Nitrofurantoin is a medication with the active ingredient nitrofurantoin. It is also known by the brand names Macrobid and Macrodantin. This medicine is used to treat urinary tract infections (UTIs) caused by bacteria. Nitrofurantoin works by killing the bacteria that cause the infection.
Nitrofurantoin pricing spectrum extends from £0.35 to £0.56 for each pills. The key influencers are pack magnitude and the grade of active substances (100 or 600 mg).
Nitrofurantoin is an antibacterial agent utilized primarily to treat urinary tract infections (UTIs). It belongs to the class of drugs known as nitrofuran derivatives. Its mechanism of action involves inhibiting bacterial enzyme systems, specifically targeting those involved in carbohydrate metabolism.
Nitrofurantoin is prescribed for the treatment and prophylaxis of acute, uncomplicated urinary tract infections caused by specific strains of Escherichia coli, Enterococci, and certain strains of Klebsiella and Staphylococcus species. It is ineffective against most other systemic infections.
Nitrofurantoin is available in various dosage forms, including capsules, tablets, and oral suspensions. The typical strengths include 25 mg/5 ml suspension, 50 mg, and 100 mg oral capsules. The macrocrystalline forms tend to be better tolerated due to slower release rates.
The medication should be taken with food to enhance absorption and minimize gastrointestinal side effects. It is often recommended to increase fluid intake while on this medication to help flush the urinary system. Adherence to dosing schedules is crucial for optimal effectiveness.
Nitrofurantoin is well-absorbed from the gastrointestinal tract. It is metabolized mainly through reduction, producing inactive metabolites. The drug’s elimination primarily occurs through renal excretion, with therapeutic concentrations achieved in the urine, facilitating its efficacy in UTIs.
Nitrofurantoin may interact with antacids containing magnesium trisilicate, which can reduce its absorption, and the uricosuric agent probenecid, which can inhibit its renal excretion. Co-administration with these agents should be closely monitored or avoided if possible.
This medication is contraindicated in patients with significant renal impairment, known hypersensitivity to nitrofurantoin, and in neonates (under 1 month of age). It is also contraindicated during the last stages of pregnancy (at term), as it may cause hemolytic anemia in the newborn.
Common side effects include gastrointestinal disturbances like nausea, vomiting, and anorexia. Pulmonary reactions such as acute, subacute, or chronic pulmonary hypersensitivity reactions can occur. Infrequent but severe adverse effects include peripheral neuropathy and hepatotoxicity.
Routine monitoring of renal function is advisable due to the drug’s renal excretion. Patients on prolonged therapy should undergo periodic liver function tests. Monitoring for signs of pulmonary reactions, particularly in long-term use, is crucial.
Nitrofurantoin should be stored at room temperature, away from excessive moisture and heat. The suspension form should be shaken well before each dose and kept in a refrigerator, but it should not be frozen. Discard any remaining suspension after the completion of the treatment course.
During pregnancy, nitrofurantoin should only be used when clearly needed and avoided near term due to the risk of hemolytic anemia in the newborn. Breastfeeding mothers should consult their healthcare provider, as the drug is excreted in small amounts into breast milk.
In elderly patients, renal function assessments are more critical to avoid adverse reactions associated with decreased renal function. For pediatric usage, dose adjustments based on weight are essential, and close monitoring is required due to the higher risk of side effects in this population.
Symptoms of overdose may include nausea, vomiting, and acute pulmonary reactions. Hemodialysis can accelerate the elimination of the drug from the body. Supportive measures should be initiated promptly, and symptomatic treatment provided as required.
Bacterial resistance to nitrofurantoin is generally less common compared to other antibiotics, but it can occur. Resistance mechanisms include modifications of target sites and enzymatic inactivation. Regular susceptibility testing is recommended for prolonged or recurrent infections.