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Nitrofurantoin Macrocrystal
Nitrofurantoin Macrocrystal is the generic name for an antibiotic commonly used to treat urinary tract infections (UTIs) caused by certain bacteria. It belongs to the nitrofuran class of antibiotics, which work by killing bacteria in the urinary tract. Nitrofurantoin is effective in treating acute uncomplicated UTIs and is often used for both treatment and prevention of recurring urinary tract infections. The "macrocrystal" formulation is designed to be slowly absorbed in the body, reducing the likelihood of gastrointestinal side effects compared to other forms of nitrofurantoin.
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Frequently Asked Questions
How long does it take for Nitrofurantoin to work?
Most patients begin to feel relief from UTI symptoms within 24 to 48 hours of starting the medication, but it's important to finish the full course to ensure the infection is fully treated.
Can Nitrofurantoin be used for severe UTIs?
Nitrofurantoin is typically used for uncomplicated UTIs. For more severe infections, other antibiotics may be recommended by your doctor.
What should I do if I miss a dose of Nitrofurantoin?
If you miss a dose, take it as soon as you remember unless it’s almost time for the next dose. Do not double up doses to make up for the missed one.
Can Nitrofurantoin be used long-term?
Yes, Nitrofurantoin is sometimes used long-term to prevent recurrent urinary tract infections, but this should be done under close medical supervision to monitor for potential side effects.
Can I take Nitrofurantoin if I’m pregnant?
Nitrofurantoin is generally safe to use during early pregnancy, but it is not recommended near term (38-42 weeks) due to the risk of hemolytic anemia in the newborn. Always consult your doctor before taking any medication during pregnancy.
Comprehensive Drug Guide
How Does Nitrofurantoin Macrocrystal Work?
Nitrofurantoin works by interfering with the production of bacterial proteins, DNA, and cell walls, which are essential for bacterial survival. This prevents the bacteria from growing and multiplying in the urinary tract. The macrocrystal formulation is absorbed more slowly, allowing the drug to stay in the system longer, targeting bacteria in the bladder and urinary tract.
Common Dosages
- Oral capsules: 50 mg, 100 mg
- The typical dose for acute UTIs is 100 mg twice daily for 5 to 7 days.
Typical Dosing
- For acute uncomplicated UTIs: The usual dose is 100 mg twice daily for 5 to 7 days, taken with food to enhance absorption and reduce the risk of stomach upset.
- For prevention of recurrent UTIs: The dose may be 50 mg to 100 mg once daily, often taken at bedtime.
Typical Dosing
FDA Approved Indications
- Acute uncomplicated urinary tract infections caused by susceptible strains of bacteria such as Escherichia coli, Enterococcus, and Staphylococcus saprophyticus.
- Prophylaxis (prevention) of recurrent urinary tract infections.
Who Shouldn't Take Nitrofurantoin Macrocrystal?
- Severe kidney impairment or reduced kidney function (creatinine clearance < 60 mL/min)
- Known hypersensitivity or allergic reaction to nitrofurantoin or any of its components
- Pregnancy at term (38 to 42 weeks) due to the risk of hemolytic anemia in the newborn
- Infants under 1 month of age
Advice From The Pharmacist
- Always take Nitrofurantoin Macrocrystal with food to reduce the risk of gastrointestinal side effects and improve absorption.
- Complete the full course of treatment, even if your symptoms improve, to prevent the infection from returning and avoid antibiotic resistance.
- Be aware that Nitrofurantoin may cause your urine to turn dark yellow or brown, which is normal and harmless.
- If you miss a dose, take it as soon as you remember, unless it's almost time for the next dose. Do not double the dose to make up for a missed one.
Side Effects of Nitrofurantoin Macrocrystal
Common Side Effects
- Nausea or vomiting
- Diarrhea
- Loss of appetite
- Dark-colored urine
Uncommon/Severe Side Effects
- Pulmonary reactions (e.g., coughing, difficulty breathing, or chest pain)
- Liver toxicity (signs include jaundice, dark urine, and upper abdominal pain)
- Peripheral neuropathy (numbness or tingling in the hands or feet)
Risks and Warnings of Nitrofurantoin Macrocrystal
- Pulmonary Toxicity: Nitrofurantoin has been associated with both acute and chronic pulmonary reactions, such as coughing, shortness of breath, and fever. Chronic use should be monitored carefully, especially in older adults.
- Liver Damage: Though rare, Nitrofurantoin can cause liver damage. If you experience signs of jaundice (yellowing of the skin or eyes), dark urine, or abdominal pain, contact your healthcare provider immediately.
- Peripheral Neuropathy: Long-term use or use in people with kidney disease may increase the risk of nerve damage, resulting in numbness, tingling, or pain in the extremities.
- Kidney Function: Nitrofurantoin should not be used in individuals with significant kidney impairment, as it may not reach effective concentrations in the urinary tract and could lead to side effects.
Interactions with Nitrofurantoin Macrocrystal
Common Drug Interactions
- Magnesium-based antacids: These can reduce the absorption of Nitrofurantoin and decrease its effectiveness.
- Probenecid and sulfinpyrazone: These medications can reduce the excretion of Nitrofurantoin, increasing the risk of toxicity.
- Fluoroquinolones: These antibiotics may counteract the effects of Nitrofurantoin, so they should not be used together.
Alternatives to Nitrofurantoin Macrocrystal
- Trimethoprim-sulfamethoxazole (Bactrim): A commonly used antibiotic for UTIs, though resistance is increasing.
- Ciprofloxacin (Cipro): A fluoroquinolone antibiotic that is effective against a wide range of bacteria but should be reserved for more severe cases.
- Fosfomycin: A single-dose antibiotic option used to treat uncomplicated UTIs.
- Cephalexin (Keflex): A cephalosporin antibiotic often used as an alternative for UTI treatment.
