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bladder infections

Can I get tested for a bladder infection while taking Azo? (phenazopyridine)

Approximately 12% of women report a bladder infection each year and 50% of women will have had a bladder infection by the age of 32.

The burning can be hell, so many women take Azo (also called Pyridium or phenazopyridine ), a medication that helps bladder pain. The problem? There is a medical myth that phenazopyridine affects the tests for a bladder infection.

Phenazopyridine turns urine orange. This color change can interfere with one component of an office test that some doctors may do to screen for a bladder infection: the urine dipstick.

A urine dipstick tests for bacteria (the nitrate component of the test) and white blood cells (the leukocyte esterase component). If a urine dipstick is positive for both nitrates and leukocyte esterase there is a 75% chance you have a bladder infection. The dipstick also tests for blood and some researchers think if this is positive the chance of a bladder infection is even greater.

Azo (I’m getting tired of typing out phenazopyridine) interferes with the leukocyte esterase part of the urine dipstick. It doesn’t interfere with the other tests: looking at the urine under the microscope (microscopy) or culturing the urine (growing the bacteria).

If you have classic bladder infection symptoms (burning when you pee and need to pee a lot more often) and don’t have vaginal discharge or vaginal irritation there is a 90% chance you have a bladder infection, which is more accurate than a urine dipstick.

As classic symptoms are more accurate than the dipstick then, well, in this situation the dipstick is pointless so who cares about the leukocyte esterase? If your symptoms aren’t classic the urine dipstick actually adds very little (75% accuracy is not stellar testing and if the dipstick is negative there is still an 18% chance you have an infection) and a more thorough evaluation is probably warranted. So, the dipstick is kind of pointless here as well.

All Azo does is make a bad test worse. As far as medical testing goes, it won’t affect a thing but it might help ease the pain while you get a hold of your doctor. And anyone who tells you that you can’t have your urine tested while taking Azo doesn’t understand testing for a bladder infection.

Remember, this post does not reflect individual medical advice.

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Discussion

23 thoughts on “Can I get tested for a bladder infection while taking Azo? (phenazopyridine)

  1. Interesting. I’ve never seen that available OTC where I am (Ireland), the usual pharmacist recommendation is Cystopurin (potassium citrate). Would that interfere with the dipstick test?

    Posted by QoB | August 12, 2012, 8:56 am
  2. Was told by Kaiser Downtown San Rafael that I could not be tested while taking AZO.

    Posted by Diane Fischler | August 12, 2012, 9:29 am
    • That’s why I write these posts.
      A urine dipstick rarely adds anything (I don’t do them) and Azo doesn’t affect the other tests.

      Posted by Dr. Jen Gunter | August 12, 2012, 11:00 am
      • what about “AZO uti” ? Can this mask the results of a culture. I am a nurse and I have a patient with horrible results on a dipstick and symptomatic. However, her culture resulted negative. Comments?

        Posted by Pepper Dupa | August 9, 2016, 4:25 pm
    • Diane- I’ve rec’d the same, from Kaiser, and from a Blue Cross provider. I think we need to push harder, because being refused treatment over a test that is only so-so in the accuracy department is unfair.

      Posted by pamzella | August 14, 2012, 2:38 pm
  3. FYI, in Canada we do not have it over the counter, it is prescription only. My pharmacist tells me that because the company wasn’t making money, it’s not even available easily by prescription, you have to find a compounding pharmacy to make it for you. It is SO WORTH IT though.

    Posted by LAT | August 12, 2012, 2:34 pm
  4. AZO also very much interferes with the nitrite portion of the urine dipstick, turning it immediately pink, a false positive. If someone is on AZO, we skip dipping all together and send it to the lab for culture and sensitivity.

    Posted by Violet Powell | December 11, 2012, 10:20 am
    • I was given a ua and was positive for lukacytes and bacteria… now I am taking azo cause it’s the only way I can pee… I have to have more test Monday I it’s already being cultured but I was told that it could cause you to have protein in your urine is this true? I have chronic pyelonephritis and IC.

