Nitrofurantoin

C. diff Risk

Low

Oral Bioavailability

NA

Approximate Cost

$1/day

Dosing

Prophylaxis: PO: 1-2mg/kg/DAY given once daily or divided twice daily. Max 100mg/DAY

Treatment dose: PO: 5-7 mg/kg/DAY divided QID (divide BID if using MacroBID capsules). Max 400mg/DAY

Contraindicated in infants < 1 month of age.

No dosage adjustment provided by manufacturer's label. Contraindicated in patients with a previous history of cholestatic jaundice or hepatic dysfunction associated with nitrofurantoin.

Use is contraindicated in CrCl< 60 mL/min. Renally cleared, requires dosage adjustment with changes in renal function. Consult a pharmacist for renal dosing.

General Information

Common Usage

Uncomplicated cystitis in patients with normal renal function

Adverse Effects

Interstitial pneumonitis and fibrosis esp. with prolonged use

Peripheral neuropathy

Additional Information

Does not provide adequate renal concentrations for treatment of systemic infections (i.e urosepsis, pyelonephritis); appropriate for cystitis and/or urinary prophylaxis.

Pharmacology

Antimicrobial class: Nitrofuran

Average serum half life: No pediatric data.
Adults: 20 to 60 minutes and is prolonged with renal impairment

Route of Elimination: As metabolites and unchanged drug (40%) in the urine and small amounts in the bile; renal excretion is via glomerular filtration and tubular secretion