GENERIC NAME: nitrofurantoin
BRAND NAMES: Macrodantin; Furadantin; Macrobid
DRUG CLASS AND MECHANISM: Nitrofurantoin is an anti-
bacterial that is used to treat urinary tract infections caused by many gram-negative and some gram-positive bacteria. Three forms are
available: a microcrystalline form (Furadantin), a macrocrystalline form (Macrodantin), and a sustained release macrocrystalline form
used twice daily (Macrobid). The macrocrystalline form is more slowly
absorbed than the microcrystalline form and is useful for patients who cannot tolerate the microcrystalline form. Nitrofurantoin interferes with the bacterial metabolism of carbohydrate and also disrupts the formation of the bacterial cell wall. Nitrofurantoin was approved by the FDA in 1953.
PRESCRIPTION: yes
GENERIC AVAILABLE: yes
PREPARATIONS: Capsules (Macrodantin): 25mg, 50mg, 100mg.
Sustained-release capsules (Macrobid): 100 mg. Tablets (Furadantin): 50mg, 100mg. Oral suspension (Furadantin): 50mg per teaspoonful.
STORAGE: All formulations should be kept at room
temperature, 15-30°C (59-86°F).
PRESCRIBED FOR: Nitrofurantoin is used to treat or
prevent urinary tract infections.
DOSING: Nitrofurantoin can be taken with or without
meals. Taking it with meals increases its absorption into the body. The suspension can be mixed with water, milk, juice, or infant
formula. Except for the sustained-release product (Macrobid), nitrofurantoin usually is given 4 times daily to treat urinary tract infections. It also is used once a day (or in some children, twice daily) to prevent urinary tract infections. It should not be used in persons with poor kidney function.
DRUG INTERACTIONS: High doses of probenecid (Benemid) or
sulfinpyrazone (Anturane) can partially block the kidney's elimination of
nitrofurantoin. This can increase the blood concentrations of
nitrofurantoin and the risk of toxicity from nitrofurantoin.
Higher concentrations of nitrofurantoin also can occur with the use of
medications that slow the rate of stomach emptying. Such drugs
include propantheline (Probanthine), dicyclomine (Bentyl), and bethanechol (Urecholine).
PREGNANCY: Although there are no adequate studies of
nitrofurantoin in pregnant women, many women have used it during
pregnancy, and it has proved to be safe. Studies in animals
suggest no important effects on the fetus. Nitrofurantoin, therefore, can be used in pregnancy if the physician feels that it is necessary. However, nitrofurantoin should not be used near term (38-42 weeks
gestation) since it interferes with the immature enzyme systems in the red blood cells of newborns, damaging the cells and resulting in anemia.
NURSING MOTHERS: Nitrofurantoin is distributed into breast milk and should be used with caution in women who are breast-
feeding.
SIDE EFFECTS: The most common side effects noted with
nitrofurantoin are gastrointestinal, including nausea, vomiting, loss of appetite, diarrhea, and abdominal pain. The macrocrystalline
form (Macrodantin) appears to cause fewer side effects. The side
effects also can be minimized by using a lower dose (with the physician's consent) or by taking the drug with food or milk. Headache is the most common nervous system effect.
Nitrofurantoin can cause serious lung injury. The reaction can
occur within hours of the start of treatment if the patient has
previously received nitrofurantoin or within a few days of starting
nitrofurantoin
for the first time. Symptoms include difficult breathing,
chills, fever,
chest pain, and cough. In other persons, lung injury may occur
after
approximately a month of treatment. Symptoms include difficult
breathing,
rapid breathing, and cough. Fortunately, the symptoms usually
resolve
within a week if the medication is stopped. In still other
persons, lung
injury may not develop until after several months or years of
therapy.
Unless it is recognized and treated, this delayed lung injury
can result
in permanent lung damage that remains even after the drug is
stopped.
Allergic skin reactions also can occur, including some which
are severe.
A condition known as peripheral neuropathy (damage to the
nerves of the
arms and legs), may occur with nitrofurantoin therapy, most
commonly
causing tingling in the extremities. The condition can become
severe and
is more likely to occur in patients with diabetes mellitus,
vitamin B
deficiency or general debilitation.
A type of anemia (reduced red blood cell count) called
hemolytic anemia
can occur during therapy with nitrofurantoin. This reaction
occurs most
frequently in persons with a deficiency of an enzyme called
glucose-6-phosphate dehydrogenase which is very important to
the survival
of red blood cells.
Nitrofurantoin also can cause liver damage leading to jaundice
or a form
of hepatitis which can be fatal. Elevated liver enzymes
indicate liver
damage and are a reason to stop the drug.
Treatment with nitrofurantoin can cause urine to change color
to a dark
yellow or brown.
Last Editorial Review: 3/26/1998 2:30:00 PM
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From the Doctors at MedicineNet.com  |
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- Urinary Tract Infection In Adults - Read about urinary tract infection (UTI) causes (in men, women), symptoms, treatment (antibiotic medicine), recurrent bladder infection prevention (cranberry) and FAQ. Source:Government
- Urinalysis - Learn about the urinalysis test. Diseases and conditions such as urinary tract or kidney infection, kidney stones, kidney failure, diabetes, or high blood pressure can be diagnosed or monitored. Source:MedicineNet
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