DrugindexOnline^{2nd edition}

Generic name: Nitrofurantoin
Brand names: Macrodantin, Macrobid

Why is Macrodantin prescribed?

Nitrofurantoin, an antibacterial drug, is prescribed for the treatment of urinary tract infections caused by certain strains of bacteria.

Most important fact about Macrodantin

Breathing disorders have occurred in people taking nitrofurantoin. The drug can cause inflammation of the lungs marked by coughing, difficulty breathing, and wheezing. It has also been known to cause pulmonary fibrosis (an abnormal increase in fibrous tissue of the lungs). This condition can develop gradually without symptoms and can be fatal. An allergic reaction to Macrodantin is also possible and may occur without warning. Symptoms include a feeling of ill health and a persistent cough. However, all these reactions occur rarely and generally in those receiving nitrofurantoin therapy for 6 months or longer.

Sudden and severe lung reactions are characterized by fever, chills, cough, chest pain, and difficulty breathing. These acute reactions usually occur within the first week of treatment and subside when therapy with nitrofurantoin is stopped.

Your doctor should monitor your condition closely, especially if you are receiving long-term treatment with Macrodantin.

How should you take Macrodantin?

To improve absorption of the drug, nitrofurantoin should be taken with food.

Your doctor will only prescribe Macrodantin to treat a bacterial infection. Macrodantin will not cure a viral infection such as the common cold. It's important to take all of your medication as instructed by your doctor, even if you're feeling better in a few days. Skipping doses or not finishing the complete dosage of Macrodantin may decrease the drug's effectiveness and increase the chances of bacterial resistance to Macrodantin and similar antibiotics.

This medication works best if your urine is acidic. Ask your doctor whether you should be taking special measures to assure its acidity.

Nitrofurantoin may turn the urine brown.

--If you miss a dose...

Take the forgotten dose as soon as you remember, then space out the rest of the day's doses at equal intervals.

--Storage instructions...

Store at room temperature. Protect from light and keep the container tightly closed.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking nitrofurantoin.

• More common side effects may include:
  Lack or loss of appetite, nausea, vomiting

Why should Macrodantin not be prescribed?

If you are sensitive to or have ever had an allergic reaction to nitrofurantoin or other drugs of this type, such as Furoxone, you should not take Macrodantin. Make sure that your doctor is aware of any drug reactions that you have experienced.

Unless you are directed to do so by your doctor, do not take Macrodantin if you have poor kidneys, producing little or no urine.

Nitrofurantoin should not be taken at term of pregnancy or during labor and delivery; it should not be given to infants under 1 month of age.

Special warnings about Macrodantin

Tell your doctor if you have any unusual symptoms while you are taking Macrodantin.

Fatalities have been reported from hepatitis (liver disease) during treatment with nitrofurantoin. Long-lasting, active hepatitis can develop without symptoms; therefore, if you are receiving long-term treatment with Macrodantin, your doctor should test your liver function periodically.

Fatalities from peripheral neuropathy--a disease of the nerves--have also been reported in people taking nitrofurantoin. Conditions such as a kidney disorder, anemia, diabetes mellitus, a debilitating disease, or a vitamin B deficiency make peripheral neuropathy more likely. If you develop symptoms such as muscle weakness or lack of sensation, check with your doctor immediately.

If you experience diarrhea, tell your doctor. It may be a sign of serious intestinal inflammation.

Hemolytic anemia (destruction of red blood cells) has occurred in people taking nitrofurantoin.

Continued or prolonged use of Macrodantin may result in growth of bacteria that do not respond to it. This can cause a renewed infection, so it is important that your doctor monitor your condition on a regular basis.

Possible food and drug interactions when taking Macrodantin

If nitrofurantoin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining nitrofurantoin with the following:

Magnesium trisilicate (Gaviscon Antacid Tablets)
The gout drugs probenecid and sulfinpyrazone and other drugs that increase the amount of uric acid in the urine

Special information if you are pregnant or breastfeeding

The safety of nitrofurantoin during pregnancy and breastfeeding has not been established. Nitrofurantoin does appear in human breast milk. If you are pregnant or breastfeeding or you plan to become pregnant or breastfeed, inform your doctor immediately.

Recommended dosage

Treatment with nitrofurantoin should be continued for 1 week or for at least 3 days after obtaining a urine specimen free of infection. If your infection has not cleared up, your doctor should re-evaluate your case.

ADULTS

The recommended dosage of Macrodantin is 50 to 100 milligrams taken 4 times a day. For long-term treatment, your doctor may reduce your dosage to 50 to 100 milligrams taken at bedtime.

The recommended dosage of Macrobid is one 100 milligram capsule every 12 hours for 7 days.

CHILDREN

This medication should not be prescribed for children under 1 month of age.

The recommended daily dosage of Macrodantin for infants and children over 1 month of age is 5 to 7 milligrams per 2.2 pounds of body weight, divided into 4 doses over 24 hours.

For the long-term treatment of children, the doctor may prescribe daily doses as low as 1 milligram per 2.2 pounds of body weight taken in 1 or 2 doses per day.

The dosage of Macrobid for children over 12 years of age is one 100 milligram capsule every 12 hours for 7 days. Safety and effectiveness have not been established for children under 12.

OLDER ADULTS

Doctors tend to prescribe lower doses of Macrodantin for older adults. The drug is more likely to cause lung and liver problems in members of this group; and because more older adults have poor kidneys, the risk of toxic reactions to Macrodantin is also greater.

Overdosage

An overdose of nitrofurantoin does not cause any specific symptoms other than vomiting. If vomiting does not occur soon after an excessive dose, it should be induced.

If you suspect an overdose, seek emergency medical treatment immediately.