Shobz Pharmacy

Pictures: Front view of carton, Back view of carton, what tablets/capsules look like inside

NITROFURANTOIN

[back view of carton]

[view of capsules inside]

Nitrofurantoin (brand name MacroBID) is an antibiotic used for uncomplicated urinary tract infections (UTI).

One tablet taken twice a day (ideally once every 12 hours)

Works quick – 3 day course.

Low level of antibiotic resistance.

Usually feel better within 2-3 days

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[More information on this medicine]

INFORMATION ON NITROFURANTOIN AND UTIs

Signs of more serious infection include:

• Fever 38+
• Pain in backs or sides, just below ribs
• Blood in urine
• Mental changes, especially in elderly
• Shivering/chills
• Vomiting
• Severe infections can spread to the blood causing SEPSIS – a life-threatening condition.
  • Signs of sepsis include:
    • Extreme temperature – either very hot or very cold
    • Shivering
    • Chills
    • Confusion
    • Feeling faint
    • Feeling of something seriously wrong – extreme discomfort
    • Rash that does not disappear when glass pressed against it – same as meningitis
    • Shortness of breath
    • Faster heartbeat
    • Faster breathing
    • Having not urinated in a while – at least 1 day
    • Change in skin colour

What is nitrofurantoin?

Nitrofurantoin (brand name MacroBID) is the first-choice antibiotic used for uncomplicated lower urinary tract infections (UTI).

It belongs to a group of antibiotics known as nitrofuran antibiotics.

How does nitrofurantoin work?

• Gets filtered out from blood into urine, where the bacteria is, and then it can kill the bacteria by destroying the cells.

Nitrofurantoin warnings and precautions:

• Nitrofurantoin is NOT suitable for:
  • Allergies to any of the ingredients in nitrofurantoin capsules (listed below):
  • Severely compromised kidney function
  • Final stage of pregnancy – week 28 onwards
  • History of blood disorders –
    • known as porphyria
    • Deficiency in enzyme ‘G6PD’ (Glucose-6-phosphate-dehydrogenase)
    • Breastfeeding baby with G6PD deficiency
  • Infants less than 3 months old
• Do not take if under 16 or over 64

• .
• Consult your doctor, pharmacist or nurse before taking if:
  • Diabetic
  • Conditions causing severe weakness
  • Anaemia (lack of red blood cells causing weakness and pale skin)
  • History of allergic reactions
  • Mild-moderate kidney impairment
  • Lung disease
• .
• .
• Pregnancy and breastfeeding
  • .Avoid in final stage of pregnancy – week 28 onwards
  • Avoid if breastfeeding a G6PD deficient baby
• .
• .
• Alcohol
  • No interaction with medicine but best to avoid or limit it until 3 days (72 hours) after end of treatment
  • Alcohol irritates bladder; may worsen symptoms and increase discomfort
• .
• Sleepiness
  • May make the user sleepy.
  • If this happens, avoid driving or skilled tasks until sleepiness wears off.

Side-effects of nitrofurantoin

Most common side effects include:

• Diarrhoea
• Feeling or being sick
• Loss of appetite
• Headaches
• Dizziness
• Sleepiness

Rare but serious side effects include (less than 1 in 1000 people):

• Severe headaches
• Signs of lung issues – cough (blood or phlegm), shortness of breath, pain when breathing, high temperature
• Signs of liver issues – yellowing of skin and eye whites, pale poo AND dark pee
• Signs of blood issues – unexplained brusing or bleeding, sore throat, high temperature, general unwellness

Call 999 or go A+E if:

• Chest pain with difficulty breathing
• Pins and needles sensation, tingling sensation, numbness, weakness. Sign of nerve problems (peripheral neuropathy).

Alternatives to nitrofurantoin

• Fosfomycin

Over-the-counter remedies to help symptoms:

• Potassium/sodium citrate
• Painkillers: ibuprofen/paracetamol
• Cranberry juice – may prevent returning. No evidence to suggest it may help an ongoing infection

Lifestyle changes to help symptoms

• Pee as soon as possible after sex
• Wash vaginal skin before and after sex
• Change nappies regularly
• Plenty of fluids
• Wipe from front to back at toilet
• Avoid moist genital area
• Use fragrance-free soap
• Wear looser and cotton underwear
• Avoid excess alcohol
• Moderate sugary food consumption as this can encourage bacterial growth
• Avoid spermicidal lube
• Do not hold in pee – go as soon as you need to
• Ensure fully emptied when pee.

Medicines that may interfere with nitrofurantoin

• Antacids for indigestion
• Gout medication
• Raised eye pressure medication
• Potassium citrate or sodium citrate
• Other medications for infections
• Typhoid vaccine (live vaccine with bacteria may be interfered by the antibiotic nitrofurantoin)

Nitrofurantoin ingredients

The active substance is 100mg nitrofurantoin in each capsule.

The other ingredients are talc, corn starch, lactose, carbopol, povidone, sugar and magnesium stearate. The capsule shell contains gelatin, quinoline yellow (E104), titanium dioxide (E171) and FD&C Blue No.2 (E132). The printing ink contains shellac, propylene glycol (E1520), titanium dioxide (E171) black iron oxide (E172), ammonium hydroxide (E527) and simethicone.

SOURCES

https://www.nhs.uk/conditions/sepsis/

https://www.nhs.uk/medicines/nitrofurantoin/

https://www.medicines.org.uk/emc/product/15362/pil#gref

https://onlinedoctor.superdrug.com/nitrofurantoin-and-alcohol.html

https://www.nhs.uk/conditions/urinary-tract-infections-utis/