Nitrofurantoin
An antibiotic used to treat urinary tract infections.
Information about Nitrofurantoin[edit source]
Nitrofurantoin is an oral antibiotic widely used either short term to treat acute urinary tract infections or long term as chronic prophylaxis against recurrent infections.
Liver safety of Nitrofurantoin[edit source]
Nitrofurantoin is one of the most common causes of drug induced liver disease and can cause either an acute or a chronic hepatitis-like syndrome that can be severe and lead to liver failure or cirrhosis.
Mechanism of action of Nitrofurantoin[edit source]
Structurally, nitrofurantoin (nye" troe fure an' toyn) is a nitrated 5-member furan ring with a side chain of hydantoin. Nitrofurantoin inhibits several bacterial enzyme systems and has broad antibacterial activity. Its precise mechanism of action is not known. Importantly, antibacterial resistance to nitrofurantoin is rare, which makes it an attractive choice for long term treatment. In addition, nitrofurantoin is well absorbed orally and is rapidly excreted in the urine so that drug levels in urine are high while serum levels are minimal, which makes it an appropriate agent to treat urinary tract but not systemic infections.
FDA approval information for Nitrofurantoin[edit source]
Nitrofurantoin was first approved for use in the United States in 1953 and is still in wide use with more than 5 million prescriptions filled yearly. Current indications are treatment of acute and prophylaxis against chronic or recurrent urinary tract infections due to susceptible organisms.
Dosage and administration for Nitrofurantoin[edit source]
For treatment of acute infections, the recommended regimen is 50 to 100 mg orally four times daily for one week. For prophylaxis against chronic or recurrent infections, the recommended dose is 50 to 100 mg daily long term.
Generic formulations are available (25, 50, and 100 mg); specific commercial names include Macrodantin, Macrobid and Furadantin, among others.
Side effects of Nitrofurantoin[edit source]
Common side effects include nausea, diarrhea, dyspepsia, dizziness, drowsiness and rash. Nitrofurantoin has multiple rare, but potentially severe side effects that arise particularly with long term use and include interstitial pneumonitis, peripheral neuropathy, exfolative dermatitis, hemolytic anemia, lupus-like syndromes and hepatotoxicity.
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