Uro-Pain 95mg Tablets

Manufacturer RISING PHARMACEUTICALS Active Ingredient Phenazopyridine(fen az oh PEER i deen) Pronunciation Fen-az-oh-PEER-i-deen
It is used to ease pain from a bladder infection.It is used to treat signs of urinary problems.
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Drug Class
Urinary Analgesic
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Pharmacologic Class
Azo Dye; Local Anesthetic (Urinary Tract)
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Pregnancy Category
Category B
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FDA Approved
Jan 1970
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DEA Schedule
Not Controlled

Overview

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What is this medicine?

Phenazopyridine is a medication used to relieve pain, burning, urgency, and frequency caused by urinary tract infections or other irritations of the urinary tract. It works by numbing the lining of the urinary tract. It is not an antibiotic and does not treat the infection itself, but helps with the symptoms.
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How to Use This Medicine

Taking Your Medication

To use this medication correctly, follow your doctor's instructions and read all the information provided. Take the medication by mouth, either with or after food, and swallow it with a full glass of water.

Storing and Disposing of Your Medication

Store the medication at room temperature, protected from light, and in a dry place. Avoid storing it in a bathroom. Keep all medications in a safe location, out of the reach of children and pets. When disposing of unused or expired medication, do not flush it down the toilet or pour it down the drain unless instructed to do so. Instead, check with your pharmacist for guidance on the best disposal method. You may also want to explore local drug take-back programs.

Missing a Dose

If you take this medication regularly and miss a dose, take it as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and resume your normal schedule. Do not take two doses at the same time or take extra doses. If you take this medication as needed, follow your doctor's instructions and do not take it more frequently than recommended.
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Lifestyle & Tips

  • Drink plenty of fluids to help flush out the urinary tract.
  • Take the medication after meals to reduce stomach upset.
  • Do not use for more than 2 days when taken with an antibiotic for a UTI, unless directed by your doctor.
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Available Forms & Alternatives

Dosing & Administration

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Adult Dosing

Standard Dose: 190 mg (two 95 mg tablets) orally three times daily after meals
Dose Range: 95 - 200 mg

Condition-Specific Dosing:

duration: Should not be used for more than 2 days when used concomitantly with an antibacterial agent for urinary tract infection.
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Pediatric Dosing

Neonatal: Not established
Infant: Not established
Child: Not established (generally not recommended for children under 12 years)
Adolescent: Not established (generally not recommended for children under 12 years)
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Dose Adjustments

Renal Impairment:

Mild: Use with caution; monitor for signs of toxicity.
Moderate: Contraindicated due to risk of accumulation and toxicity (e.g., methemoglobinemia, hemolytic anemia).
Severe: Contraindicated.
Dialysis: Contraindicated.

Hepatic Impairment:

Mild: Use with caution.
Moderate: Use with caution; monitor for signs of toxicity.
Severe: Contraindicated due to potential for accumulation and toxicity.

Pharmacology

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Mechanism of Action

Phenazopyridine HCl is an azo dye which exerts a local anesthetic or analgesic action on the mucosa of the urinary tract. Its exact mechanism is not fully understood, but it is believed to act directly on the urinary tract mucosa to relieve pain, burning, urgency, and frequency.
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Pharmacokinetics

Absorption:

Bioavailability: Not precisely quantified, but readily absorbed from the GI tract.
Tmax: Approximately 2-4 hours
FoodEffect: Absorption may be enhanced or gastric irritation reduced when taken after meals.

Distribution:

Vd: Not widely distributed; concentrates in the urinary tract.
ProteinBinding: Not precisely quantified, but generally low.
CnssPenetration: Limited

Elimination:

HalfLife: Approximately 7.35 hours (range 5-11 hours)
Clearance: Not precisely quantified.
ExcretionRoute: Renal (primarily unchanged and as metabolites).
Unchanged: Approximately 65% excreted unchanged in urine.
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Pharmacodynamics

OnsetOfAction: Rapid, typically within 1 hour.
PeakEffect: Not precisely quantified, but aligns with Tmax.
DurationOfAction: Approximately 6-8 hours.

