How do you cope with Macrobid nausea. What are the common side effects of nitrofurantoin. How can you mitigate the side effects of this antibiotic. What are the serious side effects to watch out for when taking nitrofurantoin.

Understanding Nitrofurantoin and Its Common Side Effects

Nitrofurantoin, commonly known by its brand name Macrobid, is a widely prescribed antibiotic used to treat urinary tract infections (UTIs). While it’s an effective medication, it can cause various side effects that patients should be aware of. Understanding these side effects and knowing how to manage them can significantly improve your treatment experience.

What are the most common side effects of nitrofurantoin?

The most frequently reported side effects of nitrofurantoin include:

• Nausea
• Vomiting
• Diarrhea
• Loss of appetite
• Headaches
• Dizziness or drowsiness

It’s important to note that while these side effects can be uncomfortable, they are generally not severe and often subside as your body adjusts to the medication.

Coping with Macrobid Nausea: Practical Tips and Strategies

Nausea is one of the most common complaints among patients taking nitrofurantoin. Fortunately, there are several strategies you can employ to minimize this uncomfortable side effect.

How can you reduce nausea when taking Macrobid?

To alleviate nausea associated with nitrofurantoin:

1. Take the medication with food or immediately after a meal
2. Avoid rich or spicy foods that may exacerbate nausea
3. Consume small, frequent meals throughout the day
4. Stay hydrated by sipping water or clear fluids
5. Try ginger tea or ginger supplements, known for their anti-nausea properties

If nausea persists or becomes severe, consult your healthcare provider. They may be able to adjust your dosage or suggest alternative treatments.

Managing Vomiting and Diarrhea: Preventing Dehydration

Vomiting and diarrhea are two side effects that can lead to dehydration if not properly managed. Staying hydrated is crucial when experiencing these symptoms.

What steps can you take to prevent dehydration?

To combat dehydration caused by vomiting or diarrhea:

• Drink plenty of clear fluids, such as water, clear broths, or electrolyte solutions
• Take small, frequent sips rather than large amounts at once
• Avoid caffeine and alcohol, which can worsen dehydration
• Eat bland, easily digestible foods when you feel up to it
• Monitor your urine output and color – dark, strong-smelling urine can indicate dehydration

If symptoms persist for more than 24 hours or you show signs of severe dehydration, seek medical attention immediately.

Dealing with Loss of Appetite: Maintaining Proper Nutrition

Loss of appetite is a common side effect that can impact your overall health if not addressed. Ensuring proper nutrition while taking nitrofurantoin is essential for your body’s ability to fight infection and recover.

How can you maintain good nutrition despite a decreased appetite?

To combat loss of appetite and maintain proper nutrition:

1. Eat smaller, more frequent meals throughout the day
2. Choose nutrient-dense foods to maximize your calorie intake
3. Incorporate protein-rich snacks like nuts, seeds, or yogurt
4. Try liquid nutritional supplements if solid foods are unappealing
5. Stay hydrated, as dehydration can further suppress appetite

Remember, maintaining good nutrition is crucial for your body’s ability to fight infection and recover. If your appetite doesn’t improve, consult your healthcare provider for additional strategies.

Addressing Headaches and Dizziness: Safety Precautions

Headaches and dizziness can be uncomfortable and potentially dangerous side effects of nitrofurantoin. Taking appropriate measures to manage these symptoms is crucial for your safety and well-being.

What precautions should you take if experiencing headaches or dizziness?

To manage headaches and dizziness:

• Rest in a quiet, dark room when symptoms occur
• Stay hydrated by drinking plenty of water
• Use over-the-counter pain relievers like acetaminophen or ibuprofen, if approved by your doctor
• Avoid driving or operating heavy machinery if you feel dizzy
• Move slowly when changing positions to prevent sudden drops in blood pressure

If headaches are severe or persistent, or if dizziness significantly impacts your daily activities, contact your healthcare provider for further guidance.

Recognizing Serious Side Effects: When to Seek Medical Attention

While most side effects of nitrofurantoin are mild, some can be serious and require immediate medical attention. Being aware of these potentially severe reactions is crucial for your safety.

What are the serious side effects of nitrofurantoin that require immediate medical attention?

Seek immediate medical care if you experience any of the following:

• Chest pain or difficulty breathing
• Coughing up blood or mucus
• Yellowing of the skin or eyes (jaundice)
• Unexplained bruising or bleeding
• Severe headaches
• Tingling sensations, numbness, or weakness
• Signs of a severe allergic reaction (anaphylaxis)

These symptoms could indicate serious lung, liver, or blood problems, or a severe allergic reaction that requires immediate medical intervention.

Long-term Use of Nitrofurantoin: Monitoring and Precautions

While nitrofurantoin is generally safe for short-term use, long-term or repeated use may require additional monitoring and precautions. Understanding the potential risks associated with extended use is important for patients and healthcare providers alike.

What precautions should be taken for long-term nitrofurantoin use?

For patients on long-term nitrofurantoin therapy:

1. Regular liver function tests may be necessary to monitor for potential liver damage
2. Periodic lung function tests may be recommended to check for pulmonary toxicity
3. Be vigilant for symptoms of peripheral neuropathy, such as tingling or numbness in extremities
4. Report any persistent or worsening side effects to your healthcare provider promptly
5. Discuss the benefits and risks of long-term use with your doctor regularly

Long-term use of nitrofurantoin should always be under close medical supervision to minimize the risk of serious complications.

Alternative Treatments: When Nitrofurantoin Isn’t the Right Choice

While nitrofurantoin is an effective antibiotic for many UTIs, it may not be suitable for everyone. In some cases, alternative treatments may be more appropriate, especially if side effects are severe or persistent.

