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Related Experiment Videos

An over-the-counter omission.

Danielle Bowen Scheurer1

  • 1Brigham and Women's Hospital, Department of Medicine, 75 Francis Street, PB/B4/424, Boston, MA 02115, USA. dscheurer@partners.org

Southern Medical Journal
|September 29, 2006
PubMed
Summary

Chronic use of phenazopyridine, a common over-the-counter (OTC) medication, can cause acute renal failure and hemolytic anemia. Discontinuation of phenazopyridine led to full recovery, highlighting the importance of patient history and education regarding OTC drug safety.

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Area of Science:

  • Nephrology
  • Hematology
  • Clinical Pharmacology

Background:

  • Over-the-counter (OTC) medications are widely used but their utilization is infrequently assessed during hospital admissions.
  • Adverse drug reactions from OTCs can mimic various medical conditions, complicating diagnosis.

Observation:

  • A patient presented with acute renal failure and hemolytic anemia.
  • Clinical signs included scleral icterus, normal bilirubin levels, and characteristic orange-colored urine.

Findings:

  • Chronic use of phenazopyridine, an OTC urinary analgesic, was identified as the cause of the patient's renal and hematologic complications.
  • Discontinuation of phenazopyridine resulted in complete normalization of renal function and hematologic parameters within one month.

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Implications:

  • This case underscores the potential for serious adverse events from the overuse of common OTC medications.
  • Highlights the critical need for thorough patient history-taking regarding OTC medication use and patient education on potential risks.
  • Emphasizes the importance of considering phenazopyridine toxicity in the differential diagnosis of acute kidney injury and hemolytic anemia, especially with characteristic urinary and clinical findings.