Nitrofurantoin[ Macrodantin ] Drug Information

Contains Nitrofurantoin drug information and provides Nitrofurantoin drug indication, contraindication, special concerns, side effects, overdose management and dosage
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UTIs due to susceptible strains of Escherichia coli, Staphylococcus aureus (not for treatment of pyelonephritis or perinephric abscesses), enterococci, and certain strains of Enterobacter and Klebsiella.
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Anuria, oliguria, and clients with impaired renal function (CCR below 40 mL/min); pregnant women, especially near term; infants less than 1 month of age; and lactation.
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Special Concerns:
Use with extreme caution in anemia, diabetes, electrolyte imbalance, avitaminosis B, or a debilitating disease. Safety during lactation has not been established.
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Side Effects:
Nitrofurantoin is a potentially toxic drug with many side effects. GI: N&V, anorexia, diarrhea, abdominal pain, parotitis, pancreatitis. CNS: Headache, dizziness, vertigo, drowsiness, nystagmus, confusion, depression, euphoria, psychotic reactions (rare). Hematologic: Leukopenia, thrombocytopenia, eosinophilia, megaloblastic anemia, agranulocytosis granulocytopenia, hemolytic anemia (especially in clients with G6PD deficiency). Allergic: Drug fever, skin rashes, pruritus, urticaria, angioedema, exfoliative dermatitis, erythema multiforme (rarely, Stevens-Johnson syndrome), anaphylaxis arthralgia, myalgia, chills, sialadenitis, asthma symptoms in susceptible clients; maculopapular, erythematous, or eczematous eruption. Pulmonary: Sudden onset of dyspnea, cough, chest pain, fever and chills; pulmonary infiltration with consolidation or pleural effusion on x-ray, elevated ESR, eosinophilia. After subacute or chronic use: dyspnea, nonproductive cough, malaise, interstitial pneumonitis. Permanent impairment of pulmonary function with chronic therapy. A lupus-like syndrome associated with pulmonary reactions. Hepatic: Hepatitis, cholestatic jaundice, chronic active hepatitis, hepatic necrosis (rare). CV: Benign intracranial hypertension, changes in ECG, collapse, cyanosis. Miscellaneous: Peripheral neuropathy, asthenia, alopecia, superinfections of the GU tract, muscle pain.
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Overdose Management:
Symptoms: Vomiting (most common). Treatment: Induce emesis. High fluid intake to promote urinary excretion. The drug is dialyzable.
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Drug Interactions:
Acetazolamide / Nitrofurantoin effect R/T urine alkalinity produced by acetazolamide Antacids, oral / Nitrofurantoin effect R/T GI tract absorption Anticholinergic drugs / Nitrofurantoin effect R/T stomach absorption Magnesium trisilicate / Nitrofurantoin absorption from GI tract Nalidixic acid / Effect of nalidixic acid Probenecid / High doses secretion of nitrofurantoin toxicity Sodium bicarbonate / Nitrofurantoin effect R/T urine alkalinity produced by sodium bicarbonate
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Capsules, Oral Suspension UTIs.

Adults: 50-100 mg q.i.d., not to exceed 600 mg/day. For cystitis, Macrobid is given in doses of 100 mg b.i.d. for 7 days. Pediatric, 1 month of age and over: 5-7 mg/kg/day in four equal doses.

Prophylaxis of UTIs.

Adults: 50-100 mg at bedtime. Pediatric, 1 month of age and over: 1 mg/kg/day at bedtime or in two divided doses daily.
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