nitrofurantoin microcrystals
Pregnancy Risk Category B
How supplied
nitrofurantoin macrocrystals
Capsules: 25 mg, 50 mg, 100 mg
nitrofurantoin microcrystals
Oral suspension: 25 mg/5 ml
Action
Unknown. Appears to interfere with bacterial enzyme systems and possibly with bacterial cell-wall formation.
Indications & dosage
Urinary tract infections due to susceptible Escherichia coli, Staphylococcus aureus, enterococci; or certain strains of Klebsiella and Enterobacter--
Adults and children over age 12: 50 to 100 mg P.O. q.i.d. with meals and h.s.
Children ages 1 month to 12 years: 5 to 7 mg/kg P.O. daily, divided q.i.d.
Long-term suppression therapy--
Adults: 50 to 100 mg P.O. daily h.s.
Children: 1 mg/kg P.O. daily in a single dose h.s. or divided into two doses given q 12 hours.
Adverse reactions
CNS: peripheral neuropathy, headache, dizziness, drowsiness, ascending polyneuropathy with high doses or renal impairment.
GI: anorexia, nausea, vomiting, abdominal pain, diarrhea.
Hematologic: hemolysis in patients with G6PD deficiency, agranulocytosis, thrombocytopenia.
Hepatic: hepatitis, hepatic necrosis, elevated bilirubin and alkaline phosphatase.
Metabolic: hypoglycemia.
Respiratory: pulmonary sensitivity reactions, asthmatic attacks.
Skin: maculopapular, erythematous, or eczematous eruption; transient alopecia; pruritus; urticaria; exfoliative dermatitis; Stevens-Johnson syndrome.
Other: hypersensitivity reactions, anaphylaxis, drug fever, overgrowth of nonsusceptible organisms in urinary tract.
Interactions
Drug-drug. Magnesium-containing antacids: decreased nitrofurantoin absorption. Separate administration times by 1 hour.
Probenecid, sulfinpyrazone: increased blood levels and decreased urine levels. May result in increased toxicity and lack of therapeutic effect. Don't use together.
Drug-food. Any food: increased absorption. Give drug with food.
Effects on diagnostic tests
Nitrofurantoin may cause false-positive results in urine glucose tests using cupric sulfate (such as Benedict's reagent, Fehling's solution, or Clinitest) because it reacts with these agents.
Contraindications
Contraindicated in infants ages 1 month and under and in patients with moderate to severe renal impairment, anuria, oliguria, or creatinine clearance under 60 ml/minute. Contraindicated in pregnancy at term (38 to 42 weeks) and during labor and delivery.
Nursing considerations
Patient teaching
*Liquid contains alcohol. **May contain tartrazine. †Canada ‡Australia §U.K. OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING