Superinfections by fungi or resistant organisms such as Pseudomonas. Not known (cannot be estimated from the available data) The undesirable effects are listed according to organ systems and following frequencies: Gastrointestinal reactions may be minimised by taking the drug with food or milk, or by adjustment of dosage.įor long term treatment monitor the patient closely for appearance of hepatic or pulmonary symptoms and other evidence of toxicity.ĭiscontinue treatment with nitrofurantoin if otherwise unexplained pulmonary, hepatotoxic, haematological or neurological syndromes occur.Ī tabulated list of undesirable effects is outlined below: Nitrofurantoin should be discontinued at any signs of haemolysis in those with suspected glucose-6-phosphate dehydrogenase deficiency. Patients on Nitrofurantoin are susceptible to false positive urinary glucose (if tested for reducing substances). Urine may be coloured yellow or brown after taking Nitrofurantoin. Close monitoring of the pulmonary conditions of patients receiving long-term therapy is warranted (especially in the elderly). If these reactions occur, nitrofurantoin should be discontinued immediately.Ĭhronic pulmonary reactions (including pulmonary fibrosis and diffuse interstitial pneumonitis ) can develop insidiously, and may occur commonly in elderly patients. Nitrofurantoin should be used with caution in patients with anaemia, diabetes mellitus, electrolyte imbalance, debilitating conditions, and vitamin B (particularly folate) deficiency.Īcute, subacute and chronic pulmonary reactions have been observed in patients treated with nitrofurantoin. Therefore, treatment should be stopped at the first signs of neural involvement (paraesthesiae). Peripheral neuropathy and susceptibility to peripheral neuropathy, which may become severe or irreversible has occurred and may be life threatening. Since pre-existing conditions may mask hepatic or pulmonary adverse reactions, nitrofurantoin should be used with caution in patients with pulmonary disease, hepatic dysfunction, neurological disorders and allergic diathesis. Nitrofurantoin may be used with caution as short-course therapy only for the treatment of uncomplicated lower urinary tract infection in individual cases with an eGFR between 30-44 ml/min to treat resistant pathogens, when the benefits are expected to outweigh the risks. A surgical cause for infection should be excluded in recurrent or severe cases. Nitrofurantoin is not effective for the treatment of parenchymal infections of a unilaterally functioning kidney.
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