What are some alternatives to nitrofurantoin for treating UTIs?

Alternative treatments for UTIs may include:

• Other antibiotics such as trimethoprim-sulfamethoxazole or ciprofloxacin
• D-mannose supplements, which may help prevent bacterial adhesion to the urinary tract
• Cranberry products, although evidence for their effectiveness is mixed
• Increased fluid intake to help flush out bacteria
• Probiotics to support urinary tract health

Always consult with your healthcare provider before switching treatments or trying alternative remedies. They can help determine the most appropriate course of action based on your specific situation and medical history.

In conclusion, while nitrofurantoin is an effective treatment for UTIs, it’s crucial to be aware of its potential side effects and how to manage them. By understanding these effects and taking appropriate precautions, you can maximize the benefits of your treatment while minimizing discomfort. Remember to always communicate openly with your healthcare provider about any concerns or persistent side effects you experience during your course of treatment. With proper management and care, most patients can successfully complete their nitrofurantoin therapy and recover from their UTI.

Side effects of nitrofurantoin – NHS

Like all medicines, nitrofurantoin can cause side effects, although not everyone gets them.

Common side effects

There are things you can do to help cope with these common side effects of nitrofurantoin.

Feeling sick (nausea)

Taking nitrofurantoin with or after a meal or snack should help prevent this. It may also help if you avoid rich or spicy food.

Being sick (vomiting)

Have frequent sips of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having strong-smelling pee. Do not take any other medicines to treat vomiting without speaking to a pharmacist or doctor.

If you take contraceptive pills and you’re being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Diarrhoea

Drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you take contraceptive pills and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Loss of appetite

Eat when you would usually expect to be hungry. If it helps, eat smaller meals more often than usual. Snack when you’re hungry. Have nutritious snacks that are high in calories and protein, such as dried fruit and nuts.

Headaches

Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Painkillers you can buy without a prescription, such as paracetamol and ibuprofen, are safe to take with nitrofurantoin. Speak to your doctor if these do not help or the headaches are severe.

Dizziness or feeling sleepy

If nitrofurantoin makes you feel dizzy, stop what you’re doing and sit or lie down until you feel better. Do not drive a car or ride a bike while you’re feeling dizzy or sleepy.

Keep taking the medicine, but speak to a doctor if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Nitrofurantoin may cause your pee to turn dark yellow or a brownish colour. This is normal and is not a reason to stop taking the medicine. Your pee will return to its usual colour once you stop taking nitrofurantoin.

Serious side effects

Serious side effects are rare and happen in less than 1 in 1,000 people.

Call a doctor or contact 111 straight away if you have:

• a cough, coughing up blood or mucus, shortness of breath, pain when you breathe or a high temperature – these can be signs of lung problems
• pale poo and dark pee together, or the whites of your eyes turn yellow or your skin turns yellow (this may be less obvious on brown or black skin) – this can be a sign of liver or gallbladder problems
• bruising or bleeding you cannot explain (including nosebleeds), sore throat, a high temperature and feeling tired or generally unwell – these can be signs of blood problems
• severe headaches

Go to 111. nhs.uk or call 111.

Immediate action required: Call 999 or go to A&E if:

• you get chest pain or difficulty breathing – these can be signs of lung problems
• you get pins and needles, tingling sensations, numbness or weakness – these can be signs of nerve problems

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction to nitrofurantoin (anaphylaxis).

Immediate action required: Call 999 or go to A&E now if:

• you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
• you’re wheezing
• you get tightness in the chest or throat
• you have trouble breathing or talking
• your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

Other side effects

These are not all the side effects of nitrofurantoin. For a full list see the leaflet inside your medicines packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

Page last reviewed: 7 January 2022

Next review due: 7 January 2025

What to Do About Them

If you have a urinary tract infection (UTI), you may be interested in learning more about nitrofurantoin. It’s a generic prescription antibiotic used to treat UTIs in adults and some children.

Nitrofurantoin comes as an oral capsule (a capsule that you swallow). One kind of capsule contains two forms of the drug, nitrofurantoin monohydrate/macrocrystal. Another kind contains only nitrofurantoin macrocrystal. The drug also comes as an oral suspension, which is a kind of liquid mixture that you swallow.

This article covers nitrofurantoin monohydrate/macrocrystal capsules only. The brand-name version of this generic capsule is Macrobid. To learn more about other forms of nitrofurantoin, talk with your doctor or pharmacist.

Because nitrofurantoin is used to treat an infection, you’ll take the drug only for a short time.

This article describes nitrofurantoin’s side effects. For more information about nitrofurantoin, including details about its uses, see this in-depth article.

Some people may experience mild to serious side effects during their nitrofurantoin treatment. Examples of nitrofurantoin’s commonly reported side effects include:

• vomiting
• gas
• diarrhea
• headache*
• constipation*

* To learn more about this side effect, see the “Nitrofurantoin’s side effects explained” section below.

It’s possible to have mild side effects from taking nitrofurantoin. Examples of mild side effects that have been reported with nitrofurantoin include:

• dizziness
• tiredness
• itchiness
• weakness
• hair loss
• fever or chills
• confusion
• gas
• heartburn
• body aches and joint pain*
• headache*
• nausea* or vomiting
• stomach (belly) pain*
• constipation* or diarrhea
• mild allergic reaction*

* To learn more about this side effect, see the “Nitrofurantoin’s side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking nitrofurantoin unless your doctor recommends it.

Nitrofurantoin may cause mild side effects other than the ones listed above. See the drug’s prescribing information for details.

Serious side effects from nitrofurantoin are possible but not common. Serious side effects that have been reported with nitrofurantoin include:

• pancreatitis, which is inflammation (swelling and damage) of the pancreas
• peripheral neuropathy (nerve damage in your hands or feet)
• depression
• lung problems
• liver problems
• serious skin reactions, such as Stevens-Johnson syndrome
• hemolytic anemia, caused by red blood cells being destroyed faster than they’re made
• severe diarrhea from Clostridium difficile infection
• severe allergic reaction*

* To learn more about this side effect, see the “Nitrofurantoin’s side effects explained” section below.

If you develop serious side effects while taking nitrofurantoin, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with nitrofurantoin, visit MedWatch.

Get answers to some frequently asked questions about nitrofurantoin’s side effects.

Will taking nitrofurantoin monohydrate/macrocrystal 100 mg increase my risk of side effects compared with taking nitrofurantoin macrocrystal 100 mg?

It’s probably unlikely. You should experience similar side effects from both nitrofurantoin monohydrate/macrocrystal capsules (Macrobid) and nitrofurantoin macrocrystal capsules (Macrodantin). This is because both drugs contain similar ingredients.

Nitrofurantoin capsules can contain one form of the drug, nitrofurantoin macrocrystal, or two forms of the drug, nitrofurantoin monohydrate/macrocrystal.

Both versions of nitrofurantoin come in a strength of 100 milligrams (mg). (Nitrofurantoin monohydrate/macrocrystal capsules contain 75 mg of nitrofurantoin monohydrate and 25 mg of nitrofurantoin macrocrystal.) Nitrofurantoin macrocrystal is also available in other strengths.

Both kinds of nitrofurantoin capsule are used to treat urinary tract infections (UTIs). But nitrofurantoin macrocrystal can also be used to help prevent UTIs.

Nausea may occur more often in people taking nitrofurantoin monohydrate/macrocrystal than in people taking nitrofurantoin macrocrystal. If you have nausea from taking the former, talk with your doctor about switching to nitrofurantoin macrocrystal.

This article covers side effects of only nitrofurantoin monohydrate/macrocrystal capsules. If you have questions or concerns about the side effects of nitrofurantoin macrocrystal capsules, talk with your doctor.

Do older adults have a higher risk of side effects from nitrofurantoin?

It’s not known whether adults ages 65 years and older have a higher risk of side effects from nitrofurantoin. Studies of the drug did not include enough older adults to determine whether they may have a higher risk of side effects.

But older adults may have a higher risk of kidney problems than younger people. Since the kidneys work to break down nitrofurantoin, having kidney problems may cause the drug to build up in the body. This can increase the risk of side effects from nitrofurantoin.

If you’re an older adult and have concerns about your risk of nitrofurantoin’s side effects, talk with your doctor or pharmacist.

Could taking nitrofurantoin affect my urine?

Yes, it’s possible. For example, nitrofurantoin may cause your urine to turn brown. After you stop taking the medication, your urine will go back to its usual color.

Taking nitrofurantoin may also cause a false-positive urine sugar test. This is a test that can check for diabetes. If you need to have a urine sugar test during treatment with nitrofurantoin, tell your doctor that you’re taking this drug. They may be able to recommend a different test to check your sugar level.

Learn more about some of the side effects nitrofurantoin may cause.

Body aches and joint pain

Nitrofurantoin can cause body aches and joint pain. Studies of the drug didn’t report how often these side effects occurred.

What might help

If you develop body aches or joint pain during your treatment with nitrofurantoin, tell your doctor. They may be able to recommend ways to ease any discomfort that you have. For example, they may suggest taking an over-the-counter (OTC) pain reliever such as Tylenol (acetaminophen) or Advil (ibuprofen).

Body aches may be a symptom of a fever, which can occur from a urinary tract infection (UTI), the condition nitrofurantoin is used to treat. If you have body aches, your doctor can check to make sure that the drug is working to treat your UTI.

Nausea

You may have nausea from taking nitrofurantoin. Nausea was one of the most common side effects that people taking nitrofurantoin reported in studies.

What might help

If you notice nausea from taking nitrofurantoin, tell your doctor. They can recommend ways to help prevent or treat your nausea. You might also try the home remedies discussed in this article.

It’s recommended that you take nitrofurantoin with food. In addition to helping the drug work more effectively, it may also help prevent nausea.

Nausea may occur more often with nitrofurantoin monohydrate/macrocrystal capsules than with nitrofurantoin macrocrystal capsules.* If you’re experiencing nausea from nitrofurantoin monohydrate/macrocrystal, your doctor may recommend switching to nitrofurantoin macrocrystal.

* For more information about these two kinds of nitrofurantoin capsules, see the “FAQs about nitrofurantoin’s side effects” section above.

Headache

Nitrofurantoin can cause headache. In studies, this was one of the most commonly reported side effects of the drug.

What might help

If you have headaches from taking nitrofurantoin, tell your doctor. They can help recommend ways to treat this side effect. For example, they may suggest taking an OTC medication, such as Tylenol (acetaminophen), to lessen your headaches.

Check out this article for a few tips that may also help relieve headache pain.

Stomach (belly) pain

It’s possible to have stomach (belly) pain from taking nitrofurantoin. But studies of the drug didn’t report how often this side effect occurred.

What might help

If you have belly pain during nitrofurantoin treatment, let your doctor know. In rare cases, this may be a symptom of a more serious side effect. Examples include pancreatitis, which is inflammation (swelling and damage) of the pancreas, and liver problems.

Your doctor will check to see what may be causing your belly pain. In addition, they can recommend ways to ease this pain.

Constipation

Nitrofurantoin can cause constipation, although studies did not report how often this side effect occurred.

Symptoms of constipation include straining when having a bowel movement or going to the bathroom less often than usual.

What might help

If you have constipation from taking nitrofurantoin, tell your doctor. They can recommend ways to decrease your constipation. For example, they may suggest increasing your fiber or taking an OTC medication such as MiraLAX (polyethylene glycol).

You can also try some of the constipation remedies discussed in this article.

Allergic reaction

Like most drugs, nitrofurantoin can cause an allergic reaction in some people.

Symptoms can be mild to serious and may include:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)
• swelling under your skin, usually in your eyelids, lips, hands, or feet
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

• an antihistamine you take by mouth, such as Benadryl (diphenhydramine)
• a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to nitrofurantoin, they’ll decide if you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to nitrofurantoin, they may have you switch to a different treatment.

Keeping track of side effects

During your nitrofurantoin treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

• what dose of the drug you were taking when you had the side effect
• how soon you had the side effect after starting that dose
• what your symptoms were
• how symptoms may have affected your daily activities
• what other medications you were taking
• any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how nitrofurantoin affects you. They can then use this information to adjust your treatment plan if needed.

Nitrofurantoin may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether nitrofurantoin is a good treatment option for you.

Talk with your doctor about your health history before starting nitrofurantoin. Factors to consider include those described below.

Peripheral neuropathy. Nitrofurantoin can cause peripheral neuropathy. If you already have this kind of nerve damage, taking nitrofurantoin may make your condition worse. Before taking nitrofurantoin, tell your doctor if you have nerve damage. This will help them determine whether the drug is safe for you to take.

Liver conditions. Nitrofurantoin can cause liver problems, including liver damage. If you have a liver condition, taking this drug may worsen your condition. Let your doctor know about any liver problems you have before starting nitrofurantoin treatment. They’ll discuss with you whether it’s safe for you to take the drug.

Glucose-6-phosphate dehydrogenase deficiency (G6PD deficiency). If you have G6PD deficiency, tell your doctor before starting nitrofurantoin treatment. This genetic condition may increase your risk of hemolytic anemia if you take nitrofurantoin. Your doctor may monitor you more closely for this side effect during treatment. Or they may recommend a medication other than nitrofurantoin for your condition.

Allergic reaction. If you’ve had an allergic reaction to nitrofurantoin or any of its ingredients, your doctor will likely not prescribe nitrofurantoin. Ask them what other medications are better options for you.

Lung conditions. Although rare, it’s possible for nitrofurantoin to cause lung problems. If you already have a lung condition, the drug may increase your risk of this side effect. Tell your doctor about any lung conditions that you have before taking nitrofurantoin. This will help them determine whether nitrofurantoin may be safe for you to take.

Kidney problems. It may not be safe for people with certain kidney conditions to take this drug. If you have any kidney problems, tell your doctor before taking nitrofurantoin. They can determine whether nitrofurantoin is a good treatment option for you. Depending on how severe your kidney problem is, your doctor may recommend a different treatment for your condition.

Alcohol and nitrofurantoin

It might be safe to drink alcohol during your nitrofurantoin treatment. But drinking alcohol during your treatment with this medication may increase your risk of certain side effects. Examples include:

• headache*
• nausea* or vomiting
• dizziness
• confusion
• liver problems

* To learn more about this side effect, see the “Nitrofurantoin’s side effects explained” section above.

If you’d like to drink alcohol while taking nitrofurantoin, talk with your doctor. They can let you know how much alcohol, if any, may be safe for you to consume during treatment.

Pregnancy and breastfeeding while taking nitrofurantoin

It’s not known whether it’s safe to take nitrofurantoin while pregnant. At this time, there aren’t enough studies to determine what risks nitrofurantoin may cause in someone taking the drug during pregnancy.

But it’s important to note that anyone who is pregnant should not take nitrofurantoin after week 37 of pregnancy. This drug can cause hemolytic anemia, a condition resulting from red blood cells being destroyed faster than they’re made. Due to this side effect, it’s thought that the drug may cause damage to red blood cells in a newborn.

As a result, doctors will usually prescribe nitrofurantoin during pregnancy only if no safer treatment options are available.

In addition, nitrofurantoin can pass into breast milk. Because of the risk of side effects in a child who is breastfed, doctors usually will not recommend breastfeeding while taking nitrofurantoin.

If you’re pregnant or breastfeeding, or planning to become pregnant or breastfeed, tell your doctor. They can answer any questions you may have about using nitrofurantoin during pregnancy or while breastfeeding.

In most cases, side effects from nitrofurantoin are mild. But serious side effects are also possible from taking this medication.

If you have any questions about side effects that nitrofurantoin can cause, ask your doctor. Knowing more about the drug’s side effects can help you and your doctor decide if it’s a good treatment option for you.

Here are a few questions you might want to ask:

• Is my risk of side effects higher when I start taking nitrofurantoin?
• How do the side effects of nitrofurantoin compare with other drugs to treat my condition?
• Does nitrofurantoin cause any long-term side effects?
• Are there any side effects I should tell you about right away?

You can also ask your doctor about Macrobid, which is the brand-name version of nitrofurantoin. A generic drug and its brand-name version are expected to have similar side effects because they contain the same active ingredient. (An active ingredient is what makes a drug work.)

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Nitrofurantoin Monohydrate Macrocrystals – instructions for use, dosage, composition, analogs, side effects / Pillintrip Presentation forms

Therapeutic indications Method of application and doses Contraindications Special warnings and precautions Influence on the ability to drive and use machines Side effects Overdose Pharmacodynamics 0005 Pharmacokinetics Preclinical safety data Interactions Special precautions for disposal and other processing Prices

Page reviewed by pharmacist Milityan Inessa Mesropovna Last updated 2020-03-24

Attention!
The information on this page is for healthcare professionals only!
The information is collected from open sources and may contain significant errors!
Be careful and double-check all the information on this page!

Top 20 medicines with the same ingredients: ifurettenFuradoninNitrofurantoin (Monohydrate/Macrocrystals)Infurin

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GyrablockNoroxinNolicin-SMonuralOfloxacine StullnSupramycina ForteMonuralMonodoksNorxacinTarividAmermycinRemycinFloxa WestFosfomycin AristoOflodexDoxycycline Hyclate KukjeDoxyfermDoxylcapMonur ilTetradox

Name of the medicine

Description The name of the medicine Nitrofurantoin Monohydrate Macrocrystals is an automatic translation from the original language.
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Nitrofurantoin Monohydrate Macrocrystals

Composition

Description Composition Nitrofurantoin Monohydrate Macrocrystals is an automatic translation from the original language.
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Nitrofurantoin

Formulations

Description Formulations Nitrofurantoin Monohydrate Macrocrystals is an automatic translation from the original language.
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Capsule

Therapeutic indications

Description Therapeutic indications Nitrofurantoin Monohydrate Macrocrystals is an automatic translation from the original language.
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For the treatment and prevention of acute or recurring uncomplicated lower urinary tract infections or pyelitis either spontaneously or after surgery. Indicated in adults, children and children over 12 years of age.

Macrobid is specifically indicated for the treatment of infections when it comes to susceptible strains Escherichia coli , Enterococci, Staphylococci, Citrobacter , Klebsiella as well as Enterobacter acts.

Most of the tribes of Proteus and Serratia resistant. All Pseudomonas – Resistant strains.

Macrobid is not indicated for the treatment of kidney-related cortical or peripheric ABSENCES

Dosage and Administration

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Dosage

Adults and children over 12 years of age.

The dose should be taken with food or milk (eg with food).

Acute or recurrent uncomplicated UTI and pyelitis 100 mg twice daily for seven days.

Surgical prophylaxis – 100 mg twice a day on the day of the procedure and 3 days after it.

Older

Unless there is significant renal insufficiency for which nitrofurantoin is contraindicated, the dosage should be applied to every normal adult.

See Precautions and Risks for Elderly Patients Associated with Long-Term Therapy.

Children under 12

Macrobid is a fixed dosage and therefore not suitable for children under 12 years of age

Renal insufficiency

eGFR less than 45 ml/min.

Directions for use

Oral

Contraindications

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–

– Patients with renal insufficiency with eGFR less than 45 ml/min.

-)

– Acute porphyria.

– in children under three months of age and in pregnant women during pregnancy (during labor and delivery) due to the theoretical possibility of hemolytic anemia in the fetus or in the newborn due to immature erythrocyte enzyme systems.

Special warnings and precautions

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Nitrofurantoin is not effective in the treatment of parenchymal infections in a unilaterally functioning kidney. The cause of surgical infection must be ruled out in recurrent or severe cases.

Nitrofurantoin should only be used as short-term therapy for the treatment of uncomplicated lower urinary tract infection in selected cases with an eGFR in the range of 30-44 ml/min for the treatment of resistant pathogens with caution if use outweighs the risks.

Because existing medical conditions may mask liver or lung side effects, nitrofurantoin should be used with caution in patients with lung disease, liver dysfunction, neurological disorders, and allergic diathesis.

Peripheral neuropathy and susceptibility to peripheral neuropathy, which may become severe or irreversible, has occurred and may be life-threatening. Therefore, treatment should be stopped at the first sign of neuronal damage (paresthesia).

Nitrofurantoin should be used with caution in patients with anemia, diabetes mellitus, electrolyte imbalance, debilitating conditions and vitamin B deficiency (especially folic acid).

Acute, subacute and chronic pulmonary reactions have been observed in patients treated with nitrofurantoin. If these reactions occur, nitrofurantoin should be discontinued immediately.

Chronic lung reactions (including pulmonary fibrosis and diffuse interstitial pneumonitis) can develop insidiously and are common in the elderly. Accurate monitoring of lung disease in patients receiving long-term therapy is justified (especially in the elderly).

Urine may be yellow or brown after taking nitrofurantoin. Nitrofurantoin patients are prone to false positive urinary glucose (if tested for reducing agents).

Nitrofurantoin should be discontinued if patients suspected of having glucose-6-phosphate dehydrogenase deficiency show signs of hemolysis.

Gastrointestinal reactions can be minimized by taking the drug with food or milk or by adjusting the dose.

For long-term treatment, closely monitor the patient for liver or lung symptoms and other signs of toxicity.

Discontinue treatment with nitrofurantoin if unexplained pulmonary, hepatotoxic, haematological or neurological syndromes otherwise occur.

Effect on ability to drive and use machines

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Macrobid may cause dizziness and drowsiness. Patients should be advised not to drive or operate machinery if so affected until such symptoms have resolved.

Side effects

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A tabular list of side effects is shown below:

Undesirable effects are listed according to organ systems and the following frequencies:

Rare (> 1/10000 – <1/1000)

Unknown estimated from available data)

9 0004

900 68

* Acute pulmonary reactions usually occur within the first week of treatment and are reversible when therapy is discontinued. Acute pulmonary reactions often present with fever, chills, cough, chest pain, dyspnea, pulmonary infiltration with consolidation or pleural effusion on chest x-ray, and eosinophilia. In subacute pulmonary reactions, fever and eosinophilia occur less frequently than in the acute form. Chronic lung reactions are rare in patients who have received continuous therapy for six months or more and are more likely to occur in the elderly. ECG changes occurred in conjunction with lung responses

** May be fatal

Reporting suspected side effects

It is important to report suspected side effects after drug approval. This allows for continuous monitoring of the balance of benefits and risks of the drug. Healthcare professionals are encouraged to report suspected side effects through the MHRA Yellow Card Scheme website: www.mhra.gov.uk/yellowcard or search for an MHRA Yellow Card on Google Play or the Apple App Store.

Overdose

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Symptoms

Symptoms And signs of overdose – stomach irritation, nausea and vomiting.

Control

No specific antidote. However, nitrofurantoin can be hemodialyzed. Standard treatment is by induction of vomiting or gastric lavage if taken recently. Monitoring of whole blood count, liver function tests and lung function is recommended. A high fluid intake must be maintained to increase urinary excretion.

Pharmacodynamics

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Pharmacotherapeutic group: systemic antibacterials, nitrofuranderivates

ATC code: J01XE01

Mechanism of action

Nitrofurantoin is a broad-spectrum antibacterial agent that works against most urinary pathogens. It is a bactericide in kidney tissue and in all urinary tracts. A wide range of organisms susceptible to bacterial activity include Escherichia coli, Enteroccus faecalis, Klebsiella spp., Enterobacter spp., Staphylococcus spp.: (e.g. S. aureus, S. saprophyticus, S. epidermidis)

Clinically, the most common urinary pathogens are sensitive to nitrofurantoin. Some tribes from Enterobacter and Klebsiella are resistant. Nitrofurantoin is not effective against most strains of Proteus or Serratia species. It has no activity against Pseudomonas species.

Pharmacokinetics

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Entry:

Each macrobid capsule contains two forms of nitrofurantoin. 25% of the dose is macrocrystalline nitrofurantoin, which has a slower resolution and absorption than microcrystalline nitrofurantoin. The remaining 75% of the dose is microcrystalline nitrofurantoin, which is contained in a powder mixture that forms a gel matrix when exposed to gastric and intestinal fluids, resulting in an altered release of active substances over time. Together, these systems offer a clinically effective bactericidal concentration of urine at therapeutic doses.

Distribution:

Plasma concentrations of nitrofurantoin at therapeutic doses of macrobid capsules are low, with peak values ​​usually less than 1 µg/mL. Nitrofurantoin is readily soluble in urine, which may give a brown color. Unlike many drugs, the presence of products or agents that delay gastric emptying increases the bioavailability of the macrobid capsule.

Liquidation:

Approx. 20-25% of the total single dose of nitrofurantoin is still obtained from the urine within 24 hours.

Preclinical Safety Data Sheet

Description Preclinical Safety Data Sheet Nitrofurantoin Monohydrate Macrocrystals is an automatic translation from the original language.
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No one specified.

Interaction

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Unusable

Special precautions for disposal and other handling

Description Special precautions for disposal and other handling Nitrofurantoin Monohydrate Macrocrystals is an automatic translation from the original language.
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unused product or waste must be disposed of in accordance with local regulations.

Nitrofurantoin Monohydrate Macrocrystals price

We do not have exact data on the cost of this medicine.
However, we will provide data for each active ingredient

The average cost of Nitrofurantoin 100 mg per unit in online pharmacies is from $0. 54 to $0.98, per package from $41 to $98.

The average cost of Nitrofurantoin 50 mg per unit in online pharmacies is from $0.48 to $0.8, per pack from $38 to $80.

Sources:

• https://www.drugs.com/search.php?searchterm=nitrofurantoin-monohydrate-macrocrystals-1
• https://pubmed.ncbi.nlm.nih.gov/?term= nitrofurantoin-monohydrate-macrocrystals-1

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Nausea – causes, diagnosis and treatment

Nausea is a peculiar feeling of discomfort in the epigastrium, behind the sternum, in the throat and mouth, which is often a harbinger of vomiting. May be accompanied by salivation, hyperhidrosis, weakness, dizziness. It is extremely rarely observed in healthy people with diet errors. Usually appears in diseases of the digestive organs and the central nervous system, intoxication conditions. To clarify the causes of nausea, endoscopic, radiological, ultrasound, electrophysiological and laboratory research methods are used. Before the diagnosis is made, sedative herbal remedies, prokinetics, and enterosorbents are usually used to reduce the severity of the symptom.

General characteristics

Patients characterize nausea as a painful sensation in the mouth, throat, along the esophagus, in the epigastrium, accompanied by a desire to induce vomiting or an urge to vomit. In addition to discomfort in the digestive tract, abundant salivation, an unusual taste in the mouth, cold extremities, sweating, hyperhidrosis of the palms and feet are often noted. Characterized by weakness, dizziness, darkening of the eyes, unsteady gait. Epigastric constriction may be felt. From the outside, patients look confused, insecure, pale, sweaty. In some cases, the connection of nausea with food is revealed.

With food errors, mild poisoning, a number of gastroenterological diseases, the patient’s condition may improve spontaneously or after vomiting. Constant nausea lasting longer than two days is an indication for consulting a gastroenterologist or therapist. The combination of nausea with thoracic, abdominal and headache, vomiting of blood or masses of the color of coffee grounds, black tarry stools, hyperthermia over 38 ° C, convulsions, lack of urine, confusion is sufficient reason to seek emergency medical help.

Mechanism of development

Nausea is based on the activation of the neural arc of the gag reflex at a level insufficient for the onset of vomiting. The most common starting point for a reflex reaction is irritation of peripheral receptors located in the digestive and a number of other organs. Less commonly, the reflex is activated due to excitation of the vomiting center, exposure to toxic substances or metabolites on the receptive zone of the bottom of the fourth ventricle of the brain. In a number of conditions (for example, pregnancy), a combination of several triggering factors is possible.

