Phenazopyridine 100mg tablets

BACKGROUND: Bacillus Calmette-Guerin (BCG) immunotherapy is the standard adjuvant treatment for high-risk, non-muscle invasive bladder cancer (NMIBC). However, BCG immunotherapy is commonly accompanied by significant lower urinary tract symptoms (LUTS) including symptoms such as urinary urgency, frequency, dysuria and pelvic pain. These symptoms can undermine treatment adherence and clinical outcomes. In this study, the treatments for preventing LUTS after BCG instillations were compared through a systemic review and network meta-analysis (NMA). METHODS: Eligible studies were obtained from the PubMed, Web of Science, Embase and Cochrane Library databases. We also searched the references of the included studies. Our protocol followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist. We performed NMA using Review Manager 5.3 and STATA MP 18.0. RESULT: The analysis included 6 studies with 556 participants. The results of the NMA revealed that celecoxib and prulifloxacin effectivelty reduce the incidence of LUTS including frequency, urgency and dysuria. Phenazopyridine showed the best performance in improving pelvic pain. CONCLUSION: The NMA indicated that medications such as celecoxib, prulifloxacin and phenazopyridine are effective in reducing the incidence of LUTS after BCG immunotherapy of bladder tumors.

Abstract licence: CC BY-NC-ND

Methemoglobinemia is an acute medical emergency that requires prompt correction. Physicians should have a high degree of suspicion of methemoglobinemia in cases that present with hypoxemia that does not resolve with supplemental oxygenation, and they should confirm this suspicion with a positive methemoglobin concentration on arterial blood gas. There are multiple medications that can induce methemoglobinemia, such as local anesthetics, antimalarials, and dapsone. Phenazopyridine is an azo dye used over-the-counter as a urinary analgesic for women with urinary tract infections, and it has also been implicated in causing methemoglobinemia. The preferred treatment of methemoglobinemia is methylene blue, but its use is contraindicated for patients with glucose-6-phosphatase deficiency or those who take serotonergic drugs. Alternative treatments include high-dose ascorbic acid, exchange transfusion therapy, and hyperbaric oxygenation. The authors report a case of a 39-year-old female who took phenazopyridine for 2 weeks to treat dysuria from a urinary tract infection and subsequently developed methemoglobinemia. The patient had contraindications for the use of methylene blue and was therefore treated with high-dose ascorbic acid. The authors hope that this interesting case promotes further research into the utilization of high-dose ascorbic acid for managing methemoglobinemia in patients who are unable to receive methylene blue.

Abstract licence: CC BY

Methemoglobinemia is a condition caused by elevated levels of methemoglobin (MetHb) in the blood, a reduced form of hemoglobin that cannot properly bind to oxygen, interfering with delivery to tissues. If left untreated, this condition can be fatal. Phenazopyridine, an over-the-counter urinary tract analgesic, has been reported to cause methemoglobinemia in rare instances. In the present case, a 67-year-old patient demonstrated hypoxia and oral cyanosis in the setting of chronic phenazopyridine use and chronic obstructive pulmonary disease (COPD). A "chocolate-brown" coloration of his blood and an elevated MetHb level of 14.5% confirmed the diagnosis of methemoglobinemia. He was treated with methylene blue, ascorbic acid, bronchodilators, steroids, and supportive oxygen. This regimen led to a gradual improvement in the patient's clinical condition, including his hypoxia, cyanosis, and MetHb levels. This report illustrates a rare, unique case of phenazopyridine-induced methemoglobinemia and acute hypoxic respiratory failure in a patient with pre-existing COPD. In such patients, effective management requires a careful treatment approach directed at both methemoglobinemia and COPD.

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Parkinson’s disease (PD) is a complex neurodegenerative disorder that affects multiple neurotransmitters, and its exact cause is still unknown. Developing new drugs for PD is a lengthy and expensive process, making it difficult to find new treatments. This study aims to create a detailed dataset to build strong predictive models with various machine learning algorithms. An ensemble modeling approach was employed to screen the DrugBank database, aiming to repurpose approved medications as potential treatments for Parkinson’s disease (PD). The dataset was constructed using pIC50 values of various compounds targeting the inhibition of leucine-rich repeat kinase 2 (LRRK2). The best ensemble model showed exceptional predictive performance, with five-fold cross-validation and external validation metrics exceeding 0.8 (Q2cv = 0.864 and Q2ext = 0.873). The DrugBank screening resulted in three promising drugs—triamterene, phenazopyridine, and CRA_1801—with predicted pIC50 values greater than 7, warranting further investigation as novel PD treatments. Molecular docking and molecular dynamics simulations were performed to provide a comprehensive understanding of the interactions between LRRK2 and the inhibitors in the data set and best molecules of the screening. Free energy of binding calculation along with hydrogen bond occupancy analysis and RMSD of the ligand in the pocket show CRA_1801 as the best candidate to be repurposed as LRRK2 inhibitor.

Abstract licence: CC BY-NC-ND

Methemoglobinemia is a rare but serious condition affecting the blood's ability to carry oxygen. Symptoms at presentation are often nonspecific. We describe the case of a 58-year-old female presenting with unexplained central cyanosis and severe hypoxia despite preserved respiratory effort and seemingly reassuring lab values. Further questioning revealed recent ingestion of a large quantity of phenazopyridine, an over-the-counter urinary analgesic known to cause oxidative stress. Co-oximetry confirmed significant elevation of methemoglobin levels. Methylene blue is well-regarded as the gold standard, and its use in treatment of this patient led to favorable clinical and laboratory improvement. Clinicians must maintain a high index of suspicion for dyshemoglobinemias in patients with unexplained cyanosis refractory to oxygen therapy, particularly when conventional metrics of oxygenation are inconsistent with the overall clinical picture.

Abstract licence: CC BY