Nitrofurantoin "eql Pharma" (Nitrofurantoin)

• Nitrofurantoin is used to treat infections of the urinary tract caused by susceptible bacteria.
• Uncomplicated urinary tract infection (UTI): eradicates the causative organisms and relieves symptoms such as burning during urination and increased frequency.
• Prophylaxis of recurrent UTIs: reduces the frequency of future infections in patients with a history of repeated episodes.
• Acute uncomplicated cystitis: provides bactericidal activity to clear infection and restore normal urinary function.

• Nitrofurantoin is reduced by bacterial flavoproteins to reactive intermediates that damage bacterial DNA, ribosomal proteins, and enzymes involved in carbohydrate metabolism. This multi‑targeted attack disrupts essential cellular processes, leading to bactericidal activity primarily against common urinary pathogens such as Escherichia coli and Staphylococcus saprophyticus.

Nitrofurantoin may cause a range of adverse reactions.

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Loss of appetite: reduced desire to eat.
• Headache: transient head discomfort.
• Diarrhea: loose stools, usually self‑limiting.
• Metallic taste: temporary alteration of taste perception.
• Rash: mild skin irritation.

Serious or Rare Side Effects

• Pulmonary toxicity: interstitial lung disease presenting with cough and shortness of breath.
• Hepatic injury: elevated liver enzymes or hepatitis.
• Hemolytic anemia in G6PD deficiency: rapid destruction of red blood cells.
• Severe skin reactions: Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Peripheral neuropathy: tingling or numbness in extremities.
• Eosinophilic lung disease: eosinophil‑rich infiltrates causing respiratory symptoms.

• Before prescribing Nitrofurantoin, consider the following safety measures.
• Renal function: assess creatinine clearance and avoid use in patients with severe renal impairment.
• Pregnancy: avoid unless benefits outweigh potential risks, as safety data are limited.
• G6PD deficiency: contraindicated due to risk of hemolysis.
• Drug interactions: review concomitant medications for potential absorption or efficacy issues.
• Store at ambient temperature: keep in the original packaging, protect from moisture and direct sunlight.

Nitrofurantoin can interact with several medicines; monitor patients accordingly.

Major Interactions (Avoid)

• Antacids containing magnesium or aluminum: markedly reduce nitrofurantoin absorption.
• Probenecid: may increase nitrofurantoin plasma concentrations, raising toxicity risk.
• Warfarin: can potentiate anticoagulant effect, increasing bleeding risk.

Moderate Interactions (Monitor Closely)

• Ciprofloxacin: may antagonize nitrofurantoin’s antibacterial activity.
• Methenamine: concurrent use may diminish nitrofurantoin efficacy.
• High‑dose vitamin C: alters urinary pH and may affect drug activity.