Nitrofurantoin Mercury Pharmaceuticals (Nitrofurantoin)

Nitrofurantoin is converted by bacterial flavoprotein enzymes into reactive metabolites that bind to bacterial DNA and other macromolecules. This binding damages the bacterial genome and interferes with essential cellular processes, ultimately inhibiting bacterial growth and leading to bacterial death.

The prescribed dose of Nitrofurantoin is set by the treating clinician based on factors such as the severity of infection, the patient’s renal function, age, and any relevant comorbidities. Dosage regimens are individualized and should follow the prescriber’s instructions.

Nitrofurantoin is classified as pregnancy category B, indicating that animal studies have not shown risk but adequate human data are lacking. It may be used during pregnancy only when clearly needed. Small amounts are excreted in breast milk; caution is advised, and the prescriber should evaluate the risk‑benefit ratio.

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The most common alternative for uncomplicated UTIs is trimethoprim‑sulfamethoxazole. Nitrofurantoin offers a different mechanism of action and retains activity against many strains resistant to trimethoprim‑sulfamethoxazole. It is generally well‑tolerated but requires adequate renal function for urinary concentration, whereas trimethoprim‑sulfamethoxazole may be used in patients with reduced kidney function.

Nitrofurantoin tablets should be stored at room temperature, below 25 °C, in the original packaging to protect from moisture and light. Keep the container tightly closed and out of reach of children. Do not store in humid or excessively hot environments.

Nitrofurantoin is taken orally, usually as a tablet, with a full glass of water. It can be taken with food or milk to reduce gastrointestinal irritation. The exact timing and frequency are determined by the prescriber, and the full course should be completed even if symptoms improve.

Serious adverse reactions include pulmonary toxicity (interstitial lung disease), hepatic injury, severe allergic responses such as anaphylaxis, hemolytic anemia in patients with G6PD deficiency, peripheral neuropathy, and rare skin reactions like Stevens‑Johnson syndrome. Prompt medical attention is required if any of these occur.

Nitrofurantoin should be avoided in patients with severe renal impairment (creatinine clearance <60 mL/min), known hypersensitivity to nitrofurantoin or other nitrofurans, G6PD deficiency, and in those who have previously experienced serious pulmonary or hepatic reactions to the drug.