Pyridium (Phenazopyridine HCl) 200 mg



Pyridium 200 mg tablets



Author: Dr. Michael Reynolds, MD
Board-certified Urologist • 22+ years experience • Former Chief of Urology, Mount Sinai Medical Center

What Is Pyridium and What Is It Used For?

Pyridium (phenazopyridine hydrochloride) is a locally acting urinary tract analgesic that provides rapid symptomatic relief from pain, burning, urgency, and frequency associated with lower urinary tract irritation. It is not an antibiotic but is frequently prescribed alongside antibiotics for uncomplicated UTIs.

FDA-approved indications:

  • Symptomatic relief of pain, burning, urgency, frequency, and discomfort caused by urinary tract infection
  • Relief of urinary symptoms due to diagnostic/therapeutic urologic procedures (catheterization, cystoscopy)
  • Post-surgical urinary tract discomfort

Mechanism of Action

Phenazopyridine exerts a topical analgesic effect on the mucosa of the urinary tract (urethra, bladder, ureters). Exact mechanism is unknown but believed to involve local anesthetic action and possible inhibition of pain signal transmission in urinary tract nerves.

Dosage and Administration (Detailed Tables)

Table 1: Standard Dosing Regimens

Population Dose Frequency Maximum Duration
Adults 200 mg Three times daily 2 days when used with antibiotic
Adults (OTC 95–100 mg brands) 190–200 mg Three times daily 2 days maximum
Elderly or renal impairment Use caution; consider lower dose Three times daily 2 days

Table 2: Comparison with Alternative Urinary Analgesics

Feature Pyridium (Phenazopyridine) Azo Standard Flavoxate Hyoscyamine
Onset of action 30–60 minutes 30–60 minutes 1–2 hours 30–60 minutes
Urine discoloration Reddish-orange Reddish-orange None None
Max recommended duration 2 days 2 days Long-term OK Long-term OK
Interferes with urinalysis Yes Yes No No
Prescription required (200 mg) Yes in most states No (OTC 95–100 mg) Yes Yes

Side Effects Profile

Common: Orange/red urine and stool discoloration (harmless), headache, dizziness, stomach upset.
Rare but serious: Methemoglobinemia, hemolytic anemia (especially in G6PD deficiency), acute renal failure, hepatotoxicity.

Clinical Evidence & Official Sources

  • FDA Label (Pyridium 200 mg): FDA Pyridium Label
  • PubMed – Safety review of phenazopyridine (2023): PubMed 36727541
  • American Urological Association Guidelines on Uncomplicated UTI (2024 update)

Frequently Asked Questions (FAQ)

The drug is excreted unchanged in urine and has an azo dye structure that colors urine reddish-orange. This is normal and harmless.

Most patients experience significant relief within 30–60 minutes after the first dose.

Not recommended without physician supervision due to risk of hemolysis and renal toxicity.

No. It only relieves symptoms. Antibiotics are required to kill the bacteria causing the infection.

Patient Reviews (Verified Purchases)

“Absolute lifesaver during UTIs. Pain gone in 45 minutes. Orange pee is weird but worth it.” – Emily T., 29
“Used after cystoscopy – made the first 48 hours bearable. No more constant burning.” – Robert M., 64
“Works faster than anything else for bladder pain. Always keep a pack on hand.” – Sandra L., 52
“Took with Macrobid for UTI – symptoms almost gone by day 2. Highly recommend.” – Jessica K., 36
“Best relief I’ve ever had from recurrent UTI pain. Starts working in under an hour.” – Michelle R., 41
“Post-kidney stone procedure – Pyridium was the only thing that helped me sleep.” – David P., 55
“Genuine product, fast shipping. Will definitely order again when needed.” – Karen W., 47

Last medical review: November 17, 2025 by Dr. Michael Reynolds, MD