nitrofurantoin: UTI Uses, Side Effects & Dosage (original) (raw)
- Uses
- Side Effects
- Dosage
- Drug Interactions
- Pregnancy & Breastfeeding
- What Else to Know
- Comments
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Generic Name: nitrofurantoin
Brand Names: Macrodantin, Furadantin, Macrobid
Drug Class: Antibiotics, Other
What is nitrofurantoin, and what is it used for?
Nitrofurantoin is an antibiotic that is used for treating urinary tract infections caused by several types of bacteria. It is effective against E. Coli, Enterobacter cystitis, Enterococcus, Klebsiella, and Staphylococcus aureus. Nitrofurantoin interferes with the production of bacterial proteins, DNA, and cell walls. Bacteria cannot survive without a cell wall or multiply without DNA.
Three forms of nitrofurnatoin are available:
- Furadantin, a microcrystalline form,
- Macrodantin, a macrocrystalline, and
- Macrobid, a sustained release form of macrocrystalline used twice daily.
The macrocrystalline form is more slowly absorbed than the microcrystalline form and is useful for patients who cannot tolerate the microcrystalline form.
What are the side effects of nitrofurantoin?
- Common side effects of nitrofurantoin include:
- The macrocrystalline form (Macrodantin) appears to cause less stomach upset. Stomach upset also can be minimized by using a lower dose or by taking nitrofurantoin with food or milk.
- Possible serious side effects include:
- Lung injury
- Anemia
- Liver damage
- Exfoliative dermatitis
- Clostridium difficile colitis
- Vasculitis
- 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:
- Difficulty breathing
- Chills
- Fever
- Chest pain
- Cough
- In other persons, lung injury may occur after approximately a month of treatment. Symptoms include:
- Difficulty breathing
- Rapid breathing
- Cough
- Fortunately, the symptoms usually resolve within a week if the medication is stopped. In other individuals, 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.
- Nitrofurantoin can also cause damage to the sensory nerves of the arms and legs (peripheral neuropathy), which can cause tingling in the extremities. The condition can become severe and is more likely to occur in people with diabetes, vitamin B deficiency, or general debilitation.
- Reduced red blood cell count (anemia) by breaking red blood cells (hemolytic anemia) can occur from nitrofurantoin. This reaction occurs most frequently in persons with a deficiency of an enzyme called glucose--6-phosphate dehydrogenase that is very important to the survival of red blood cells.
- Nitrofurantoin also can cause liver damage leading to jaundice or a form of hepatitis that 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.
SLIDESHOW Urinary Incontinence in Women: Types, Causes, and Treatments for Bladder Control See Slideshow What is the dosage for nitrofurantoin?
- The recommended adult dose for treating urinary tract infections is 50-100 mg 4 times daily (Macrodantin, Furadantin) or 100 mg every 12 hours (Macrobid) for 7 days or for 3 days after obtaining sterile urine.
- 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.
- 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.
Which drugs interact with nitrofurantoin?
- High doses of probenecid (Benemid) or sulfinpyrazone (Anturane) can partially block the kidneys' elimination of nitrofurantoin. This can increase the blood concentrations of nitrofurantoin and the risk of toxicity from nitrofurantoin.
- Concomitant administration of a magnesium trisilicate antacid may decrease the absorption of nitrofurantoin, reducing the effectiveness of nitrofurantoin.
- Nitrofurantoin may reduce the activity of live tuberculosis vaccine (BCG vaccine) and live typhoid vaccine. In laboratory tests, nitrofurantoin reduced the effect of quinolone antibiotics, for example, norfloxacin (Noroxin). Therefore, nitrofurantoin should not be combined with quinolone antibiotics.
Health News
Is nitrofurantoin safe to use during pregnancy or while breastfeeding?
- Although there are no adequate studies of nitrofurantoin in pregnant women, many women have safely used it during pregnancy. However, nitrofurantoin should not be used near the time of delivery (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.
- Nitrofurantoin is distributed into breast milk and should be used with caution in women who are breastfeeding.
What else should I know about nitrofurantoin?
Do I need a prescription for nitrofurantoin (Macrobid, Macrodantin, Furadantin)?
Yes
What preparations of nitrofurantoin (Macrobid, Macrodantin, Furadantin) are available?
- Capsules: 25, 50, 75, and 100 mg.
- Oral suspension: 25 mg/5 ml.
How should I keep nitrofurantoin (Macrobid, Macrodantin, Furadantin) stored?
- All formulations should be kept at room temperature, 15 C TO 30 C (59 F to 86 F).
When was nitrofurantoin (Macrobid, Macrodantin, Furadantin) approved by the FDA?
- The FDA approved nitrofurantoin in 1953.
Summary
Nitrofurantoin is a drug available in three forms prescribed for the treatment or prevention of urinary tract infections (UTIs). Common side effects include loss of appetite, diarrhea, abdominal pain, vomiting, and rash. Review warnings and precautions, drug interactions, and pregnancy and breastfeeding safety information prior to taking any medication.
