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Nitrofurantoin

    Brands

    DEA Class; Rx

    Common Brand Names; Macrobid, Macrodantin, Furadantin

    • Antibiotics, Other

    Oral nitrofuran antibacterial agent specifically used to treat urinary tract infections caused by many gram-negative and some gram-positive bacteria.

    Urinary Tract Infection

    Susceptible strains of Escherichia coli, Enterobacter spp, Klebsiella spp, Staphylococcus aureus, and S saprophyticus

    Renal failure (anuria, oliguria, or CrCl <60 mL/min)

    Pregnancy at term (38-42 weeks of gestation)

    History of hepatic dysfunction/cholestatic jaundice with nitrofurantoin

    Neonates (<28 days)

    Hypersensitivity

    • Anorexia
    • Arthralgia
    • Chest pains
    • Chills
    • Cough
    • Clostridium difficile colitis
    • Cyanosis secondary to methemoglobinemia
    • Diarrhea
    • Dizziness
    • Drowsiness
    • Dyspnea
    • Exfoliative dermatitis
    • Fatigue
    • Fever
    • Flatulence
    • Headache
    • Hemolytic anemia
    • Hepatitis
    • Increased LFTs
    • Itching
    • Nausea
    • Numbness
    • Paresthesia
    • Rash
    • Sore throat
    • Stomach upset
    • Vomiting
    • Weakness
    • Urine discoloration
    • Vasculitis

    Caution in patients with G6PD deficiency (may increase risk for hemolytic anemia)

    Avoid long-term use in the elderly (may increase risk for pulmonary toxicity)

    Renal impairment

    Discontinue if paresthesia or hemolysis develop

    Risk of occasional hepatotoxicity and pulmonary toxicity

    Protect from light

    Peripheral neuropathy may occur; risk may increase in patients diagnosed with anemia, diabetes, vitamin B deficiency, or electrolyte imbalance (use caution)

    Acute/chronic pulmonary reactions (eg., cough, interstitial pneumonitis or fibrosis) reported

    Bacterial superinfections may occur with prolonged treatment

    Pregnancy category: B; contraindicated at term

    Crosses placenta, but not well distributed

    Lactation: Enters breast milk; discontinue drug or do not nurse

    Adults

    200 mg/day PO for Macrobid; 400 mg/day PO for all other products.

    Geriatric

    200 mg/day PO for Macrobid; 400 mg/day PO for all other products.

    Adolescents

    200 mg/day for Macrobid; 7 mg/kg/day PO (Max: 400 mg/day) for all other products.

    Children

    7 mg/kg/day PO (Max: 400 mg/day) for all products except Macrobid; safety and efficacy of Macrobid not established in this population.

    Infants

    7 mg/kg/day PO.

    Neonates

    Contraindicated.

    Nitrofurantoin macrocrystals

    capsule, macrocrystals

    • 25mg
    • 50mg
    • 100mg

    capsule, monohydrate/macrocystals

    • 100 mg

    oral suspension

    • 25mg/5mL