Nitrofurantoin Olikla (Nitrofurantoin)

Nitrofurantoin is used to manage infections of the urinary tract caused by susceptible bacteria.

• Uncomplicated urinary tract infection: eradicates the causative uropathogen and relieves urinary symptoms.
• Acute cystitis: provides bacteriostatic or bactericidal activity to clear bladder infection.
• Prophylaxis of recurrent urinary tract infection: reduces the frequency of future episodes when taken as a preventive regimen.

• Nitrofurantoin interferes with bacterial carbohydrate metabolism and disrupts cell‑wall synthesis. The drug is reduced by bacterial flavoproteins to reactive intermediates that damage bacterial DNA, ribosomal proteins, and other macromolecules, resulting in bacteriostatic or bactericidal activity against susceptible urinary pathogens.

Nitrofurantoin may cause a range of adverse reactions, most of which are mild and reversible.

Common Side Effects

• Nausea: mild to moderate upset stomach.
• Loss of appetite: reduced desire to eat.
• Headache: transient cranial discomfort.
• Diarrhoea: loose stools occurring during therapy.

Serious or Rare Side Effects

• Pulmonary toxicity: interstitial lung disease presenting with cough and dyspnoea.
• Hepatic injury: elevated liver enzymes or jaundice.
• Peripheral neuropathy: tingling or numbness in extremities.
• Hemolytic anaemia: especially in patients with G6PD deficiency.
• Severe allergic reactions: rash, angioedema, or anaphylaxis.
• Blood dyscrasias: agranulocytosis or leukopenia.

Before prescribing Nitrofurantoin, clinicians should evaluate patient‑specific risk factors and monitor for adverse events.

• Renal function assessment: avoid use when creatinine clearance is below 60 mL/min.
• G6PD deficiency: use with caution due to risk of haemolysis.
• Pulmonary monitoring: discontinue if signs of lung toxicity develop.
• Pregnancy and lactation: consider alternative agents unless benefits outweigh risks.
• Drug‑induced liver injury: monitor liver function tests during prolonged therapy.
• Store at below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Nitrofurantoin can interact with several medicines, altering its absorption or increasing toxicity.

Major Interactions (Avoid)

• Antacids containing magnesium or aluminium: reduce oral absorption of nitrofurantoin.
• Probenecid: increases plasma concentrations, raising risk of toxicity.
• Warfarin: may enhance anticoagulant effect, requiring INR monitoring.
• Methenamine: concurrent use can diminish antimicrobial efficacy.

Moderate Interactions (Monitor Closely)

• Diuretics: may increase nitrofurantoin serum levels, necessitating renal monitoring.
• NSAIDs: combined renal stress may impair kidney function.
• Oral contraceptives: possible reduction in contraceptive effectiveness, advise additional protection.