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.
Dr. Jen Gunter 
I have type 1 diabetes. When I am not being diligent and keeping my blood sugars in check, I get frequent UTIs. My man said once, “I know you’ve been doing well because you haven’t had an infection lately.” Maybe if you have frequent UTIs, you should make sure you’re not diabetic.
I get rejected all the time for taking azo over the weekend if I get in horrific pain, it’s the only thing that helps, but my dr insists that she can’t and won’t test me unless I go 3 days with out taking azo, which puts me back in the crippling pain, why does my dr choose to torture me this way? My only option is going to the er and that’s too expensive
Absolutely! I usually keep one at least on hand. I typically have an hour and a half at the most oncr you notice you have one before intense pain and burning starts. The more you have bladder infections the easier to get them next time. Also little kids can get them also. They are not an std!
Tommorow am going to my Dr. Office lab to get my urine tested for UTI. am having painful bladder spasms. Is it ok to take Pyridium before I go to the lab to get my urine tested
Thanks so much your info really helped
Can Azo (pryridium) cause microalbumin to be abnormally high?
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.
There is a condition called interstital cystitis in which one should not take any cranberry. It irritates the bladder. You should be checked before doing this. Look this condition up on the web.
how long will the urine be orange after a dose?
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!!!
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.
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.
You can still do a microscopy and culture
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.
Don’t know if you read my comment two posts up, but yes, Uribel will interfere with urine tests, and it takes at least a few days to get out of your system.
I take Elmiron for my IC. It does not interfere with UTI testing.
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.
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.
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.
Funny because the Azo package says it will effect lab tests especially showing sugar in the urine.
Sugar in the urine isn’t something we consider when diagnosing a bladder infection
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
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.
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.
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.
Find a friend in USA!
Was told by Kaiser Downtown San Rafael that I could not be tested while taking AZO.
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.
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?
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.
This is in response to Pepper. If the test is negative, please consider Interstitial Cystitis (I have this). It feels exactly like a UTI, but is a nerve response to irritants that feels exactly the same as a UTI. I was treated for years as having UTIs when I always tested negative, and so have many thousands of other people.
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?