Generic
Nitrofurantoin
30 brands available in the market
At a glance
Nitrofurantoin is an antibiotic used for treatment and prophylaxis of uncomplicated urinary tract infections. It kills bacteria in the urine to cure the infection.
Description
Nitrofurantoin is an antibacterial agent specific for urinary tract infections. It is highly soluble in urine and may impart a brown color. Nitrofurantoin inactivates or alters bacterial ribosomal proteins and other macromolecules. It is bactericidal to most gram-positive and gram-negative urinary tract pathogens.
Indications
- Acute uncomplicated urinary tract infections (caused by E. coli, Enterococci, S. aureus, S. saprophyticus, Klebsiella, Enterobacter)
- Prophylaxis of urinary tract infections
Therapeutic class
Systemic Urinary Anti-infective
Pharmacological class
Nitrofuran Antibiotic
Pharmacology
Nitrofurantoin interferes with cell metabolism and cell wall synthesis by inhibiting several enzyme systems including acetyl coenzyme A, resulting in bacterial cell death.
Mechanism of action
Treats urinary tract infections by killing bacteria in the urine.
Dosage
Adult Dose (Oral):
- Acute uncomplicated UTI: 50-100 mg 4 times daily for 7 days or 3 days after sterile urine; SR: 100 mg twice daily
- Prophylaxis: 50-100 mg at bedtime for up to 12 months
Pediatric Dose (>1 month):
- UTI: 5-7 mg/kg/day divided q6hr for 7 days
- Prophylaxis: 1-2 mg/kg at bedtime or 2 divided doses
Administration
- Take with food (to reduce nausea)
- Swallow tablet whole; do not chew, crush or break
- 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
- Headache
- Flatulence
- Dyspepsia
- Abdominal pain
- Constipation
- Dizziness, drowsiness
Precautions & warnings
- Discontinue if acute, sub-acute or chronic pulmonary reactions occur
- Do not take antacids containing magnesium trisilicate
- Caution in G6PD deficiency
- Caution in anemia, diabetes, electrolyte imbalance, vitamin B deficiency
- Caution while driving (may cause dizziness and drowsiness)
Contraindications
- Severe renal impairment (anuria, oliguria, CrCl <60 mL/min)
- Hypersensitivity
- G6PD deficiency
- Infants <3 months
- Pregnancy at term, during labour and delivery
Drug interactions
- Reduced excretion with probenecid or sulfinpyrazone
- Reduced absorption with magnesium trisilicate
- Antagonistic effects with quinolone antibacterials
- Reduced effects with carbonic anhydrase inhibitors or urinary alkalinisers
Food interactions
Alcohol may cause disulfiram-like reaction (flushing, increased heartbeat, nausea, thirst, chest pain, low blood pressure).
Use in pregnancy
Use in Pregnancy: Nitrofurantoin is safe during pregnancy (Category B); use only if clearly needed.
Pregnancy Category: B — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Nitrofurantoin is excreted in human milk in trace amounts; caution during breastfeeding; risk in infants under 1 month.
Pediatric use
Contraindicated in infants <3 months; dose established for >1 month.
Geriatric use
Elderly patients have increased risk of decreased renal function; caution.
Renal / hepatic impairment
Renal Impairment: Loses effectiveness in CrCl <60 mL/min; not recommended; monitor renal function regularly.
Hepatic Impairment: Caution in liver disease; not recommended in severe liver disease.
Overdose effects
Overdose: No specific symptoms other than vomiting; induction of emesis recommended.
Storage conditions
Do not store above 30°C; keep away from light; keep out of reach of children.
Chemical structure
Nitrofurantoin