Safety & Warnings

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Side Effects

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of methemoglobinemia, a rare but potentially deadly condition, such as:
+ Blue or gray discoloration of the lips, nails, or skin
+ Abnormal heartbeat
+ Seizures
+ Severe dizziness or fainting
+ Severe headache
+ Excessive sleepiness
+ Feeling extremely tired or weak
+ Shortness of breath
Signs of a meningococcal infection, such as:
+ Severe headache with or without nausea, vomiting, fever, or stiff neck or back
+ Confusion
+ High fever
+ Fever with a rash
+ Sensitivity to light
+ Severe muscle aches or pain with or without flu-like symptoms
Signs of liver problems, such as:
+ Dark urine
+ Fatigue
+ Decreased appetite
+ Upset stomach or stomach pain
+ Light-colored stools
+ Vomiting
+ Yellow skin or eyes
Feeling extremely tired or weak
Difficulty urinating or changes in urine output
Changes in vision

Other Possible Side Effects

Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to contact your doctor if you're bothered by any of the following:

Headache
Diarrhea
Upset stomach or vomiting

This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
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Seek Immediate Medical Attention If You Experience:

  • Bluish discoloration of skin, lips, or nails (methemoglobinemia)
  • Yellowing of skin or eyes (jaundice)
  • Unusual tiredness or weakness, pale skin (signs of hemolytic anemia)
  • Fever, chills, sore throat (signs of infection, not treated by this drug)
  • Rash, itching, swelling (allergic reaction)
  • Severe stomach pain, nausea, vomiting
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Before Using This Medicine

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
Certain health conditions, including:
+ Kidney problems
+ Kidney infection during pregnancy
+ Liver problems

This list is not exhaustive, and it is crucial to discuss all your health problems and medications with your doctor.

To ensure your safety, please provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Natural products and vitamins you are using
* Any health problems you have

It is vital to verify that it is safe to take this medication with all your other medications and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
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Precautions & Cautions

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

This drug is not a substitute for an antibiotic and will not cure a bladder infection. To avoid staining, take precautions to protect your clothing and fabrics. Additionally, this medication may stain contact lenses. You may notice that your urine or stools turn orange or red, but this is a normal and harmless side effect.

When taking this medication, be aware that breaking or holding the tablet in your mouth before swallowing can cause tooth discoloration. If you have concerns, discuss them with your doctor.

If you have a deficiency of the enzyme glucose-6-phosphate dehydrogenase (G6PD), you may be at risk of developing anemia. This deficiency is more common in individuals of African, South Asian, Middle Eastern, and Mediterranean descent.

Do not exceed the prescribed duration of treatment. This medication may interfere with certain laboratory tests, so it is crucial to inform all your healthcare providers and laboratory personnel that you are taking this drug.

If you are pregnant, planning to become pregnant, or breastfeeding, consult your doctor to discuss the potential benefits and risks to you and your baby.
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Overdose Information

Overdose Symptoms:

  • Methemoglobinemia (cyanosis, shortness of breath, dizziness, fatigue)
  • Hemolytic anemia (pallor, jaundice, dark urine)
  • Renal dysfunction
  • Hepatic dysfunction
  • Vertigo
  • Nausea
  • Vomiting

What to Do:

Seek immediate medical attention. Call 911 or Poison Control at 1-800-222-1222. Treatment may involve methylene blue for methemoglobinemia, blood transfusions for severe hemolytic anemia, and supportive care.

Drug Interactions

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Moderate Interactions

  • Interference with laboratory tests (e.g., urine bilirubin, urobilinogen, ketones, protein, glucose, porphyrins, albumin, phenolsulfonphthalein (PSP) excretion tests, urine specific gravity, urine colorimetric tests).
  • Prilocaine (increased risk of methemoglobinemia)

Monitoring

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Baseline Monitoring

Renal function (BUN, creatinine)

Rationale: To assess baseline kidney function, as the drug is renally excreted and contraindicated in severe renal impairment.

Timing: Prior to initiation, especially in elderly or those with suspected renal issues.

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Routine Monitoring

Symptom relief (pain, burning, urgency, frequency)

Frequency: Daily

Target: Significant reduction or resolution of symptoms.

Action Threshold: If symptoms persist or worsen after 2 days, re-evaluate diagnosis and treatment.

