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Macrobid
Macrobid is the brand name for nitrofurantoin, an antibiotic primarily used to treat urinary tract infections (UTIs). Nitrofurantoin works by stopping the growth of bacteria that cause infections in the urinary tract, such as E. coli. It is often prescribed for uncomplicated UTIs and can also be used as a preventive treatment for recurrent UTIs. Macrobid is commonly used due to its effectiveness in targeting the bacteria that thrive in the urinary tract, while also having a lower risk of developing bacterial resistance compared to other antibiotics.
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Frequently Asked Questions
How long does it take for Macrobid to work?
Macrobid typically starts working within 1-2 days of starting treatment, but it’s important to complete the entire prescribed course to ensure the infection is fully cleared. Macrobid typically starts working within 1-2 days of starting treatment, but it’s important to complete the entire prescribed course to ensure the infection is fully cleared.
Can I take Macrobid if I’m pregnant?
Macrobid is generally safe to use during the first and second trimesters of pregnancy. However, it is not recommended in the third trimester, especially near delivery, as it can increase the risk of hemolytic anemia in newborns.
Can I drink alcohol while taking Macrobid?
There is no specific interaction between alcohol and Macrobid, but drinking alcohol may increase the risk of side effects like nausea or dizziness. It’s best to avoid alcohol until your infection is fully treated.
What should I do if I miss a dose?
If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take two doses at once.
Can Macrobid be used to treat kidney infections?
No, Macrobid is not typically used to treat kidney infections (pyelonephritis) because it does not achieve high concentrations in the kidneys. It is primarily effective for lower urinary tract infections (bladder infections).
Comprehensive Drug Guide
How Does Macrobid Work?
Macrobid works by interfering with bacterial enzymes and protein synthesis, disrupting the bacteria's ability to reproduce and survive. Specifically, nitrofurantoin is reduced by bacterial flavoproteins, generating reactive intermediates that damage bacterial DNA, RNA, and proteins. This action is localized to the urinary tract, making it highly effective in treating infections caused by susceptible bacteria such as E. coli. Macrobid does not work against viral infections or infections outside of the urinary tract.
Common Dosages
- 100 mg capsules (extended-release form)
Typical Dosing
- For acute urinary tract infections: The typical dose is 100 mg taken twice daily for 5 to 7 days, depending on the severity of the infection. It is important to complete the entire prescribed course to ensure the infection is fully treated.
- For prophylaxis of recurrent UTIs: The dose may be 50 to 100 mg taken once daily at bedtime, as directed by a healthcare provider.
Typical Dosing
FDA Approved Indications
- Uncomplicated urinary tract infections (UTIs)
- Prophylaxis for recurrent UTIs in some patients
Who Shouldn't Take Macrobid?
- Severe kidney disease (creatinine clearance below 60 mL/min), as nitrofurantoin may not be effective in patients with poor kidney function.
- A known allergy to nitrofurantoin or any component of the formulation.
- Women who are in the last month of pregnancy (due to the risk of hemolytic anemia in the newborn).
- Infants younger than 1 month of age.
Advice From The Pharmacist
- Take Macrobid with food to improve absorption and reduce the likelihood of stomach upset.
- Finish the full course of antibiotics, even if you start feeling better, to ensure the infection is completely cleared and to prevent antibiotic resistance.
- Drink plenty of fluids while taking Macrobid to help flush the bacteria from the urinary tract.
- Do not take antacids containing magnesium trisilicate, as they may reduce the absorption of nitrofurantoin.
- Store Macrobid at room temperature, away from moisture and heat.
Side Effects of Macrobid
Common Side Effects
- Nausea or vomiting
- Diarrhea
- Headache
- Stomach pain
- Dizziness or drowsiness
Uncommon/Severe Side Effects
- Pulmonary toxicity (lung problems) such as shortness of breath, coughing, or chest pain.
- Liver toxicity, including jaundice or liver enzyme elevations.
- Peripheral neuropathy (nerve damage) leading to tingling or numbness in the hands and feet.
Risks and Warnings of Macrobid
- Pulmonary Toxicity: Macrobid can cause acute or chronic lung conditions, especially in long-term use. Symptoms such as cough, shortness of breath, or chest pain should be reported to a healthcare provider immediately.
- Liver Damage: Nitrofurantoin can affect liver function, and patients with pre-existing liver conditions should be closely monitored while taking this medication.
- Peripheral Neuropathy: Macrobid can cause nerve damage, particularly in individuals with kidney disease or diabetes. Contact your doctor if you experience unusual numbness, tingling, or pain.
- Hemolytic Anemia: Macrobid can cause hemolysis (breakdown of red blood cells) in patients with a genetic deficiency of the enzyme G6PD, leading to hemolytic anemia.
Interactions with Macrobid
Common Drug Interactions
- Antacids containing magnesium trisilicate can reduce the absorption of Macrobid, decreasing its effectiveness.
- Probenecid and sulfinpyrazone: These drugs may reduce the renal excretion of nitrofurantoin, increasing the risk of side effects.
- Fluoroquinolones (e.g., ciprofloxacin): Taking Macrobid with other antibiotics like fluoroquinolones is generally unnecessary as their effects may overlap.
Alternatives to Macrobid
- Bactrim (trimethoprim-sulfamethoxazole): Another commonly used antibiotic for UTIs.
- Ciprofloxacin: A fluoroquinolone antibiotic used for more complicated or resistant urinary tract infections.
- Amoxicillin: An antibiotic used to treat UTIs, particularly in pregnant women or those allergic to sulfa drugs.
- Fosfomycin: A single-dose antibiotic often used for uncomplicated UTIs.
