Phenazopyridine Template
Prescription Template
400 Taché Ave, Winnipeg, MB R2H 2A4
Phone: (204) 233-3469 Fax: (204) 231-1739
Patient
SexMF
Preparation
Check one
Commercial phenazopyridine (Pyridium) is discontinued in Canada. We compound capsules to order for short-course urinary analgesia alongside antibiotic treatment.
Phenazopyridine 100 mg capsules
Phenazopyridine 200 mg capsules
Directions
Take
capsule(s) three times daily after meals for days (commonly 2 days while antibiotics take effect)
Patients are counselled that urine turns orange-red and can stain; not for use beyond short courses or with significant renal impairment.
Quantity
capsules
Refills
Prescriber
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Signature