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Related Disease Conditions
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Can You Flush Out a UTI With Water? Patients with urinary tract infection (UTI) are usually advised to drink six to eight glasses (1.5 to 2 liters) of water every day to flush the infection out of the urinary system. -
Liver Disease Liver disease can be cause by a variety of things including infection (hepatitis), diseases, for example, gallstones, high cholesterol or triglycerides, blood flow obstruction to the liver, and toxins (medications and chemicals). Symptoms of liver disease depends upon the cause and may include nausea, vomiting, upper right abdominal pain, and jaundice. Treatment depends upon the cause of the liver disease. -
Urinary Tract Infection (UTI) A urinary tract infection (UTI) is an infection of the bladder, kidneys, ureters, or urethra. E. coli, a type of bacteria that lives in the bowel and near the anus, causes most UTIs. UTI symptoms include pain, abdominal pain, mild fever, urinary urgency, and frequency. Treatment involves a course of antibiotics. -
How Long Should a UTI Last After Antibiotics? Depending on the severity of your UTI, you may need to take a 3-day, 7-day or even 2-week course of antibiotics. Since the bacteria causing your UTI can stay in your body even after symptoms are gone, it’s important to finish your entire course of antibiotics. - How Long Does It Take a UTI to Turn Into a Kidney Infection? Failing to treat a urinary tract infection can lead to serious health problems, including kidney infections. If you have lingering symptoms, or recurrent UTIs, it is important to see your medical provider.
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How Can I Treat a UTI While Pregnant Without Antibiotics? What is a UTI? Learn what other treatments aside from antibiotics can help to relieve your UTI symptoms while pregnant. - Can You Get Rid of a UTI By Drinking Water? UTI stands for urinary tract infection and it describes when your urinary system gets infected. While the effects of drinking water to flush out or get rid of UTIs is not proven, there has been a link between drinking over 2.2 liters of water daily and a decreased risk for UTIs.
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Is a Urinary Tract Infection (UTI) Contagious? Bacteria such as E. coli or Pseudomonas can cause a urinary tract infection (UTI). The incubation period for a UTI ranges from three to eight days. -
Is E. coli Contagious? E. coli is an infection found worldwide. There are several subtypes of the E. coli species. E. coli spreads from person to person via contaminated food or water. Symptoms and signs of E. coli infection include diarrhea, stomach cramps, and sometimes fever. Antibiotics treat E. coli infection. - How Do You Know if a UTI Has Spread to Your Kidneys? A UTI is an infection anywhere in the urinary tract. Signs that a UTI has spread to the kidneys include chills, high fever, nausea, and vomiting, and other signs.
- Can UTI Symptoms Linger After Antibiotics? Sometimes, UTI symptoms can linger even after antibiotic therapy. Reasons for this may be that your UTI is caused by an antibiotic-resistance strain of bacteria or caused by another type of bacteria, or you may have another condition entirely that causes UTI-like symptoms.
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E. coli (0157:H7) Infection There are many types of E. coli (Escherichia coli). E. coli can cause urinary tract and bladder infections, or lead to sepsis. E coli O157:H7 (EHEC) causes bloody diarrhea and colitis. Complications of E. coli infection include hemorrhagic diarrhea, hemolytic-uremic syndrome, and thrombotic thrombocytopenic purpura. Symptoms include severe abdominal pain and bloody diarrhea. E coli O157:H7 commonly is due to eating raw or undercooked hamburgers or raw milk or dairy products. -
Yeast Infection vs. Urinary Tract Infection (UTI) Candida albicans typically causes vaginal yeast infections. Bacterial infections typically cause urinary tract infections (UTIs). Thick white cottage-cheese like vaginal discharge characterizes vaginal yeast infections. Painful, frequent urination characterize urinary tract infections. Antifungal medications treat yeast infections while prescription antibiotics treat UTIs. -
Urinary Tract Infections in Children Urinary tract infections (UTIs) are very common in children. Symptoms and signs include fever and abdominal pain. Associated symptoms and signs include flank pain, vomiting, and blood in the urine. Treatment for a UTI involves antibiotic therapy. - What Does the Beginning of a UTI Feel Like? Learn the symptoms seen in the early stages of a UTI below, which include a burning sensation during urination and pain in the lower abdomen.
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Enterovirulent E. coli (EEC) Enterovirulent Escherichia coli (E. coli) are strains of related bacteria that have a strong propensity to cause gastrointestinal tract infections. Examples of strains include EHEC (enterohemorrhagic E. coli), ETEC (enterotoxigenic E. coli), EPEC (enteropathogenic E. coli), EIEC (enteroinvasive E. coli), EAEC (enteroadherent E. coli), and EAggEC (enteroaggregative E. coli). Symptoms may vary depending on the strain the individual contracts. Infection is spread generally through contaminated food or drink. -
What Is the Best Treatment for Urinary Tract Infection? In most cases, the best treatment for a urinary tract infection (UTI) is a course of antibiotics. Which antibiotics are prescribed depend on the type of bacteria responsible.
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References
Medically reviewed by John P. Cunha, DO, FACOEP; Board Certified Emergency Medicine
REFERENCE:
FDA Prescribing Information