Nitrofurantoin

Aka: Nitrofurantoin, Macrodantin, Macrobid, Furadantin

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II. Indications

  1. Urinary Tract Infection

III. Contraindications

  1. Prolonged use longer than 6 months
  2. Prolonged use >14 days in age over 65 years (relative contraindication if normal Renal Function)
  3. Creatinine Clearance <30-40 ml/min (short-term use <14 days appears safe at GFR >30 ml/min)
  4. References
    1. (2018) Presc Lett 25(8)
    2. Oplinger (2013) Ann Pharmacother 47(1):106-11 [PubMed]

IV. Adverse Effects

  1. Pulmonary fibrosis
    1. Chronic Nitrofurantoin use
  2. Acute Nitrofurantoin Pulmonary Toxicity

V. Preparations

  1. Macrobid
    1. Capsules: 100 mg
  2. Nitrofurantoin
    1. Capsules: 25 mg, 50 mg, 100 mg
    2. Suspension: 25 mg per 5 ml

VI. Technique

  1. Take immediately after food to increase absorption
  2. Food decreases gastrointestinal upset

VII. Dosing: Adults

  1. Nitrofurantoin: 50 to 100 mg orally four times daily
  2. Macrobid: 100 mg orally twice daily
  3. Course: 5 days (instead of 7) is sufficient for uncomplicated UTI in non-pregnant women
    1. Gupta (2007) Arch Intern Med 167(20):2207-12 [PubMed]

VIII. Dosing: Children

  1. Nitrofurantoin: 5-7 mg/kg/day divided qid

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Cost: Medications

nitrofurantoin (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
NITROFURANTOIN 25 MG/5 ML SUSP Generic $1.44 per ml
NITROFURANTOIN MCR 100 MG CAP Generic $0.99 each
NITROFURANTOIN MCR 25 MG CAP Generic $4.68 each
NITROFURANTOIN MCR 50 MG CAP Generic $0.65 each
NITROFURANTOIN MONO-MCR 100 MG Generic $0.85 each
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information.

Ontology: Nitrofurantoin (C0028156)

Definition (NCI) A synthetic derivative of imidazolidinedione, Nitrofurantoin inhibits bacterial DNA, RNA, and cell wall protein synthesis. Activated by bacterial flavoproteins to intermediates that inactivate bacterial ribosomal proteins, Nitrofurantoin is used prophylactically as a urinary anti-infective agent against most gram-positive and gram-negative organisms and for long-term suppression of infections. (NCI04)
Definition (MSH) A urinary anti-infective agent effective against most gram-positive and gram-negative organisms. Although sulfonamides and antibiotics are usually the agents of choice for urinary tract infections, nitrofurantoin is widely used for prophylaxis and long-term suppression.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D009582
SnomedCT 373543005, 85343003
LNC LP16140-3, MTHU008460
English Nitrofurantoin, 2,4-Imidazolidinedione, 1-(((5-nitro-2-furanyl)methylene)amino)-, nitrofurantoin, nitrofurantoin (medication), urological antibacterial nitrofurantoin, Nitrofurantoin [Chemical/Ingredient], NITROFURANTOIN, Nitrofurantoin (product), Nitrofurantoin (substance)
Swedish Nitrofurantoin
Czech nitrofurantoin
Finnish Nitrofurantoiini
Russian NITROFURANTOIN, FURADONIN, НИТРОФУРАНТОИН, ФУРАДОНИН
Japanese ニトロフラントイン
Croatian NITROFURANTOIN
Spanish Nitrofurantoína, nitrofurantoína (producto), nitrofurantoína (sustancia), nitrofurantoína
Polish Furadantyna, Nitrofurantoina
French Nitrofurantoïne
German Nitrofurantoin
Italian Nitrofurantoina
Portuguese Nitrofurantoína
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Macrobid (C0591750)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
English Macrobid, macrobid
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Macrodantin (C0700187)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D009582
English macrodantin, Macrodantin
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Pharmacology

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