Adult Dosing
Initial or recurrent urinary tract infections
- 50-100 mg PO qid or 100 mg dual-release capsules PO bid x 1 wk
Suppression therapy for urinary tract infections
- 50-100 mg PO qd at bedtime
Pediatric Dosing
Initial or recurrent urinary tract infections
- >12 yrs: 50-100 mg PO qid or 100 mg dual-release capsules PO bid x 1 wk
- 1 mo-12 yrs: 5-7 mg/kg/day PO divided qid x 1 wk. Max: 400 mg/day
Suppression therapy for urinary tract infections
- >1 month: 1-2 mg/kg/day PO divided bid/qd. Max: 100 mg/day
[Outline]
Renal Dose Adjustment (Based on CrCl)
- >60 mL/min: Dosage adjustments not defined
- <60 mL/min: Contraindicated (may accumulate toxic metabolites)
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined
- If acute, subacute, or chronic pulmonary reactions occur, discontinue therapy and take appropriate measures. Chronic pulmonary reactions (diffuse interstitial pneumonitis or pulmonary fibrosis, or both) have occurred insidiously and have been associated with death. Patients receiving therapy for
6 months are susceptible to these reactions. Closely monitor pulmonary condition of patients receiving prolonged therapy and weigh benefits of therapy against potential risks - Rare occasions of hepatic reactions, including hepatitis, cholestatic jaundice, chronic active hepatitis, hepatic necrosis and even fatalities have occurred. Onset of chronic active hepatitis is insidious. Periodically monitor patients for changes in biochemical tests that would indicate liver injury. On occurrence of hepatitis, immediately withdraw the drug and take appropriate measures
- Severe or irreversible peripheral neuropathy has occurred. Renal impairment (creatinine clearance <60 mL/min or clinically significant elevated serum creatinine), anemia, diabetes mellitus, electrolyte imbalance, vitamin B deficiency, and debilitating disease enhances occurrence of peripheral neuropathy. Periodically monitor patients receiving prolonged therapy for changes in renal function. Rare occasions of optic neuritis have occurred
- Cases of hemolytic anemia of the primaquine-sensitivity type have occurred. Glucose-6-phosphate dehydrogenase deficiency in the red blood cells of the affected patients is associated with hemolysis; discontinue therapy
- Clostridium difficile associated diarrhea (CDAD) which may range from mild diarrhea to fatal colitis has been reported. It can occur during therapy or >2mo after discontinuation. Consider diagnosis if diarrhea presents after antibiotic administration
- To reduce the development of drug-resistant bacteria, use only to treat infections proven or strongly suspected to be caused by susceptible bacteria. Obtain susceptibility tests before starting therapy
- Antibiotics may alter colon flora, leading to C. difficile overgrowth. C. difficile produces toxins A and B which contribute to CDAD. Hypertoxin producing strains cause increased morbidity and mortality since these infections can be refractory to antibiotic therapy and may require colectomy
- On suspection/confirmation of CDAD, discontinue use. Patients may need fluid, electrolyte, and protein supplementation along with antibiotics for C. difficile, surgical evaluation as needed
- Overgrowth of nonsusceptible organisms may occur; take appropriate measures on occurrence of superinfections
Cautions: Use cautiously in
- Peripheral neuropathy
- Anemia
- Diabetes mellitus
- Electrolyte abnormalities
- G6PD deficiency
- Prolonged use
Pregnancy Category:B (contraindicated at 38-42 weeks of gestation)
Breastfeeding: Levels in breast milk are low, can be used while breastfeeding older infants. Avoid use in infants under 1 month of age and those with G-6PD deficiency at any age. An exclusively breastfed infant receives 0.2 mg/kg/day or about 6% of the weight-adjusted maternal dosage. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT)This drug is usually considered compatible with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776 last accessed 14 January 2011). Exhibits potential for serious adverse reactions from nitrofurantoin in nursing infants under one month of age. Manufacturer advises to make a decision whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Macrobid 100 MG CAPS [Bottle] (ALMATICA)
20 mg = $83.99
60 mg = $225.98 - Furadantin 25 MG/5ML SUSP [Bottle] (SHIONOGI PHARMA)
60 5ml = $187.2
180 5ml = $547.18 - Macrodantin 25 MG CAPS [Bottle] (ALMATICA)
30 mg = $69.99
90 mg = $195.97 - Macrodantin 50 MG CAPS [Bottle] (ALMATICA)
30 mg = $62.4
90 mg = $181.73 - Macrodantin 100 MG CAPS [Bottle] (ALMATICA)
30 mg = $116.99
90 mg = $330.98
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