Regardless of the reasons that provoked the development of nausea, the mechanism of its formation is based on a single pathophysiological process. When the vomiting center is activated, the tone of the muscular membrane of the stomach decreases, its peristalsis slows down or completely stops. A simultaneous increase in the tone of the duodenum and the proximal part of the jejunum causes duodenogastric reflux. An increase in the volume of gastric chyme leads to reflex relaxation of the cardia, contraction of the antrum, diaphragm and intercostal muscles, which is perceived as an urge to vomit.

Classification

When systematizing the forms of nausea, its duration, features of onset and mechanism of development are taken into account. According to the duration of discomfort, episodic and permanent forms of the disorder are distinguished. Episodic nausea usually comes on suddenly and may or may not be food related. More often it appears with errors in nutrition, poisoning, and other acute conditions. Constant nausea of ​​varying intensity is more characteristic of CNS damage and chronic diseases. Depending on the pathogenesis, the following symptom variants are distinguished:

• Central (cerebral) nausea . Based on the excitation of the vomiting center in the pathology of the nervous system. It is observed with inflammatory or tumor damage to the substance and membranes of the brain, craniocerebral injuries, hypertensive crises. May occur suddenly or disturb the patient for a long time. After vomiting, the condition, as a rule, does not improve, but often intensifies.
• Toxic nausea . Associated with the activation of the vomiting center due to exo- and endotoxin irritation of the chemoreceptor zone in the bottom of the IV ventricle. It is noted in case of poisoning with drugs, poisonous products and substances, toxic metabolites in liver and kidney failure, radiation sickness, ketoacidosis in patients with diabetes mellitus. The intensity of the symptom depends on the severity of intoxication.
• Reflex nausea . Caused by irritation of the receptor apparatus of the nervous chain of the gag reflex. Nerve endings that stimulate nausea are located in the root of the tongue, posterior pharyngeal wall, stomach, ileocecal zone, intestines, pancreas, hepatobiliary system, peritoneum, inner ear and other organs. It is most often associated with food intake and manifests itself in the structure of gastrointestinal diseases.
• Vestibular (motor) nausea . It is provoked by a change in body position, direction or speed of movement with irritation of the vestibular apparatus and excitation of the vomiting center. In a healthy person, it occurs in the form of motion sickness when driving a car or rotating movements of the body. It is characteristic of brain pathology with damage to the inner ear, cerebellopontine angle and vestibular stem nuclei.
• Psychogenic nausea . It is observed during the implementation of a firmly fixed conditioned reflex. Nausea is triggered by olfactory and visual sensations that cause disgust or unpleasant emotions. It often manifests itself in neurotic and neurosis-like states, psychogenies, overwork, conflicts. It can serve as a somatoform manifestation of depression, psychotic disorders.
• Metabolic nausea . It develops due to violations of the physiological transformation of nutrients against the background of vitamin, mineral, endocrine deficiency. Probably, it is realized through the influence of metabolites on the receptor zone of the medulla oblongata and activation of nerve endings against the background of a secondary gastrointestinal tract lesion. Detected in patients with hypothyroidism, hyperfunction of the parathyroid glands, premenstrual syndrome, etc.

Causes of nausea

Causes of nausea after eating

In some patients, nausea associated in time with the use of food has a physiological origin and is caused by overeating, errors in diet, changes during pregnancy. Pathological causes of nausea after eating are:

• Diseases of the stomach : acute gastritis, atony, neoplasms.
• Food allergy .
• Body poisoning : food poisoning, plant poisoning, drug overdose.
• Diseases of the pancreato-duodenal zone : duodeno-gastric reflux, duodenostasis, chronic pancreatitis (including alcohol).
• Pathology of the hepatobiliary system : chronic cholecystitis and cholangitis, biliary dyskinesia, liver echinococcosis.
• Infectious processes : rotavirus and norovirus infections, escherichiosis, salmonellosis.
• Complications after surgical interventions : dumping syndrome, postcholecystectomy syndrome.

Causes of nausea on an empty stomach

A healthy person may experience nausea on an empty stomach when taking certain medications (vitamins, iron preparations) before meals. In most cases, the appearance of a symptom indicates damage to the gastrointestinal tract, less often – about other pathological conditions. Causes of nausea on an empty stomach are:

• Diseases Gastrointestinal tract : erosion of the esophagus, gastritis and peptic ulcer, irritable stomach syndrome.
• Parasitic infestations : giardiasis, toxoplasmosis, ascariasis.
• Endogenous poisonings : uremia, chronic renal failure, cancer intoxication.
• Migraine .
• Early toxicosis during pregnancy .
• Emergency conditions : hypertensive crisis, acute abdomen syndrome (appendicitis, peritonitis).

Causes of nausea during pregnancy

Nausea is one of the most common symptoms that pregnant women experience. Usually it is explained by a complex restructuring of the body for bearing a child, but it can also have pathological causes. Nausea during pregnancy is caused by:

• Physiological prerequisites : overeating, growth of the uterus, delayed defecation.
• Early toxicosis.
• Pathologies of pregnancy : preeclampsia and eclampsia, hyperthyroidism of pregnant women, polyhydramnios, cholestasis.
• Concomitant diseases of the gastrointestinal tract : GERD, chronic gastritis and pancreatitis, dysbacteriosis.
• Ovarian hyperstimulation syndrome .

