Nitrofurantoin Eql Pharma (Nitrofurantoin)

Nitrofurantoin is used to manage infections of the urinary tract by acting on susceptible bacterial pathogens.

• Uncomplicated urinary tract infection (cystitis): eradicates causative bacteria and resolves urinary symptoms.
• Acute uncomplicated cystitis: provides short‑course therapy to clear infection.
• Prophylaxis of recurrent urinary tract infection: reduces recurrence when administered over a longer period.

• 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 bacterial cell death while sparing most human cells due to limited drug activation in mammalian tissues.

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

Common Side Effects

• Nausea: mild to moderate stomach upset.
• Loss of appetite: reduced desire to eat.
• Headache: transient cranial discomfort.
• Diarrhea: loose stools, usually self‑limiting.
• Metallic taste: persistent after‑taste in the mouth.
• Rash: mild skin irritation or redness.

Serious or Rare Side Effects

• Pulmonary toxicity: interstitial lung disease or acute respiratory distress.
• Hepatic injury: elevated liver enzymes or hepatitis.
• Hemolytic anemia: especially in patients with G6PD deficiency.
• Severe allergic reactions: anaphylaxis or angioedema.
• Peripheral neuropathy: tingling or numbness in extremities.
• Blood dyscrasias: agranulocytosis or leukopenia.

Before prescribing Nitrofurantoin, clinicians should consider several safety factors.

• Renal function: assess creatinine clearance; avoid if severely impaired.
• Pregnancy: avoid unless benefits outweigh risks, especially in the first trimester.
• Elderly patients: monitor renal function and adjust therapy as needed.
• G6PD deficiency: contraindicated due to risk of hemolysis.
• Concomitant medications: review for potential interactions.
• Store below 25°C: keep in the original pack, protect from moisture.

Nitrofurantoin can interact with other medicines, requiring attention to avoid reduced efficacy or increased toxicity.

Major Interactions (Avoid)

• Antacids containing magnesium or aluminum: markedly decrease nitrofurantoin absorption.
• Probenecid: may increase nitrofurantoin plasma concentrations.
• Cimetidine: can raise nitrofurantoin levels, enhancing toxicity.

Moderate Interactions (Monitor Closely)

• Warfarin: nitrofurantoin may potentiate anticoagulant effect, requiring INR monitoring.
• Fluoroquinolones: combined use may increase risk of tendonitis or tendon rupture.
• High‑dose vitamin C: may reduce nitrofurantoin efficacy by altering urinary pH.