II. Indications

III. Contraindications

  1. Prolonged use longer than 6 months
  2. Creatinine Clearance <30-40 ml/min (previously limited to 30 ml/min)
    1. Oplinger (2013) Ann Pharmacother 47(1):106-11 [PubMed]

IV. Adverse Effects

  1. Pulmonary fibrosis
    1. Chronic Nitrofurantoin use
  2. Acute Nitrofurantoin Pulmonary Toxicity

V. Preparations

  1. Macrobid
    1. Capsules: 100 mg
  2. Nitrofurantoin
    1. Capsules: 25 mg, 50 mg, 100 mg
    2. Suspension: 25 mg per 5 ml

VI. Directions

  1. Take immediately after food to increase absorption
  2. Food decreases gastrointestinal upset

VII. Dosing: Adults

  1. Nitrofurantoin: 50 to 100 mg orally four times daily
  2. Macrobid: 100 mg orally twice daily
  3. Course: 5 days (instead of 7) is sufficient for uncomplicated UTI in non-pregnant women
    1. Gupta (2007) Arch Intern Med 167(20):2207-12 [PubMed]

VIII. Dosing: Children

  1. Nitrofurantoin: 5-7 mg/kg/day divided qid

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Cost: Medications

nitrofurantoin (on 5/17/2017 at Medicaid.Gov Survey of pharmacy drug pricing)
NITROFURANTOIN 25 MG/5 ML SUSP Generic $1.44 per ml
NITROFURANTOIN MCR 100 MG CAP Generic $0.99 each
NITROFURANTOIN MCR 25 MG CAP Generic $4.68 each
NITROFURANTOIN MCR 50 MG CAP Generic $0.65 each
NITROFURANTOIN MONO-MCR 100 MG Generic $0.85 each

Ontology: Nitrofurantoin (C0028156)

Definition (NCI) A synthetic derivative of imidazolidinedione, Nitrofurantoin inhibits bacterial DNA, RNA, and cell wall protein synthesis. Activated by bacterial flavoproteins to intermediates that inactivate bacterial ribosomal proteins, Nitrofurantoin is used prophylactically as a urinary anti-infective agent against most gram-positive and gram-negative organisms and for long-term suppression of infections. (NCI04)
Definition (MSH) A urinary anti-infective agent effective against most gram-positive and gram-negative organisms. Although sulfonamides and antibiotics are usually the agents of choice for urinary tract infections, nitrofurantoin is widely used for prophylaxis and long-term suppression.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D009582
SnomedCT 373543005, 85343003
LNC LP16140-3, MTHU008460
English Nitrofurantoin, 2,4-Imidazolidinedione, 1-(((5-nitro-2-furanyl)methylene)amino)-, nitrofurantoin, nitrofurantoin (medication), urological antibacterial nitrofurantoin, Nitrofurantoin [Chemical/Ingredient], NITROFURANTOIN, Nitrofurantoin (product), Nitrofurantoin (substance)
Swedish Nitrofurantoin
Czech nitrofurantoin
Finnish Nitrofurantoiini
Russian NITROFURANTOIN, FURADONIN, НИТРОФУРАНТОИН, ФУРАДОНИН
Japanese ニトロフラントイン
Croatian NITROFURANTOIN
Spanish Nitrofurantoína, nitrofurantoína (producto), nitrofurantoína (sustancia), nitrofurantoína
Polish Furadantyna, Nitrofurantoina
French Nitrofurantoïne
German Nitrofurantoin
Italian Nitrofurantoina
Portuguese Nitrofurantoína

Ontology: Macrobid (C0591750)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
English Macrobid, macrobid

Ontology: Macrodantin (C0700187)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D009582
English macrodantin, Macrodantin