Diagnosis

Patients complaining of nausea are initially referred to a specialist gastroenterologist. The doctor conducts a comprehensive examination of the digestive system to identify structural and functional disorders, which are most often accompanied by nausea. To establish the cause of nausea, laboratory and instrumental studies are used, the most informative of which are:

• Ultrasonic method . Ultrasound of the abdominal organs is a non-invasive and safe study that can be prescribed to all patients, including pregnant women. With the help of sonography, the doctor detects organic causes from the gastrointestinal tract and the biliary system: thickening or deformation of the walls of organs, volumetric formations.
• X-ray examination . Nausea is a common symptom of diseases of the esophagus and duodeno-gastric zone, for the detection of which X-ray with contrasting barium suspension is used. To assess the patency of the digestive tract and the rate of passage of chyme, a series of delayed x-rays is performed.
• Endoscopy . With the help of endoscopy, the state of the upper gastrointestinal tract is visually assessed: the mucous membrane is examined, signs of inflammation and destruction are revealed, and a biopsy of altered tissue areas is performed. If reflux is suspected, the method is supplemented by daily pH-metry inside the stomach and lower part of the esophagus.
• Examination of stool masses . The coprogram is carried out to detect characteristic signs of gastrointestinal pathologies, which are manifested by nausea. In the presence of symptoms of an intestinal infection, as a cause of nausea, bacteriological culture of feces is recommended to detect microorganisms. Additionally, the level of fecal elastase is determined.
• Laboratory tests . To clarify the diagnosis, a biochemical study of blood with liver tests, an assessment of the levels of acute phase indicators are shown. With the help of serological reactions, causative agents of intestinal infections are identified, helicobacteriosis is detected. The method is supplemented with specific breath tests.

In case of difficulties in diagnosis, CT or MRI of the abdominal cavity, duodenal sounding with bacteriological culture of bile are performed. Sometimes allergy tests are carried out with the most common allergens. Women who complain of nausea must be referred for a consultation with a gynecologist. After exclusion of gastroenterological pathology, a comprehensive neurological examination and consultations of other specialists are indicated.

Various medicines are used to relieve nausea

Treatment

Help before diagnosis

To reduce the intensity of nausea, it is recommended to drink ginger or mint tea, slowly eat a slice of lemon. It is better to eat food in small portions, avoid smoked meats and spicy foods, carbonated drinks and fast food. After eating, it is undesirable to occupy a horizontal position. People prone to allergies should limit their consumption of strawberries, peanuts, and citrus fruits as much as possible. Severe prolonged nausea, which makes it difficult to eat and is accompanied by vomiting, is the basis for contacting a gastroenterologist.

Conservative therapy

The treatment regimen is selected individually, after identifying the cause of nausea. In addition to medications, diet therapy, psychotherapy methods are used, which are especially effective for functional digestive disorders in pregnant women. Etiotropic and pathogenetic therapy is aimed at eliminating the cause of the underlying disease and individual links in the mechanism of its development, and drugs are also prescribed to relieve unpleasant symptoms. The most commonly used groups of pharmaceuticals are:0069

• Herbal sedatives . With moderate nausea, herbal medicines (valerian, motherwort) help, which normalize the autonomic nervous regulation of the digestive tract. Sometimes combined medicines, bromides are used.
• Antihistamines . These drugs are good at relieving nausea, the causes of which are associated with an allergic reaction to food. In case of systemic allergies, short courses of glucocorticosteroid hormones are additionally prescribed.
• Prokinetics . Medicines stimulate the peristalsis of the digestive tract, normalize the tone of the esophageal and gastric sphincters. To eliminate nausea, prokinetics are often combined with enterosorbents.
• Antisecretory agents . Proton pump inhibitors and H2 receptor blockers are indicated for nausea caused by increased stomach acid. High efficiency has a new class of drugs – prostaglandins.
• Serotonin receptor antagonists .
  

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System organ class	Frequency	Adverse effects
Infections and parasitic diseases	Unknown	Super infections caused by fungi or resistant organisms such as Pseudomonas. However, they are limited to the urogenital tract
Blood and lymphatic disorders	Rare Unknown	Aplastic anemia Agranulocytosis, leukopenia, granulocytopenia, hemolytic anemia, thrombocytopenia, glucose-6-phosphate hydrogenase deficiency anemia , megaloblasticemia and eosinophilia
Immune system disorders	Unknown	Allergic skin reactions, angioedema and anaphylaxis 9 0006
Mental disorders	Unknown	depression, euphoria, confusion, psychotic reactions
Nervous system disorders	Unknown	Peripheral neuropathy including optic neuritis (sensory and motor involvement), nystagmus, vertigo, dizziness, headache and drowsiness. Benign intracranial hypertension
Cardiac disease	Rare	Collapse and cyanosis 900 69
Respiratory, thoracic and mediastinal disorders	Unknown	Acute pulmonary reactions Subacute pulmonary reactions * Chronic pulmonary reactions Cough, dyspnea, pulmonary fibrosis; possible association with erythematous lupus syndrome.
Gastrointestinal disorders	Unknown	Sialadenitis, pancreatitis, nausea, anorexia, vomiting, abdominal pain and diarrhea.
Diseases of the liver and biliary tract	Unknown	Cholestatic jaundice, chronic active hepatitis**, liver necrosis 90 006
Skin and subcutaneous tissue disorders	Unknown	Temporary alopecia Exfoliative dermatitis and erythema multiforme (including Stevens-Johnson syndrome), maculopapular, erythematous or eczematous eruptions, urticaria, rash and pruritus. Hair-like syndrome associated with the reaction of the lungs. Drug rash With eosinophilia and systemic symptoms (DRESS syndrome), skin vasculitis 06	Yellow or brown discoloration of urine
General diseases and state administration site	Unknown	Asthenia, fever, chills, drug fever and arthralgia
Investigations	Unknown	False positive urine sugar