Urine color

Frequency: Daily

Target: Orange to reddish-brown discoloration (expected effect).

Action Threshold: Unusual color changes (e.g., blue/green) or lack of expected discoloration may indicate issues.

Signs of methemoglobinemia (cyanosis, dyspnea, fatigue)

Frequency: Daily, especially in patients with G6PD deficiency or renal impairment.

Target: Absence of cyanosis (bluish discoloration of skin/nails), shortness of breath, or unusual fatigue.

Action Threshold: If signs develop, discontinue drug immediately and seek medical attention.

Signs of hemolytic anemia (pallor, jaundice, dark urine)

Frequency: Daily, especially in patients with G6PD deficiency.

Target: Absence of pallor, yellowing of skin/eyes, or dark/tea-colored urine.

Action Threshold: If signs develop, discontinue drug immediately and seek medical attention.

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Symptom Monitoring

  • Relief of urinary pain, burning, urgency, and frequency
  • Urine discoloration (orange to reddish-brown)
  • Signs of allergic reaction (rash, itching, swelling)
  • Signs of methemoglobinemia (bluish skin/nails, shortness of breath, dizziness, fatigue)
  • Signs of hemolytic anemia (unusual tiredness, pale skin, yellowing of skin/eyes, dark urine)
  • Gastrointestinal upset (nausea, vomiting, diarrhea)

Special Patient Groups

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Pregnancy

Category B. While animal studies have not shown harm, there are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and potential benefits outweigh risks.

Trimester-Specific Risks:

First Trimester: Low risk based on animal data, but human data limited.
Second Trimester: Low risk based on animal data, but human data limited.
Third Trimester: Low risk based on animal data, but human data limited. Potential for hemolytic anemia in G6PD deficient neonates if used near term.
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Lactation

Excreted in breast milk. Use with caution. The American Academy of Pediatrics considers it compatible with breastfeeding, but monitor infant for adverse effects (e.g., jaundice, methemoglobinemia).

Infant Risk: Low to moderate risk. Potential for hemolytic anemia in G6PD deficient infants. Monitor for jaundice or unusual lethargy.
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Pediatric Use

Generally not recommended for children under 12 years of age due to lack of established safety and efficacy, and increased risk of methemoglobinemia in infants and young children.

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Geriatric Use

Use with caution due to increased likelihood of impaired renal function, which can lead to accumulation and increased risk of adverse effects like methemoglobinemia and hemolytic anemia. Lower doses or avoidance may be necessary.

Clinical Information

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Clinical Pearls

  • Inform patients that phenazopyridine will turn urine orange or reddish-brown, and may stain clothing or contact lenses.
  • Emphasize that this drug is for symptomatic relief only and does not treat the underlying infection; it should be used in conjunction with an appropriate antibiotic for UTIs.
  • Advise patients to take the medication with or after food to minimize gastrointestinal upset.
  • Instruct patients to discontinue the drug and seek medical attention immediately if they experience bluish discoloration of skin/nails, yellowing of skin/eyes, or unusual fatigue.
  • Limit use to a maximum of 2 days when co-administered with an antibiotic for UTI, as prolonged use increases the risk of adverse effects without additional benefit.
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Alternative Therapies

  • Non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief (e.g., ibuprofen, naproxen)
  • Acetaminophen for pain relief
  • Antispasmodics (e.g., oxybutynin, tolterodine) for bladder spasms (different mechanism)
  • Antibiotics (for the underlying infection, not for symptomatic relief)
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Cost & Coverage

Average Cost: $10 - $30 per 30 tablets (generic 200mg)
Generic Available: Yes
Insurance Coverage: Tier 1 or Tier 2 (most insurance plans)
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General Drug Facts

If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further evaluation and guidance. To ensure your safety and the effectiveness of your treatment, never share your medication with others or take someone else's medication. It's also important to note that some medications may come with additional patient information leaflets, so be sure to check with your pharmacist if you have any questions. If you are unsure about any aspect of your medication, consult with your doctor, nurse, pharmacist, or other healthcare provider for personalized guidance. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide detailed information about the overdose, including the medication taken, the amount, and the time it occurred.