Nitrofurantoin Activase Pharmaceuticals (Nitrofurantoin)

• Nitrofurantoin is used to manage infections of the urinary tract caused by susceptible bacteria.
• Acute uncomplicated urinary tract infection: eliminates the causative bacteria, relieving symptoms such as dysuria and frequency.
• Prevention of recurrent urinary tract infection: used as a prophylactic agent to reduce the incidence of repeat infections in susceptible individuals.
• Urinary tract infection caused by susceptible Escherichia coli: provides targeted antibacterial activity against common uropathogens.

• Nitrofurantoin is reduced by bacterial nitroreductases to reactive intermediates that bind bacterial DNA and inhibit essential enzymatic processes, leading to bacterial cell death. The activation occurs primarily within urinary pathogens, allowing selective antimicrobial activity in the urinary tract.

Nitrofurantoin may cause a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Nausea or vomiting
• Loss of appetite
• Diarrhea
• Headache

Serious or Rare Side Effects

• Pulmonary toxicity (interstitial pneumonitis)
• Hepatic injury (hepatitis, jaundice)
• Severe allergic reactions (anaphylaxis, Stevens‑Johnson syndrome)
• Hemolytic anemia in patients with G6PD deficiency

• When prescribing Nitrofurantoin, several safety considerations should be reviewed.
• Renal function: assess creatinine clearance before initiating therapy, as reduced renal function limits drug excretion.
• G6PD deficiency: avoid use due to risk of hemolytic anemia.
• Pregnancy: use only if benefits outweigh potential risks, especially in later trimesters.
• Elderly patients: monitor for reduced renal clearance and increased toxicity.
• Drug interactions: review concomitant medications, particularly antacids and warfarin, for potential interactions.
• Store at ambient temperature: keep below 25 °C, retain in original packaging, and protect from moisture.

Nitrofurantoin can affect, or be affected by, several co‑administered medicines.

Major Interactions (Avoid)

• Antacids containing magnesium or aluminum: decrease nitrofurantoin absorption.
• Warfarin: may enhance anticoagulant effect, increasing bleeding risk.
• Probenecid: raises nitrofurantoin plasma concentrations, raising toxicity potential.
• Fluoroquinolones: may antagonize nitrofurantoin activity.

Moderate Interactions (Monitor Closely)

• Diuretics: increase risk of crystalluria; ensure adequate hydration.
• NSAIDs: may compound renal impairment when combined.
• ACE inhibitors or ARBs: monitor renal function and electrolytes closely.