Nitrofurantoin: Difference between revisions
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==General== | ==General== | ||
*Type: | *Type: [[Antibiotic]] | ||
*Dosage Forms: | *Dosage Forms: oral | ||
*Common Trade Names: | *Common Trade Names: Macrobid | ||
==Adult Dosing== | ==Adult Dosing== | ||
===Cystitis, acute uncomplicated or acute simple:<ref>Nitrofurantoin: Drug information. UpToDate. www.uptodate.com. Accessed April 1, 2019.</ref>=== | |||
*Monohydrate/macrocrystals (Macrobid): 100mg PO q12h | |||
*Macrocrystals: 50-100mg PO 4 times daily for 5 days | |||
===Cystitis, recurrent, prophylaxis (continuous):<ref>Nitrofurantoin: Drug information. UpToDate. www.uptodate.com. Accessed April 1, 2019.</ref>=== | |||
*Monohydrate/macrocrystals (Macrobid): 100mg PO daily at bedtime | |||
*Macrocrystals: 50-100mg PO daily at bedtime | |||
===Cystitis, postcoital prophylaxis=== | |||
*Monohydrate/macrocrystals (Macrobid): 100mg PO once within 2 hours of sexual intercourse | |||
*Macrocrystals: 50-100mg PO once within 2 hours of sexual intercourse | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
*>12yo: same as adult dosing | |||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B | ||
*Lactation: | *Lactation Risk: Infant risk minimal | ||
*Renal Dosing | *Renal Dosing: Contraindicated if CrCl <60 | ||
*Hepatic dosing: | |||
*Hepatic | |||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*Neonates, pregnant women at term or when delivery imminent | |||
*Renal failure due to accumulation of metabolites that may cause peripheral neuropathy<ref>Spring PJ, Sharpe DM, Hayes MW. Nitrofurantoin and peripheral neuropathy: A forgotten problem? Med J Aust 2001;174:153-4.</ref> | |||
*CrCL < 60, oliguria, anuria | |||
*Cholestatic jaundice history | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*[[Hemolytic anemia]] can occur in patients with G6PD deficiency and in infants less than 1 month old | |||
*Hepatic necrosis | |||
*[[Hepatitis]] | |||
*Cholestatic jaundice syndrome | |||
*Erythema multiforme/SJS | |||
*[[Pancreatitis]] | |||
*Peripheral [[neuropathy]] | |||
*Pulmonary hypersensitivity | |||
*[[Agranulocytosis]] | |||
*[[Leukopenia]] | |||
*[[Thrombocytopenia]] | |||
*[[Pneumonitis]] | |||
*Pulmonary fibrosis | |||
*Cyanosis | |||
*ECG abnormality | |||
*C. difficle associated [[diarrhea]] | |||
*Optic neuritis | |||
*Pseudotumor cerebri | |||
*Psychosis | |||
*[[Vasculitis]] | |||
===Common=== | ===Common=== | ||
*[[Nausea]] | |||
*[[Headache]] | |||
*Anorexia | |||
*[[Abdominal pain]] | |||
*[[Diarrhea]] | |||
*Flatulence | |||
*Asthenia | |||
*[[Vertigo]] | |||
*[[Nystagmus]] | |||
*[[Dizziness]] | |||
*Confusion | |||
*Depression | |||
*Alopecia | |||
*Yellow/brown urine | |||
*Sialadenitis | |||
*[[Fever]] | |||
*[[Pruritus]] | |||
*Urticaria | |||
*Arthralgia | |||
*Myalgia | |||
*Rigors | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 45-60min | ||
*Metabolism: | *Metabolism: Hepatic | ||
*Excretion: | *Excretion: Urine primarily (30-40% unchanged); Bile | ||
*Mechanism of Action: | *Mechanism of Action: Inactivates bacterial ribosomal proteins | ||
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>== | ==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>== | ||
Line 153: | Line 205: | ||
===Key=== | ===Key=== | ||
{{Template:Antibacterial Spectra Key}} | {{Template:Antibacterial Spectra Key}} | ||
==See Also== | ==See Also== | ||
== | ==References== | ||
<references/> | |||
[[Category:Pharmacology]] | |||
[[Category:ID]] |
Latest revision as of 22:25, 28 November 2019
General
- Type: Antibiotic
- Dosage Forms: oral
- Common Trade Names: Macrobid
Adult Dosing
Cystitis, acute uncomplicated or acute simple:[1]
- Monohydrate/macrocrystals (Macrobid): 100mg PO q12h
- Macrocrystals: 50-100mg PO 4 times daily for 5 days
Cystitis, recurrent, prophylaxis (continuous):[2]
- Monohydrate/macrocrystals (Macrobid): 100mg PO daily at bedtime
- Macrocrystals: 50-100mg PO daily at bedtime
Cystitis, postcoital prophylaxis
- Monohydrate/macrocrystals (Macrobid): 100mg PO once within 2 hours of sexual intercourse
- Macrocrystals: 50-100mg PO once within 2 hours of sexual intercourse
Pediatric Dosing
- >12yo: same as adult dosing
Special Populations
- Pregnancy Rating: B
- Lactation Risk: Infant risk minimal
- Renal Dosing: Contraindicated if CrCl <60
- Hepatic dosing:
Contraindications
- Allergy to class/drug
- Neonates, pregnant women at term or when delivery imminent
- Renal failure due to accumulation of metabolites that may cause peripheral neuropathy[3]
- CrCL < 60, oliguria, anuria
- Cholestatic jaundice history
Adverse Reactions
Serious
- Hemolytic anemia can occur in patients with G6PD deficiency and in infants less than 1 month old
- Hepatic necrosis
- Hepatitis
- Cholestatic jaundice syndrome
- Erythema multiforme/SJS
- Pancreatitis
- Peripheral neuropathy
- Pulmonary hypersensitivity
- Agranulocytosis
- Leukopenia
- Thrombocytopenia
- Pneumonitis
- Pulmonary fibrosis
- Cyanosis
- ECG abnormality
- C. difficle associated diarrhea
- Optic neuritis
- Pseudotumor cerebri
- Psychosis
- Vasculitis
Common
- Nausea
- Headache
- Anorexia
- Abdominal pain
- Diarrhea
- Flatulence
- Asthenia
- Vertigo
- Nystagmus
- Dizziness
- Confusion
- Depression
- Alopecia
- Yellow/brown urine
- Sialadenitis
- Fever
- Pruritus
- Urticaria
- Arthralgia
- Myalgia
- Rigors
Pharmacology
- Half-life: 45-60min
- Metabolism: Hepatic
- Excretion: Urine primarily (30-40% unchanged); Bile
- Mechanism of Action: Inactivates bacterial ribosomal proteins
Antibiotic Sensitivities[4]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
See Also
References
- ↑ Nitrofurantoin: Drug information. UpToDate. www.uptodate.com. Accessed April 1, 2019.
- ↑ Nitrofurantoin: Drug information. UpToDate. www.uptodate.com. Accessed April 1, 2019.
- ↑ Spring PJ, Sharpe DM, Hayes MW. Nitrofurantoin and peripheral neuropathy: A forgotten problem? Med J Aust 2001;174:153-4.
- ↑ Sanford Guide to Antimicrobial Therapy 2014