Reviewed by Dr Roy Kedem, MD
Information last reviewed 10/18/19
Nitrofurantoin is an antibiotic used to treat uncomplicated urinary tract infections (UTIs). An uncomplicated UTI may involve the bladder but does not involve the kidneys. UTIs are usually caused by bacteria traveling up the urethra and into the bladder.
Nitrofurantoin works by concentrating in the bladder, killing bacteria that have entered the bladder through the urethra and multiplied. At lower concentrations, Nitrofurantoin is generally bacteriostatic, meaning it stops bacteria from reproducing, At higher concentrations, Nitrofurantoin is bactericidal, meaning it kills bacteria.
Nitrofurantoin takes effect within days to stop bacteria from multiplying. For uncomplicated urinary tract infections, a 3 to 7 day course may be prescribed. Nitrofurantoin can also be used to prevent UTIs in patients with recurrent infections. When used for prevention, it may be prescribed daily for several months. Ultimately, your doctor will decide the appropriate duration of treatment.
Nitrofurantoin is not an appropriate treatment for kidney infections. Although it may have some effect, your doctor is more likely to prescribe an alternative antibiotic, that is better-suited for this purpose.
Each capsule contains 50 or 100mg of Nitrofurantoin as the active ingredient.
Additional ingredients include lactose, maize starch, pregelatinized maize starch, sodium starch glycolate, magnesium stearate. Inactive ingredients may vary between manufacturers.
While a severe allergic reaction to this medication is rare, it is still essential to know the signs of a severe allergic reaction. Signs of an allergic reaction include itchiness of the throat, difficulty breathing, hives, dizziness, and facial/throat swelling. If you notice these symptoms shortly after consuming this antibiotic, you should keep medical attention as soon as possible.
To treat a UTI, you'll usually take 200mg of Nitrofurantoin each day. This might be in the format of 2-4 pills daily. Space these out evenly throughout the day, taking one in the morning and one 12 hours later in the evening. If the dose is split into 4 tablets, then you should take these every 3-4 hours. Always take the full course of antibiotics as prescribed.
Nitrofurantoin should be taken as soon as possible after noticing symptoms.
Always finish the course of Nitrofurantoin that you have been prescribed. Stopping treatment early can lead to a recurrence of the infection, as bacteria may still be present in the bladder.
Accidentally taking one additional dose of Nitrofurantoin should not result in significant toxicity. If you take more than one additional dose, you should contact your doctor or seek medical attention.
Side Effects commonly include:
Drowsiness
Nausea
Diarrhea
Abdominal pain
Vomiting
Reduced appetite
Feeling dizzy
Headache
Darker urine
Serious side effects which require attention from a doctor include:
Weakness, numbness or tingling in the muscles or joints
Yellowed skin (jaundice)
Coughing, chest pain and shortness of breath
Fever or chills
Unexplained bruising or bleeding
A severe headache
Allergic reaction
Feeling generally unwell
Tell your doctor if you have any of the following conditions:
Regarding the above conditions, your doctor will be able to assess if nitrofurantoin is suitable for you.
Certain medications may interact with Nitrofurantoin. Tell your doctor if you are taking:
Antacids
Medication for gout
Any over-the-counter UTI remedies
Quinolones
A UTI can be uncomfortable, painful and disruptive to your daily life. If you are prone to UTIs, you can try to implement these preventative steps:
Drink lots of water
Wipe from front to back after going to the toilet
Always urinate after sexual intercourse
Avoid using contraception with spermicide
Avoid perfumed washes and perfumed sanitary products
Macrobid and Nitrofurantoin are the same medication with the same active ingredient. Nitrofurantoin is the generic name for the medicine, while Macrobid is a brand name.
Some alternative antibiotics for a UTI include:
Cephalexin
Fosfomycin
Ceftriaxone
Trimethoprim
Cranberry juice is often marketed as being helpful for preventing urinary tract infections. Although some studies have shown that cranberry juice helps in this regard, to date, there is no definitive evidence to support this claim. Cranberry juice does not help treat an active infection.
If you take Nitrofurantoin for longer than the standard length of treatment, this makes you more likely to get a yeast infection. This happens because the antibiotic kills off the bacteria, which would normally stop a yeast infection from growing.
You can still drink alcohol while you are taking Nitrofurantoin.
Nitrofurantoin is safe for pregnant women to take.
Nitrofurantoin is an antibiotic specifically used to treat urinary tract infections (UTIs). Nitrofurantoin is generally effective when the UTI is caused by certain strains of E. coli, enterococci, Staphylococcus aureus, and some strains of Klebsiella and Enterobacter species.
Nitrofurantoin is not indicated for treatment of STIs. If you suspect that you may have a sexually transmitted infection, you should see your doctor for evaluation and treatment to ensure proper treatment for the specific infection.
Alcohol does not directly affect the efficacy of Nitrofurantoin. It is generally safe to drink alcohol in moderation while taking Nitrofurantoin. However, alcohol has been shown to intensify some of the side effects of Nitrofurantoin. You should talk to your doctor about alcohol use if you are prescribed Nitrofurantoin. Even though alcohol may not directly affect Nitrofurantoin, it is recommended to avoid alcohol if you have a urinary tract infection. Alcohol can lead to dehydration, which can make it more difficult to treat your infection.
Nitrofurantoin is safe during pregnancy. It is rated pregnancy category B. This means that there was not a risk to the fetus in animal reproduction studies that have been completed. There have not been any well controlled studies with pregnant women.
Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.
“DailyMed - NITROFURANTION- Nitrofurantion Capsule” (U.S. National Library of Medicine) <https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=ad020393-1c97-49da-b0f3-d6a9359fb73d> accessed July 27, 2019
“FDA Pregnancy Categories - CHEMM” (U.S. National Library of Medicine) <https://chemm.nlm.nih.gov/pregnancycategories.htm> accessed July 27, 2019
Ghouri F, Hollywood A and Ryan K, “A Systematic Review of Non-Antibiotic Measures for the Prevention of Urinary Tract Infections in Pregnancy” (2018) 18 BMC Pregnancy and Childbirth
Nicolle LE, “Cranberry for Prevention of Urinary Tract Infection?” (2016) 316 Jama 1873
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