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Macrodantin
Macrodantin (nitrofurantoin) is an antibiotic used to treat and prevent urinary tract infections (UTIs) caused by certain bacteria. It works by inhibiting bacterial enzymes involved in DNA, RNA, and cell wall synthesis, which helps to stop the growth and spread of bacteria in the urinary tract. Macrodantin is particularly effective in treating infections in the bladder, such as cystitis, and is often prescribed for long-term use to prevent recurrent UTIs.
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Frequently Asked Questions
How quickly does Macrodantin start working?
Macrodantin typically starts working within 1-2 days of starting treatment. However, it’s important to continue taking the medication for the full prescribed course, even if symptoms improve early, to ensure complete eradication of the infection.
How quickly does Macrodantin start working?
Macrodantin typically starts working within 1-2 days of starting treatment. However, it’s important to continue taking the medication for the full prescribed course, even if symptoms improve early, to ensure complete eradication of the infection.
Can Macrodantin be used for kidney infections?
No, Macrodantin is not typically used for kidney infections (pyelonephritis), as it concentrates in the bladder and lower urinary tract but does not reach high enough levels in the kidneys to effectively treat an infection there.
What should I do if I miss a dose of Macrodantin?
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take your next dose at the regular time. Do not take two doses at once to make up for a missed dose.
Can I drink alcohol while taking Macrodantin?
While alcohol does not directly interact with Macrodantin, it’s generally best to avoid alcohol while treating a UTI to allow your body to focus on fighting the infection. Alcohol may also worsen certain side effects, such as nausea and dizziness.
Is Macrodantin safe to take during pregnancy?
Macrodantin is generally considered safe during early pregnancy (before 38 weeks gestation), but it should be avoided in the late stages of pregnancy (38-42 weeks) due to the risk of hemolytic anemia in newborns. Always consult your doctor before taking any medication during pregnancy.
Comprehensive Drug Guide
How Does Macrodantin Work?
Macrodantin works by interfering with the bacterial enzymes that are responsible for producing DNA, RNA, and cell wall proteins. This inhibits the bacteria’s ability to grow, replicate, and repair itself, effectively killing the bacteria causing the infection. It is specifically active in the urinary tract, where it concentrates and works to clear infections in the bladder and lower urinary tract.
Common Dosages
- 25 mg, 50 mg, and 100 mg oral capsules.
Typical Dosing
- For acute urinary tract infections: The usual dose is 50 mg to 100 mg four times daily for 7 days.
- For prophylaxis (prevention of recurrent UTIs): The dose is usually 50 mg to 100 mg once daily, often taken at bedtime.
Typical Dosing
FDA Approved Indications
- Treatment of acute uncomplicated urinary tract infections (cystitis) caused by susceptible strains of Escherichia coli, Enterococci, Staphylococcus aureus, and certain strains of Klebsiella and Enterobacter species.
- Prophylaxis of recurrent urinary tract infections, especially in individuals prone to recurrent episodes.
Who Shouldn't Take Macrodantin?
- Severe kidney impairment (creatinine clearance <60 mL/min), as the drug may not be effective and can accumulate in the body, leading to toxicity.
- A history of allergic reactions or hypersensitivity to nitrofurantoin or any components of the formulation.
- Pregnancy at term (38-42 weeks gestation) and during labor and delivery, due to the risk of hemolytic anemia in newborns.
- Known cases of glucose-6-phosphate dehydrogenase (G6PD) deficiency, as Macrodantin may cause hemolytic anemia.
Advice From The Pharmacist
- Take Macrodantin with food to improve absorption and reduce stomach upset.
- Complete the full course of therapy as prescribed, even if you start to feel better, to ensure the infection is completely cleared and to prevent bacterial resistance.
- Drink plenty of fluids to help flush the bacteria out of your urinary tract.
- If you are on long-term use of Macrodantin for UTI prevention, follow your doctor’s recommendations closely and attend regular check-ups to monitor kidney function and overall health.
- Do not use antacids containing magnesium trisilicate, as they can reduce the absorption and effectiveness of Macrodantin.
Side Effects of Macrodantin
Common Side Effects
- Nausea
- Headache
- Loss of appetite
- Diarrhea
- Dizziness
- Dark-colored urine (this is harmless and caused by the breakdown of the drug)
Uncommon/Severe Side Effects
- Lung problems (e.g., shortness of breath, persistent cough)
- Liver damage (jaundice, yellowing of the skin or eyes)
- Peripheral neuropathy (tingling or numbness in the hands or feet)
- Hemolytic anemia (especially in patients with G6PD deficiency)
Risks and Warnings of Macrodantin
- Pulmonary Toxicity: Long-term use of Macrodantin has been associated with pulmonary toxicity, which may present as coughing, chest pain, and difficulty breathing. This can occur either acutely (within hours to days of starting treatment) or chronically (after long-term use). If you experience breathing problems, seek medical attention immediately.
- Peripheral Neuropathy: Macrodantin may cause nerve damage, particularly in individuals with kidney disease or diabetes. If you experience tingling, numbness, or pain in your extremities, notify your healthcare provider.
- Liver Toxicity: Rare cases of liver toxicity, including jaundice and hepatitis, have been reported. Monitor liver function during prolonged therapy, especially in individuals with preexisting liver conditions.
- Hemolytic Anemia: Macrodantin can cause hemolysis (destruction of red blood cells), especially in individuals with G6PD deficiency. This may present as fatigue, dark urine, or jaundice. Avoid use in individuals with G6PD deficiency.
Interactions with Macrodantin
Common Drug Interactions
- Antacids: Antacids containing magnesium trisilicate can decrease the absorption of Macrodantin, reducing its effectiveness.
- Probenecid and sulfinpyrazone: These medications can reduce the kidney excretion of Macrodantin, potentially leading to toxic levels of the drug in the body.
- Oral contraceptives: As with other antibiotics, Macrodantin may reduce the effectiveness of oral contraceptives. Consider using an additional form of contraception during treatment.
Alternatives to Macrodantin
- Trimethoprim/sulfamethoxazole (Bactrim, Septra): Another antibiotic commonly used for treating urinary tract infections.
- Ciprofloxacin (Cipro): A fluoroquinolone antibiotic used for UTIs, but it is often reserved for more complicated or resistant infections.
- Fosfomycin (Monurol): A single-dose antibiotic used to treat uncomplicated UTIs.
- Amoxicillin-clavulanate (Augmentin): A combination antibiotic often used when resistance to other medications is suspected.
