Nitrofurantoin


Description

Nitrofurantoin is a nitrofuran antibiotic used to treat uncomplicated urinary tract infections.[8,

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Pharmacology

Indication

Nitrofurantoin is indicated to treat acute uncomplicated urinary tract infections.[ Read more

Pharmacodynamic

Nitrofurantoin interferes with vital processes in bacteria, which leads to their death.[ Read more

Mechanism of action

Nitrofurantoin is converted by bacterial nitroreductases to electrophilic intermediates which inhibi... Read more

Absorption

Nitrofurantoin reaches a Cmax of 0.875-0.963mg/L with an AUC of 2.21-2.42mg\*h/L.[ Read more

Protein binding

Nitrofurantoin could be up to 90% protein bound in plasma.[ Read more

Volume of distribution

Data regarding the volume of distribution in humans is scarce but it has been reported as 0.46L/kg i... Read more

Clearance

The clearance of nitrofurantoin is 16.7-19.4L/h.[ Read more

Half life

The half life of nitrofurantoin is 0.72-0.78h.[ Read more

Route of elimination

27-50% of an oral dose is excreted in the urine as unchanged nitrofurantoin.[ Read more

Toxicity

Symptoms of overdose include vomiting.[ Read more


Adverse Effects

Effect Regions Age Groups Incidences Evidence Type
Nausea US
  • Kind: experimental
    • Percent: 8%
  • Varying Reports
    Headache US
  • Kind: experimental
    • Percent: 6%
  • Varying Reports
    Flatulence US
  • Kind: experimental
    • Percent: 2%
  • Varying Reports
    Chills US
  • Kind: experimental
    • Percent: <1%
  • Varying Reports
    Fever US
  • Kind: experimental
    • Percent: <1%
  • Varying Reports
    Alopecia US
  • Kind: experimental
    • Percent: <1%
  • Varying Reports
    Malaise US
  • Kind: experimental
    • Percent: <1%
  • Varying Reports
    Abdominal Pain US
  • Kind: experimental
    • Percent: <1%
  • Varying Reports
    Diarrhea US
  • Kind: experimental
    • Percent: <1%
  • Varying Reports
    Dyspepsia US
  • Kind: experimental
    • Percent: <1%
  • Varying Reports
    Emesis US
  • Kind: experimental
    • Percent: <1%
  • Varying Reports
    Dizziness US
  • Kind: experimental
    • Percent: <1%
  • Varying Reports
    Constipation US
  • Kind: experimental
    • Percent: <1%
  • Varying Reports
    Amblyopia US
  • Kind: experimental
    • Percent: <1%
  • Varying Reports
    Drowsiness US
  • Kind: experimental
    • Percent: <1%
  • Varying Reports
    Urticaria US
  • Kind: experimental
    • Percent: <1%
  • Varying Reports
    Acute pulmonary hypersensitivity reaction US
  • Kind: experimental
    • Percent: <1%
  • Varying Reports
    Pruritus US
  • Kind: experimental
    • Percent: <1%
  • Varying Reports
    Myalgia US
    Varying Reports
    Drug fever US
    Varying Reports
    Vasculitis US
    Varying Reports
    Exfoliative dermatitis US
    Varying Reports
    Erythematous eruptions US
    Varying Reports
    Eczematous eruptions US
    Varying Reports
    Anaphylaxis US
    Varying Reports
    Arthralgia US
    Varying Reports
    Hepatic necrosis US
    Varying Reports
    Lupus-like syndrome US
    Varying Reports
    Angioedema US
    Varying Reports
    Maculopapular US
    Varying Reports
    Cyanosis US
    Varying Reports
    Hepatitis US
    Varying Reports
    Cholestatic jaundice US
    Varying Reports
    Chronic active hepatitis US
    Varying Reports
    Dyspnea US
    Varying Reports
    Chest Pain US
    Varying Reports
    Changes in EKG US
    Varying Reports
    Pulmonary infiltration US
    Varying Reports
    Pulmonary hypersensitivity reactions US
    Varying Reports
    Bulging fontanels US
    Varying Reports
    Cough US
    Varying Reports
    Eosinophilia US
    Varying Reports
    Depression US
    Varying Reports
    Confusion US
    Varying Reports
    Psychotic reactions US
    Varying Reports
    Optic Neuritis US
    Varying Reports
    Vertigo US
    Varying Reports
    Asthenia US
    Varying Reports
    Benign Intracranial Hypertension US
    Varying Reports
    Nystagmus US
    Varying Reports

