II. Indications

III. Contraindications

  1. Prolonged use longer than 6 months
  2. Prolonged use >14 days in age over 65 years (relative contraindication if normal Renal Function)
  3. Creatinine Clearance <30-40 ml/min (short-term use <14 days appears safe at GFR >30 ml/min)
  4. References
    1. (2018) Presc Lett 25(8)
    2. 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. Technique

  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 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
NITROFURANTOIN MCR 100 MG CAP Generic $0.38 each
NITROFURANTOIN MCR 25 MG CAP Generic $3.49 each
NITROFURANTOIN MCR 50 MG CAP Generic $0.35 each
NITROFURANTOIN MONO-MCR 100 MG Generic $0.41 each