral (Children) 4 mg/kg 3 times daily for 2 days.

Availability (generic available)

Tablets: 95 mgOTC, 100 mg, 100 mgOTC, 200 mgOTC, 200 mg

Nursing implications

Nursing assessment

  • Assess patient for urgency, frequency, and pain on urination prior to and throughout therapy.
  • Lab Test Considerations: Renal function should be monitored periodically during course of therapy.
    • Interferes with urine tests based on color reactions (glucose, ketones, bilirubin, steroids, protein).

Potential Nursing Diagnoses

Acute pain (Indications)
Impaired urinary elimination (Indications)

Implementation

  • Medication should be discontinued after pain or discomfort is relieved (usually 2 days for treatment of urinary tract infection). Concurrent antibiotic therapy should continue for full prescribed duration.
  • Oral: Administer medication with or following meals to decrease GI irritation. Do not crush, break, or chew tablet.

Patient/Family Teaching

  • Instruct patient to take medication exactly as directed. If a dose is missed, take as soon as remembered unless almost time for next dose.
  • Advise patient that while phenazopyridine administration is stopped once pain or discomfort is relieved, concurrent antibiotic therapy must be continued for full duration of therapy. Do not save unused portion of phenazopyridine without consulting health care professional.
  • Inform patient that drug causes reddish-orange discoloration of urine that may stain clothing or bedding. Sanitary napkin may be worn to avoid clothing stains. May also cause staining of soft contact lenses.
  • Instruct patient to notify health care professional if rash, skin discoloration, or unusual tiredness occurs.

Evaluation/Desired Outcomes

  • Decrease in pain and burning on urination.
References in periodicals archive ?
Preoperative administration of oral phenazopyridine was no different from the control modality with regard to visibility and surgeon satisfaction.
Firstly, a mixture of phenazopyridine solution (50 mL) and AC/Ti[O.sub.2]/Anthocyanin (0.1 g) was stirred in dark, to check the amount of contaminant adsorbed on catalyst system surfaces.
Majority of them were prescribed Phenazopyridine Hydrochloride (14%) for burning micturition / dysuria followed by Paracetamol (12%) than Pantoprazole (11%), Dicycloverine (10%) cases, Disodium hydrogen citrate (7%) urine alkaliser, Diclofenac (6%), Terazosin (5%), Doxazosin (4%) Finasteride (3%), Estrogen and progesterone (5%) as HRT.
Phenazopyridine hydrochloride tablets [Product insert].
Nine of 30 patients complained of mild to moderate frequency, and five of dysuria, which settled within 1-2 weeks with anticholinergics and phenazopyridine. The routine use of these drugs has led to inability to accurately assess the intensity of dysuria.
Other commonly used and helpful nonspecific treatments include urinary analgesics to reduce bladder pain such as phenazopyridine hydrochloride (Pyridium), anticholinergic/antispasmodic therapies (Ditropan, Detrol, Levbid) to decrease frequency and urgency, and on occasion muscle relaxants such as Valium and Flexeril to reduce pelvic floor muscle spasticity.
Designation Examples Hereditary NADH-cytochrome [b.sub.5] reductase deficiency, cytochrome [b.sub.5] deficiency, M Hb, unstable Hb Drug/chemical induced Acetaminophen, amyl nitrite, benzocaine, dapsone, nitroglycerin, nitroprusside, phenazopyridine (pyridium), sulfanilamide, aniline dyes, chlorates, nitrofurans, sulfones Diet induced Nitrites, nitrates (a) Adapted from Mansouri and Lurie (1993).
(100 mg (Elmiron) t.i.d.) hydroxyzine HCI 10-75 mg/day, $0.18 taken at bedtime (25 mg) amitriptyline 10-150 mg/day $0.36 taken with dinner (50 mg) dimethyl sulfoxide 50 mL of 50% $6.28 ** (DMSO) solution, injected once a week tolterodine 4 mg/day $2.80 (Detrol LA) oxybutynin 5-15 mg/day $2.69 (Ditropan XL) (10 mg) celecoxib 100-200 mg/day $1.49 (Celebrex) (100 mg) rofecoxib 12.5-25 mg/day $2.52 (Vioxx) phenazopyridine 200-300 mg $2.22 t.i.d.
Table 1: Medications That May Cause Hemolysis Treatments that can cause immune complex hemolysis * Stibophen * Chlorpromazine * Aminosalicylic acid * Isoniazid * Rifampin * Quinidine, quinine * Chlorpropamide * Immunosuppressants * Penicillins * Cephalosporins * Sulforamieds and sulfonylureas Treatments that can cause autoimmune hemolytic anemia * Methyldopa * Levodpa * Mefenamic acid * Procainamide * Diclofenac sodium Treatments that can cause oxidative hemolysis * Dapsone * Sulfasalazine * Phenacetin * Sodium perchlorate * Nitroglycerin * Phenazopyridine * Primaquine * Vitamin K analogues Hypotonic and hypertonic dialysis: Hypotonic and hypertonic dialysis are extreme emergencies that can result in abrupt hemolysis, acute water intoxication, and cerebral edema.
Drug Description, Common Uses Ciprofloxacin Antibiotic used to treat urinary tract infections, infectious diarrhea and lower respiratory tract infections Ephedrine Used to treat acute asthmatic attacks Indinavir Protease inhibitor used in the treatment of HIV-positive patients Oxypurinal Used to treat gout Phenazopyridine Pain reliever for severe urinary tract infections Sulfamethoxazole Used to treat urinary tract and inner ear infections After collection from the urine stream or in situ, urinary calculi are analyzed chemically.
Other oral medications which may prove beneficial in treating IC include antispasmodics, such as oxybutynin (Ditropan[R]), and urinary mucosal anesthetics, such as phenazopyridine (Pyridium[R]).
There are no oral drugs approved by the FDA specifically for the treatment of IC, but a variety of drugs such as aspirin, ibuprofen, and histamines, and the urinary tract pain reliever phenazopyridine (available by prescription as Pyridium[R], and over-the-counter as Azo-Standard[TM]) may help lessen symptoms.