From the FDA Drug Label
Phenazopyridine HCl should not be used in patients who have previously exhibited hypersensitivity to It. The use of Phenazopyridine HCl is contraindicated in patients with renal insufficiency. The contraindications for pyridium are:
- Hypersensitivity to the drug
- Renal insufficiency 1
From the Research
Pyridium (phenazopyridine) is contraindicated in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency, renal insufficiency, or hepatic disease due to the risk of hemolysis, methemoglobinemia, and acute renal failure, as reported in a recent case study 2. The medication should be used with caution in patients taking other medications that can affect kidney function.
Contraindications and Precautions
- Patients with known hypersensitivity to the drug
- Renal insufficiency or hepatic disease
- G6PD deficiency
- Urinary tract obstruction, as it may mask symptoms of worsening infection
- Pregnant women, especially near term, due to the risk of methemoglobinemia in newborns
Safe Use of Pyridium
Pyridium should only be used for short-term symptom relief (typically 2 days) while awaiting antibiotic effects in urinary tract infections, as prolonged use can lead to toxicity 3, 4. The medication works by providing local anesthetic effects on the urinary tract mucosa but does not treat the underlying infection. Patients should be informed that pyridium turns urine and other bodily fluids orange-red, which is normal but can stain clothing and contact lenses. It is essential to monitor patients for signs of renal insufficiency and to stop the medication immediately if any adverse effects occur, as early steroid administration may improve renal recovery and decrease the risk of progression to chronic kidney disease 4.