The metabolism and excretion of phenazopyridine hydrochloride in animals and man

Johnson, Willard J.; Chartrand, A.

doi:10.1016/0041-008x(76)90100-9

Cited by 35 publications

(16 citation statements)

References 14 publications

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“…Methemoglobinemia, Heinz body hemolytic anemia, liver toxicity, skin pigmentation as well as acute renal failure are described with the use of Pyridium® [3][4][5][6][7][8][9][10][11][12][13]. It is primarily excreted by the kidneys; 90% of a single dose is cleared within 24 h. Approximately 40% of the excreted drug is unmetabolized phenazopyridine [16] while the remainder is composed of the potentially toxic metabolites p-aminophenol, N-acetyl-p-aminophenol, and aniline [15]. Therefore, even therapeutic doses of this drug and its metabolites can cause side effects, especially if there is compromised kidney function [15,17,18].…”

Section: Discussionmentioning

confidence: 99%

Acute renal failure due to phenazopyridine (Pyridium®) overdose: case report and review of the literature

et al. 2006

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Phenazopyridine (Pyridium) is a commonly used urinary tract analgesic. It has been associated with yellow skin discoloration, hemolytic anemia, methemoglobinemia, and acute renal failure, especially in patients with preexisting kidney disease. We report a 17-year-old female with vertically transmitted human immunodeficiency virus (HIV) infection, presenting with acute renal failure and methemoglobinemia following a suicidal attempt with a single 1,200 mg ingestion of Pyridium. She had no prior evidence of HIV nephropathy. The patient had a progressive nonoliguric renal failure on the 3rd day following the ingestion. She was treated with N-acetylcysteine, intravenous carnitine, and alkalinization of the urine. Her kidney biopsy revealed acute tubular necrosis with no glomerular changes. After 7 days of conservative management, she was discharged home with normal kidney function. To our knowledge, this is the second smallest amount of Pyridium overdose resulting in acute renal failure with no previous history of kidney disease.

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Section: Discussionmentioning

confidence: 99%

Acute renal failure due to phenazopyridine (Pyridium®) overdose: case report and review of the literature

et al. 2006

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“…The majority of the parent drug and its toxic metabolites; p-aminophenol, N-acetyl-p-aminophenol, aniline, tri-aminopyridine are excreted. Excretion is impaired in renal dysfunction [3][4][5][6]. Side-effects include orange discoloration of urine, yellowish discoloration of skin, diarrhoea, hepatitis, hemolytic anaemia, methemoglobinemia and acute renal dysfunction [2].…”

Section: Discussion and Review Of Literaturementioning

confidence: 99%

“…It was widely used as a urinary analgesic, though its action on uroepithelium is still controversial [3]. The usual dose is 200mg orally three times daily.…”

Section: Discussion and Review Of Literaturementioning

confidence: 99%

Phenazopyridine abuse presenting with acute kidney injury, hemolytic anaemia and jaundice

Ambinathan¹,

Elbokyl²,

McQuillan³

2017

Arch Clin Nephrol

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Phenazopyridine, an azo dye, is commonly used to relieve dysuria caused by bladder irritation or infection. We report the case of a 64-year-old lady who presented with unexplained sub-acute onset hemolytic anaemia followed by acute kidney injury (AKI) and jaundice. This created a diagnostic dilemma until concealed phenazopyridine abuse was discovered. Discontinuation of Phenazopyridine improved renal function and hemoglobin level to baseline without any other intervention. Prompt urinalysis proved crucial in solving the diagnostic challenge. We also present a review of literature highlighting the association of this commonly used medication with renal tubular dysfunction, interstitial nephritis and hemolytic anemia.

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“…Although (and perhaps because) phenazopyridine hydrochloride has been applied in clinical treatments for a very long time, there is little information available on the pharmacokinetics of this drug [9]. It is only known that it is absorbed from the gastrointestinal tract and is excreted mainly from the urine [10]. A variety of analytical techniques have been used to assay PAP [11][12][13][14][15][16][17][18][19].…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a gas chromatography‐mass spectrometry method for the determination of phenazopyridine in rat plasma: application to the pharmacokinetic study

Chen

Zhang

et al. 2007

Biopharm & Drug Disp

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Phenazopyridine hydrochloride is a strong analgesic used in the treatment of urinary tract infections. The aim of the present study was to develop a procedure based on gas chromatography-mass spectrometry (GC-MS) for the analysis of phenazopyridine in rat plasma. The method was set up and adapted for the analysis of small biological samples taken from rats. Biological samples were extracted by liquid-liquid extraction. The extraction agent was ethyl acetate. The samples were separated by GC on a DB-5MS analytical column and determined by a quadrupole mass spectrometer detector operated under selected ion monitoring mode. Excellent linearity was found between 0.01 and 1.00 microg/ml (r = 0.9991, n = 9) for plasma samples. The limit of detection (LOD) was 0.3 ng/ml. Within-day and between-day precisions expressed as the relative standard deviation (RSD) for the method were 1.83-4.91% and 2.12-4.76%, respectively. The recoveries for all samples were >90%. The main pharmacokinetic parameters obtained were T(max) = (0.35+/-0.01) h, C(max) = (0.396+/-0.079) microg/ml, AUC = (0.373+/-0.065) h microg/ml and CL = (94.2+/-5.9) ml/g/h. The results presented here clearly indicate that this proposed method could be applicable to investigate the pharmacokinetic of phenazopyridine in rats after administration. (c)

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The metabolism and excretion of phenazopyridine hydrochloride in animals and man

Cited by 35 publications

References 14 publications

Acute renal failure due to phenazopyridine (Pyridium®) overdose: case report and review of the literature

Acute renal failure due to phenazopyridine (Pyridium®) overdose: case report and review of the literature

Phenazopyridine abuse presenting with acute kidney injury, hemolytic anaemia and jaundice

Development and validation of a gas chromatography‐mass spectrometry method for the determination of phenazopyridine in rat plasma: application to the pharmacokinetic study

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