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Urinary Analgesic (Azo Dye) Pregnancy: B

Phenazopyridine

Brand names: Pyridium

Adult dose

Dose: 200 mg three times daily after meals
Route: oral
Frequency: three times daily
Max: 600 mg/day
Short-term use only (max 2 days); symptomatic relief while awaiting antibiotic effect; turns urine/tears orange-red — warn patient

Paediatric dose

Dose: 4 mg/kg
Route: oral
Frequency: three times daily
Max: 200 mg three times daily
Caution in children; G6PD deficiency contraindication

Dose adjustments

Renal

Avoid in renal impairment (methaemoglobinaemia risk)

Hepatic

Avoid in hepatic impairment

Paediatric weight-based calculator

Caution in children; G6PD deficiency contraindication

Clinical pearls

  • Analgesic effect only — does NOT treat infection; always prescribe with antibiotic
  • Warn patients about orange-red urine staining — may stain clothes and contact lenses permanently
  • Not widely available in UK (OTC in US); urinary antiseptics more commonly used

Contraindications

  • Renal impairment
  • G6PD deficiency
  • Hepatic impairment

Side effects

  • Orange-red urine/tears (stains contact lenses)
  • Nausea
  • Headache
  • Methaemoglobinaemia (overdose)
  • Haemolytic anaemia (G6PD deficiency)

Interactions

  • Masks true urine colour — MSU should be collected before starting

Monitoring

  • Renal function
  • Signs of methaemoglobinaemia

Reference: BNFc; BNF 86. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.