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Nitrofurantoin

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Molecule Description

Nitrofurantoin is an antibiotic medicine. It is primarily used to treat and prevent common urinary tract infections (UTIs), especially those affecting the bladder. It has a targeted action: it is filtered into the urine, where it reaches high concentrations directly at the infection site. This minimizes its effect on "good" bacteria elsewhere in your body, like your gut. The molecule works by interfering with the bacteria's key processes, preventing them from growing and multiplying, essentially killing the germs that cause the infection. You must finish the entire course of medicine, even if your symptoms disappear, to ensure the infection is completely cleared and prevent the bacteria from becoming resistant to the medicine. Common side effects include headache and harmlessly dark yellow or brown urine. Food significantly increases it's absorption and helps reduce common side effects like nausea, vomiting, and stomach upset.

Uses

Nitrofurantoin is used for treatment, prevention and long-term suppression of uncomplicated urinary tract infections.

Contraindications

When should one not use Nitrofurantoin

  • Allergy to Nitrofurantoin, other medicines containing Nitrofurantoin.
  • Kidney disease (moderate to severe)
  • A blood disorder in which there is over-accumulation of blood forming proteins (porphyria)
  • A blood disorder that causes break-down of red blood cells (G6PD - Glucose-6-Phosphate Dehydrogenase deficiency)
  • Infants under three months of age

Side effects

Common side effects of this drug are:

  • Headache
  • Nausea, vomiting
  • Stomach pain, reduced hunger, loose stools
  • Feeling dizzy, drowsiness
  • Damage to red blood cells – easy bruising, delayed clotting, low blood counts, fever, sore throat
  • Nervous system disorders – changes of mood, confusion, weakness, blurred vision
  • Skin rashes, reddened skin (due to damage of small blood vessels), blisters with or without rapid heart rate
  • Pain in the face, stomach and joints (due to reactive salivary glands, pancreas)
  • Liver and kidney disorders
  • Urinary tract infections (by bacteria that are not killed by Nitrofurantoin)
  • Loss of hair
  • Collapse/ loss of consciousness, lung problems – fever, chills, cough, fast breathing

Precautions and Warnings

Pregnancy

Pregnancy

Nitrofurantoin is not known to harm the unborn baby but may harm the newborn. That is why it is not recommended during labor, delivery and for infants who are less than three months old. If you want to use Nitrofurantoin during first 6 months of your pregnancy, a lower dose than usual is recommended if no other alternatives are available.

Breast Feeding

Breast Feeding

Nitrofurantoin can be used while you are breastfeeding if your baby is more than three months and does not have any blood cell disorders.

Driving

Driving

Nitrofurantoin may cause dizziness, drowsiness or decrease alertness and hence caution is advised. You may avoid driving if any such symptoms are present.

Alcohol

Alcohol

Nitrofurantoin does not interact with alcohol but you are advised to limit your alcohol intake because it may complicate a urinary infection.

Other General Warnings

Other General Warnings

Talk to your doctor if
  • You have diabetes
  • You have low red blood count or Vitamin B12 deficiency
  • You have any disease that may cause severe weakness
  • You have any diseases of the lungs or the nervous system
  • You have a history of allergic reactions
  • You pass dark coloured urine
  • You experience any symptoms of liver disease - fatigue, yellow eyes (jaundice), joint pains, stomach discomfort, vomiting, reduced hunger and pale/ grey coloured stools

Mode of Action

How Does It Work?

Nitrofurantoin kills the bacteria by entering their cells and damaging their genetic material (DNA) in the urinary bladder, kidney and other parts of the urinary tract.

Interactions

Interactions with other medicines

  • Medicines used for indigestion (antacids – Magnesium Trisilicate, etc.)
  • Medicines used for gout (Probenecid, Sufinpyrazone, etc.)
  • Medicines used to treat raised pressure in the eyes (glaucoma-Acetazolamide, etc.)
  • Medicines used to reduce acidity of urine (Potassium Citrate)
  • Medicines used to treat certain infections (Quinolones-Ciprofloxacin, Norfloxacin, etc.)
  • Typhoid vaccine

Interactions with food items

Nitrofurantoin must be taken with food – meals or milk. This will cause the medicine to be better absorbed and reduces side effects.

Dietary Restrictions

No information is available on dietary restrictions while you are taking this medicine, consult your doctor or pharmacist for further information.

Dosage

Overdose

Accidental overdose of Nitrofurantoin may irritate the stomach, nausea or vomiting. Medical attention may be necessary in case of high overdose. Inform your doctor if you experience any new symptoms.

Missed a Dose

It depends on your condition and dosage. In some situations, Nitrofurantoin may be prescribed once a day and in some others, 2-4 times a day. Check the time interval specified by your doctor between 2 doses. If it is once a day, you can take the missed dose as soon as you remember. If it is 2-4 times a day, you may skip the missed dose and continue with the next dose. Do not take a double dose to make up for a forgotten dosage. If you are not sure, ask your doctor or pharmacist.

Frequently Asked Questions (FAQs)

Nitrofurantoin will cause brown or rust coloured urine. This is not a sign to worry and your urine colour will return to normal after stopping the medicineIn some patients, Nitrofurantoin can cause loose motions which may be severe. In such cases, do not self-medicate and inform your doctor

Nitrofurantoin does not cause the blood sugar to rise but if specific methods test your urine, they will show elevated sugars. This is known as a false-positive result due to a chemical reaction and not due to elevation of sugars.

Take Nitrofurantoin exactly as your doctor prescribed. Taking it with food helps your body absorb the medicine better and can reduce stomach upset. Finish the entire prescribed course, even if you feel better.

Common side effects include nausea, vomiting, diarrhea, stomach upset, and loss of appetite. Taking the medicine with food can often help reduce these. Your urine may also turn a harmless dark yellow or brown color.

Long-term use of Nitrofurantoin (usually over six months) should be carefully monitored by a doctor and is typically only used to prevent recurrent UTIs. Prolonged use can, in rare cases, lead to serious lung or liver problems or nerve damage (peripheral neuropathy).

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