Phenazopyridine

INTRODUCTION

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.

Adverse Reactions/Side Effects

CNS: headache, vertigo. GI: hepatotoxicity, nausea. GU: bright-orange urine, renal failure. Derm: rash. Hemat: hemolytic anemia, methemoglobinemia.

PHYSICAL THERAPY IMPLICATIONS

Examination and Evaluation

• Be alert for signs of liver toxicity, including anorexia, abdominal pain, severe nausea and vomiting, yellow skin or eyes, skin rashes, flu-like symptoms, and muscle/joint pain. Report these signs to the physician immediately.

• Monitor signs of hemolytic anemia (unusual fatigue, shortness of breath, dizziness, headache, pale skin, chest pain, coldness in hands and feet) and methemoglobinemia (bluish coloring of the skin, lips fingernails; headache; shortness of breath; lack of energy). Notify physician immediately if these signs occur.

• Monitor signs of renal failure, including decreased urine output, increased blood pressure, muscle cramps/twitching, edema/weight gain from fluid retention, yellowish brown skin, and confusion that progresses to seizures and coma. Report these signs to the physician immediately.

• Assess pain and other urinary tract symptoms (burning, itching, urinary frequency) to document whether this drug is successful in helping manage the patient's pain.

• Assess vertigo that might affect gait, balance, and other functional activities. Report balance problems and functional limitations to the physician and nursing staff, and caution the patient and family/caregivers to guard against falls and trauma.

Patient/Client-Related Instruction

• Instruct patient and family/caregivers to report other troublesome side effects such as severe or prolonged headache, nausea, or skin rash.

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.

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Glomerulonephritis; Severe hepatitis, uremia, or renal failure; Renal insufficiency; G6PD deficiency.

Use Cautiously in: Hepatitis; Pregnancy or lactation (safety not established).

Interactions

Drug-Drug: None significant.

Route/Dosage

PO (Adults): 200 mg tid for 2 days.

PO (Children): 4 mg/kg tid for 2 days.