      Posted by Hope | February 8, 2014, 6:40 pm
  5. I started azo after my uaand culture so those results want be affected… Just want to know is the azo will affect results if I have another ua… I already know I have a bad infection, I started azo after I went to er. I have lupus and do have protein problems with my urine already just wanted to know if it would increase protein if they do more test

    Posted by Hope | February 8, 2014, 6:49 pm
  6. Funny because the Azo package says it will effect lab tests especially showing sugar in the urine.

    Posted by dawn | September 12, 2014, 8:06 am
  7. So all of this should be disregarded until lab results are done?
    Discussed exam findings with pt. U/A + for leuks, blood, nitrates, ketones, protein (pt taking Azo), advised pt that urine results can be skewed by this medication and that it would be sent to the lab for repeat u/a.

    Posted by gayle brennan | October 4, 2014, 7:25 pm
  8. I’m dealing with something similar at the moment. I take Uribel for interstitial cystitis, which turns the urine blue.

    I suspect I have a UTI at the moment, but my doctor’s office is refusing to take a urine sample until the Uribel is out of my system — they claim it will interfere with the urine culture and sensitivity testing. It’s been four days since I took my last Uribel, but even though I’ve chugged tons of water, my urine is still blue and the doctor is still refusing to take a sample.

    Not sure what to do.😦 My symptoms are miserable, but I can’t take anything until they get on with this test. I feel like telling them, “NO YOU’RE WRONG” won’t really help.

    Posted by Dal | October 15, 2014, 4:05 am
  9. I have one UTI after another , am taking UTI slip D-Mannose from a wellness company that has been really good for maintenance, however I have one now from taking antibiotics for an infection that caused another UTI ..I cannot get rid of it…what to do….?? any ideas.

    Posted by Marla | November 2, 2014, 8:38 am
  10. Does Uribel have an effect on urine cultures? I feel like I have a uti but don’t want to make an appt until I know if my blue urine will mess up the test.

    Posted by Nikki | June 6, 2015, 9:36 pm
  11. As a professional medical laboratory scientist I can tell you that more than the leucocyte portion of the dipstick is compromised. As stated on the package insert from the company itself nitrites and leukocyte esterase is affected by the coloration of pyridium or azo. Some other portions of the dipstick are also affected that do not necessarily interfere with diagnosing a urinary tract infection but may indicate other underlying medical issues. The professionals in the lab and at the hospital really do know what they are doing; they went through extensive training and studied hard to be able to pursue their careers.

    Posted by Michelle | August 23, 2015, 10:25 am
  12. I have taken AZO or Uristat off and on over the last 10 years. I just took a recent dose after not taking it for about a year and it didn’t turn my urine the typical orange it normally does. Should I be alarmed? Thank you.

    Posted by Vicki | July 13, 2016, 4:22 am
  13. how long will the urine be orange after a dose?

    Posted by sharon brooks | August 4, 2016, 9:56 am
    • I’m using it now and it stopped turning orange after just about 12 hours for me. I don’t know if it’s the same for everyone though. I drink copious amounts of water all the time, always have. I see my nurse practitioner Monday afternoon so I will stop using Azo at least 12 hours prior to seeing her and having my urine test to be on the safe side. Someone mentioned having Lupus and protein problems….I do also. And I’m a retired nurse too. I hope this helps and have a happy day!!!

      Posted by Christina Ellenburg | August 20, 2016, 11:53 pm
  14. I have been struggling with UTIs since I was 18 years old and the Lady Soma Cranberry Pills work faster than other products to relieve the pain with my UTIs. I use this while I am waiting to get in to see the doctor to relieve my pain and/or while I am waiting the the antibiotics to start working which usually takes anywhere from 12-24 hours.

    This stuff helps to alleviate the pain (burning, urgency, etc) associated with UTIs within 20-40 minutes of taking the pills.

    Posted by toby | November 20, 2016, 4:38 pm

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