Generic
Nalidixic Acid
18 brands available in the market
At a glance
Nalidixic Acid is a 4-quinolone antibiotic used for urinary tract infections and shigellosis. It inhibits bacterial DNA gyrase enzyme to prevent DNA replication.
Description
Nalidixic acid is a synthetic narrow spectrum antibacterial. It is bacteriostatic or bactericidal depending on concentration. It acts by inhibiting bacterial DNA synthesis, possibly by interfering with DNA polymerization. It is rapidly and completely absorbed from the GI tract and distributed to most tissues specially to kidney and urine.
Indications
- Urinary tract infections (caused by Proteus, Klebsiella, Enterobacter, E. coli)
- Shigellosis
Therapeutic class
Anti-diarrhoeal Antimicrobial Drugs, Systemic Urinary Anti-infective
Pharmacological class
4-Quinolone Antibiotic
Pharmacology
Nalidixic acid inhibits bacterial DNA gyrase enzyme to prevent DNA replication, resulting in bacterial cell death. It is active against gram-negative bacteria.
Mechanism of action
Treats urinary tract infections by inhibiting bacterial DNA replication.
Dosage
Adult Dose (Oral):
- Uncomplicated lower UTI: 1 g 4 times daily for 1-2 weeks; long-term: reduce to 2 g/day
- Shigellosis: 1 g 4 times daily for 5 days
Pediatric Dose (Oral):
- >3 months: 50 mg/kg daily in 4 divided doses; long-term: 30 mg/kg daily; prophylaxis: 15 mg/kg twice daily
- Shigellosis: 15 mg/kg 4 times daily for 5 days
Administration
- Take on empty stomach
- Use measuring cup
- Shake well before use
- Take at the same time each day
Missed dose
If you miss a dose, take it as soon as you remember; skip if it's almost time for next dose; do not double the dose.
Side effects
Common Side Effects:
- Nausea
- Vomiting
- Diarrhea
- Hemolysis in G6PD deficiency
- Allergic reactions (urticaria, rash, fever, arthralgia, eosinophilia)
- Myalgia, muscle weakness
- Phototoxicity
- Jaundice
- Visual disturbances
- Convulsions
Precautions & warnings
- Risk-benefit consideration in first trimester of pregnancy
- Caution during breastfeeding
- Caution in renal or hepatic impairment
- Caution while driving
- Avoid alcohol
Contraindications
- Hypersensitivity
- History of convulsive disorders
- Porphyria
- Infants <3 months
- Severe renal impairment
Drug interactions
- Reduced absorption with sucralfate and divalent/trivalent cations (aluminium, calcium, iron, magnesium, zinc)
- Reduced excretion and increased plasma concentrations with probenecid
- Reduced effects with chloramphenicol, nitrofurantoin, tetracycline
- Fatal hemorrhagic enterocolitis with high-dose melphalan
- May increase effects of warfarin
Food interactions
Alcohol may cause excessive drowsiness.
Use in pregnancy
Use in Pregnancy: Nalidixic Acid may be unsafe during pregnancy (Category C); animal studies show evidence of fetal harm.
Pregnancy Category: C — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Nalidixic Acid is safe during breastfeeding; not significantly excreted in breast milk.
Pediatric use
Contraindicated in infants <3 months; dose established for >3 months.
Geriatric use
Elderly may require dose adjustment.
Renal / hepatic impairment
Renal Impairment: Caution in kidney disease; dose reduction may be needed; monitor kidney function regularly.
Hepatic Impairment: Caution in liver disease; dose reduction may be needed; monitor liver function regularly.
Overdose effects
Overdose: Severe bloody diarrhea; symptomatic treatment.
Storage conditions
Store below 30°C; protect from light & moisture; keep out of reach of children.
Chemical structure
Nalidixic Acid