    Contraindications

    • Regions: US
    • Patient Conditions:
        • Name: Pregnancy at term
        • Drugbank Id: DBCOND0107943
    • Regions: US
    • Patient Conditions:
        • Name: Renal Function Impairment
        • Drugbank Id: DBCOND0055182
    • Regions: US
    • Patient Conditions:
        • Name: Oliguria
        • Drugbank Id: DBCOND0001404
    • Regions: US
    • Patient Conditions:
        • Name: Anuria
        • Drugbank Id: DBCOND0001345
    • Regions: US
    • Patient Conditions:
        • Name: History of cholestatic jaundice
        • Drugbank Id: DBCOND0107945
    • With Drugs:
        • Name: Nitrofurantoin
        • Drugbank Id: DB00698
    • Regions: US
    • Patient Conditions:
        • Name: History of hepatic dysfunction
        • Drugbank Id: DBCOND0107587
    • With Drugs:
        • Name: Nitrofurantoin
        • Drugbank Id: DB00698
    • Regions: US
    • Patient Conditions:
        • Name: Imminent onset of labor
        • Drugbank Id: DBCOND0107944
    • Regions: US
    • Below Age:
      • Amount: 1
      • Unit: month
    • Regions: US
    • Patient Conditions:
        • Name: Labor
        • Drugbank Id: DBCOND0031975
    • Regions: US
    • Patient Conditions:
        • Name: Delivery
        • Drugbank Id: DBCOND0018385

    Food Interactions

    • Do not take magnesium at the same time.
    • Take with food since it increases bioavailability and reduces irritation.

    Interactions

    Type in a drug name to check for interaction with Nitrofurantoin

    The risk or severity of bleeding can be increased when Nitrofurantoin is combined with (R)-warfarin.
    The risk or severity of bleeding can be increased when Nitrofurantoin is combined with (S)-Warfarin.
    The risk or severity of bleeding can be increased when Nitrofurantoin is combined with 4-hydroxycoumarin.
    The therapeutic efficacy of Nitrofurantoin can be decreased when used in combination with 5-fluorouridine.
    Nitrofurantoin may decrease the excretion rate of Abacavir which could result in a higher serum level.
    Abemaciclib may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level.
    Acarbose may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level.
    The risk or severity of hyperkalemia can be increased when Nitrofurantoin is combined with Acebutolol.
    Aceclofenac may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level.
    Acemetacin may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level.
    The risk or severity of bleeding can be increased when Nitrofurantoin is combined with Acenocoumarol.
    The risk or severity of methemoglobinemia can be increased when Acetaminophen is combined with Nitrofurantoin.
    Acetazolamide may increase the excretion rate of Nitrofurantoin which could result in a lower serum level and potentially a reduction in efficacy.
    Acetylsalicylic acid may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level.
    Nitrofurantoin may decrease the excretion rate of Aclidinium which could result in a higher serum level.
    Nitrofurantoin may decrease the excretion rate of Acrivastine which could result in a higher serum level.
    Acyclovir may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level.
    Adefovir may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level.
    Adefovir dipivoxil may decrease the excretion rate of Nitrofurantoin which could result in a higher serum level.
    The therapeutic efficacy of Adenovirus type 7 vaccine live can be decreased when used in combination with Nitrofurantoin.

    References

    • 1 . Mannisto PT, Lamminsivu U: Nitrofurantoin is highly bound to plasma protein. J Antimicrob Chemother. 1982 Apr;9(4):327-8. doi: 10.1093/jac/9.4.327. [PubMed: 7085535]
    • 2 . McOsker CC, Fitzpatrick PM: Nitrofurantoin: mechanism of action and implications for resistance development in common uropathogens. J Antimicrob Chemother. 1994 May;33 Suppl A:23-30. doi: 10.1093/jac/33.suppl_a.23. [PubMed: 7928834]
    • 3 . Novelli A, Rosi E: Pharmacological properties of oral antibiotics for the treatment of uncomplicated urinary tract infections. J Chemother. 2017 Dec;29(sup1):10-18. doi: 10.1080/1120009X.2017.1380357. [PubMed: 29271734]
    • 4 . Gupta K, Hooton TM, Stamm WE: Increasing antimicrobial resistance and the management of uncomplicated community-acquired urinary tract infections. Ann Intern Med. 2001 Jul 3;135(1):41-50. doi: 10.7326/0003-4819-135-1-200107030-00012. [PubMed: 11434731]
    • 5 . Rosenberg HA, Bates TR: The influence of food on nitrofurantoin bioavailability. Clin Pharmacol Ther. 1976 Aug;20(2):227-32. doi: 10.1002/cpt1976202227. [PubMed: 7376]
    • 6 . Niazi S, Vishnupad KS, Veng-Pedersen P: Absorption and disposition characteristics of nitrofurantoin in dogs. Biopharm Drug Dispos. 1983 Jul-Sep;4(3):213-23. [PubMed: 6626697]
    • 7 . Hoener B, Patterson SE: Nitrofurantoin disposition. Clin Pharmacol Ther. 1981 Jun;29(6):808-16. doi: 10.1038/clpt.1981.115. [PubMed: 7226713]
    • 8 . FDA Approved Drug Products: Macrocrystalline Nitrofurantoin Oral Capsule [Link]
    • 9 . FDA Approved Drug Products: Nitrofurantoin and Macrocrystalline Nitrofurantoin Oral Capsule [Link]
    • 10 . FDA Approved Drug Products: Nitrofurantoin Oral Suspension [Link]
    • 11 . FDA Approved Drug Products: Nitrofurantoin Oral Tablet [Link]

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