AZO (Phenazopyridine) for UTIs: What to Know

AZO is a urinary pain relief tablet that can provide fast relief from UTI symptoms, such as urinary discomfort, pain, burning, frequency, and urgency. You can purchase this medication over the counter for symptomatic relief; it can alleviate urinary symptoms as a monotherapy (taken alone) or combined with an antibiotic to reduce discomfort until it is in full effect. Please continue reading to learn more about the potential benefits and side effects, proper use of AZO for UTIs, and when to seek medical attention.

Is AZO the same as phenazopyridine?

Yes, AZO is the same as phenazopyridine. The generic drug phenazopyridine hydrochloride is available under various trade names, including AZO-Standard, AZO-Maximum Strength, Pyridium, Uristat, Phenazodine, Prodium, Baridium, Nefrecil, Pyridate, Uricalm, Sedural, Urodine, Uropyrine, and Urogesic. They all contain the same active ingredient - phenazopyridine. This medication is available with a doctor's order and over the counter without a prescription. The OTC strengths of phenazopyridine are 95 milligrams (mg), 97.5 mg, and 99.5 mg; the prescription strengths are 100 mg and 200 mg. 

What happens to your urine when you take phenazopyridine?

Unlike other general pain relievers that provide systemic (all over the body) effects, AZO pain relief tablets act directly on the lower urinary tract mucosa, the site of discomfort. It is believed that phenazopyridine works by blocking the nerve fibers in the bladder, thus providing local pain relief to help with urinary symptoms.      

Taking phenazopyridine can provide relief from urinary pain, burning sensation, urgency, frequency, irritation, and discomfort caused by a urinary tract infection (UTI), bladder infection, injury, surgery, or anything that can irritate the bladder. 

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Does AZO cure urinary tract infections?

No, AZO does not cure urinary tract infections. It is not an antibiotic.

How to take AZO urinary pain relief tablets?

Dosage and Administration

AZO (phenazopyridine) is available as an oral tablet.  

AZO (phenazopyridine)’s OTC strengths are 95 mg, 97.5 mg, and 99.5 mg. The following typical dosage of OTC AZO (phenazopyridine) can be used in adults and children 12 years and older: 2 tablets by mouth three times daily after meals for up to 2 days. 

The prescription strengths of phenazopyridine (Pyridium) are 100 mg and 200 mg. Prescription phenazopyridine should be used in adults only; the typical dosage is 200 mg by mouth three times daily after meals. 

You should feel relief from any burning, pain, or discomfort within 1 hour after taking AZO. 

You can take AZO for up to two days for symptomatic relief of UTI symptoms and stop taking it when your symptoms improve.

Do not take AZO for more than 2 days without consulting your healthcare professional. Do not give AZO to children under 12 years of age without consulting a health care professional.

Swallow AZO with a full glass of water. Do not crush or chew the tablets, as this medication contains an azo dye that can stain your teeth. 

You should know that AZO can turn your urine color to reddish-orange. This is harmless health-wise but can stain clothing. Take precautions to avoid staining clothing, such as wearing a panty liner. AZO can also stain soft contact lenses. Do not wear soft contact lenses while taking this medicine. 

Learn more: “How to Get Rid of a UTI in 24 Hours.”

Missed dose

AZO is usually taken as needed. If you are taking it on schedule and miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take a double dose to make up for a missed dose.

Overdose

In case of an overdose of AZO, call your healthcare professional immediately. You can also call the National Poison Control Center at 1-800-222-1222. Call 911 if someone has collapsed, stopped breathing, had a seizure, or is unresponsive.

Drug interactions

If you are taking other drugs, check with your healthcare professional before taking AZO. Drug interactions between AZO and your other medications may result in serious side effects and other effects on your health.

False test results

Phenazopyridine can alter the results of laboratory tests in people with diabetes. Use Clinitest (and not Clinistix or Tes-Tape) for urine sugar testing. False results are also possible with Acetest and Ketostix (urine tests for ketones). Tell your doctor and laboratory personnel you are on phenazopyridine before any laboratory testing.

Why can't I take phenazopyridine for more than 2 days?

You can’t take phenazopyridine for more than 2 days without consulting your doctor because, by providing symptomatic relief, this medicine can mask (hide) the symptoms of a worsening urinary tract infection.

What are the side effects of AZO?

Common side effects of AZO include dizziness, headache, and stomach upset. Tell your doctor if these side effects are severe or do not go away.

Though very rare, AZO can also cause more serious side effects. Seek emergency medical help if you develop the following symptoms, as they can be the signs of serious side effects:

• Allergic reaction — anaphylactic allergic reaction to phenazopyridine is rare but very serious

  • Skin rash, hives, itching- rash and itching can be potential side effects of phenazopyridine, but they can also be symptoms of an allergic reaction

  • Shortness of breath or difficulty breathing

  • Dizziness

  • Racing heart rate

• Methemoglobinemia — this is a rare but potentially fatal side effect of phenazopyridine caused by consuming a large amount of phenazopyridine. Methemoglobinemia can lead to anemia since the red blood cells aren’t able to deliver oxygen to the body’s tissues and organs. Seek emergency medical care immediately if you experience the following symptoms:

  • Bluish discoloration of the skin or lips

  • Difficulty breathing

  • Unusual tiredness, fatigue

  • Confusion, problems with staying alert

  • Feeling like fainting 

  • Irregular heartbeats (feeling like your heart is skipping beats)

  • Seizures

• Hemolytic anemia — this is a rare side effect caused by excessive consumption of phenazopyridine. Hemolytic anemia happens when the body destroys red blood cells faster than they can be replaced. Having a history of glucose-6-phosphate dehydrogenase (G6PD) deficiency (a genetic enzyme deficiency) increases the risk of developing hemolytic anemia. The symptoms of this adverse effect range from mild to severe. 

  • Mild symptoms: tiredness, dizziness, general weakness

  • Severe symptoms: enlarged spleen or liver, increased heart rate, heart murmur

What to avoid while taking phenazopyridine?

• Do not take phenazopyridine if you have had an allergic reaction (hypersensitive reaction) to any of the inactive or active ingredients in the past. The inactive ingredients in AZO include hypromellose, microcrystalline cellulose, povidone, pregelatinized corn starch, croscarmellose sodium, carnauba wax, polyethylene glycol, and vegetable magnesium stearate.  

• Do not take phenazopyridine for more than 2 days without talking to your doctor. This medicine can hide urinary symptoms of a worsening UTI.

• If you have been prescribed phenazopyridine, call your doctor if your symptoms of pain, burning, urgency, and frequency do not improve after the prescribed treatment. Do not continue taking AZO without your doctor’s approval.

• Do not wear contact lenses while taking this medicine since they can be stained by this medication.

• Do not panic if your urine color turns reddish-orange. Be aware of this side effect so you can ensure that it does not stain your clothing. 

• Do not take phenazopyridine without talking to your healthcare professional if you have kidney disease or glucose-6-phosphate dehydrogenase (G6PD) deficiency.

• Do not take phenazopyridine without talking to your doctor if you are pregnant or nursing an infant with breast milk.