If you’ve ever suffered through the burning discomfort of a urinary tract infection (UTI), you’ll know just how desperate you can be for relief.
For millions around the world, that relief has come in the form of a little orange pill: phenazopyridine, sold under brand names like Azo, Pyridium, Prodium, Pyridiate, Baridium, and Uricalm.
It’s been a go-to over-the-counter (OTC) remedy for decades, promising to numb the pain and irritation while you wait for antibiotics to kick in.
But now, doctors are raising the alarm about a potential dark side to this familiar medication.
Recent warnings from health experts and government agencies suggest that phenazopyridine could be linked to cancer, based on troubling evidence from animal studies.
If you or someone you know has ever reached for this drug, it’s time to take a closer look at what the science is saying—and what your options are for safe, effective UTI relief.
What is phenazopyridine, and why do people use it?
Phenazopyridine is a urinary tract analgesic. In plain English, it works by numbing the lining of the urinary tract, providing temporary relief from the burning, urgency, and discomfort that come with UTIs.
It doesn’t treat the infection itself—that’s a job for antibiotics—but it can make life a lot more bearable while you’re waiting for a prescription or for the antibiotics to start working.
In Australia, phenazopyridine is only available by prescription, whereas in the US and UK, lower-strength versions can be purchased over the counter, with higher strengths available by prescription.
This easy access has made it a staple in many medicine cabinets, with more than 100 million people worldwide estimated to have used it.
The cancer connection: What do the studies say?
The big concern now is that phenazopyridine may not be as harmless as once thought.
The National Institutes of Health (NIH) in the US recently highlighted animal studies showing that dietary exposure to phenazopyridine caused tumours in two different rodent species.
Female mice developed both benign and malignant liver tumours, while rats of both sexes developed benign or malignant colorectal tumours.
While these findings don’t prove that phenazopyridine causes cancer in humans, the NIH has classified it as ‘reasonably anticipated to be a human carcinogen’. That’s a strong warning, especially considering how widely the drug is used.
It’s worth noting that the key animal study was actually conducted back in 1978, but the NIH only published its warning in 2021.
This means that for decades, millions have been using phenazopyridine without knowing about these potential risks.
Doctors divided: Should you keep using it?
The news has come as a shock to many in the medical community. Dr Steven Goldstein, a New York-based gynaecologist who regularly recommends phenazopyridine to patients awaiting test results, said he was ‘totally unaware’ of the cancer link.
On the other hand, Rita Jew, president of the Institute for Safe Medication Practices, is unequivocal: ‘There is no need for this drug.’ She points out that there are safer alternatives for managing UTI symptoms while waiting for antibiotics.
Side effects: More than just a colourful surprise
If you’ve ever taken phenazopyridine, you might have noticed your urine turning a vivid orange or red.
While this is harmless (albeit alarming if you’re not expecting it!), the drug can also cause a range of side effects.
According to the Mayo Clinic, these include chest tightness, dizziness, lethargy, loss of appetite, and stomach pain.
More severe reactions—though rare—can include depression, muscle twitching, kidney failure, seizures, and nosebleeds.
Alternatives for UTI relief
So, what can you do if you’re struck down by a UTI and desperate for relief? The good news is that there are other options.
Products containing methenamine and sodium salicylate can also help ease discomfort until you can get antibiotics.
And, of course, antibiotics remain the gold standard for actually treating the infection. Common choices include nitrofurantoin, trimethoprim/sulfamethoxazole, and fosfomycin.
Why are UTIs so common, especially for women?
UTIs are incredibly common, especially among women. They account for over 10 million doctor visits and hundreds of thousands of hospitalisations each year.
Women are more susceptible due to their shorter urethra, which gives bacteria a shorter path to the bladder.
Sex can also increase the risk, as can certain types of meat consumption—recent research suggests that E. coli from chicken, turkey, and pork may be responsible for up to 8% of UTI cases.
Your turn: Have you used phenazopyridine or other UTI remedies?
As discussions around over-the-counter medications and their long-term safety continue to evolve, it’s important to stay informed and consider both the benefits and potential risks.
Ongoing research and medical advice play a key role in shaping public understanding and guiding personal health decisions.
What are your thoughts on the use of phenazopyridine for urinary tract discomfort? Have you or someone you know used this medication, and what was the experience like? Do you think more restrictions or clearer warnings should be in place for drugs available without a prescription? Share your thoughts in the comments below.
Disclaimer: The information in this article is for general informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Everyone’s health is unique, so if you have any concerns or questions about your health, it’s always best to consult with a qualified healthcare professional. We encourage you to seek expert guidance before making any medical decisions.
Also read: Could your prescription put you at risk? One patient shares a shocking story
