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Macrobid

Side Effects

Nausea, headache may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may cause your urine to turn dark yellow or brown in color. This is usually a harmless, temporary effect and will disappear when the medication is stopped. However, dark brown urine can also be a sign of rare side effects (liver problems or anemia). Therefore, seek immediate medical attention if you notice dark urine along with any of the following symptoms: persistent nausea/vomiting, stomach/abdominal pain, yellowing eyes/skin, tiredness, fast/pounding heartbeat.

Tell your doctor right away if any of these rare but very serious side effects occur: eye pain, vision changes, mental/mood changes, persistent/severe headaches, new signs of infection (e.g., fever, persistent sore throat), easy bruising/bleeding.

Seek immediate medical attention if you develop the following rare but very serious side effects: numbness/tingling of the hands/feet, unusual muscle weakness.

This medication may rarely cause very serious (possibly fatal) lung problems. Lung problems may occur within the first month of treatment or after long-term use of nitrofurantoin (generally for 6 months or longer). Get medical help right away if you develop symptoms of lung problems, including: persistent cough, chest pain, shortness of breath/trouble breathing, joint/muscle pain, bluish/purplish skin.

This medication may rarely cause a severe intestinal condition (Clostridium difficile-associated diarrhea) due to a resistant bacteria. This condition may occur during treatment or even weeks to months after treatment has stopped. Do not use anti-diarrhea or opioid medications if you have the following symptoms because these products may make them worse. Tell your doctor right away if you develop: persistent diarrhea, abdominal or stomach pain/cramping, blood/mucus in your stool.

Use of nitrofurantoin for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US –

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

nitrofurantoin uses

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ph2Product descriptionv nitrofurantoin uses./h2/p
pstrongINDICATIONS nitrofurantoin uses./strong/p
pNitrofurantoin is used for treating and preventing urinary tract infections caused by certain bacteria. Nitrofurantoin is an antibiotic for specific use in the urinary tract. It works by killing sensitive bacteria./p
pstrongINSTRUCTIONS nitrofurantoin uses./strong/p
pUse Nitrofurantoin as directed by your doctor./p
ul
liTake Nitrofurantoin by mouth with food./li
liDo not take an antacid that has magnesium trisilicate in it while you are taking Nitrofurantoin. Check with your pharmacist if you are unsure which antacids have magnesium trisilicate in them./li
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liIf you miss a dose of Nitrofurantoin, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once./li
/ul
pAsk your health care provider any questions you may have about how to use Nitrofurantoin./p
pstrongSTORAGE nitrofurantoin uses./strong/p
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Using Macrobid to Treat Urinary Tract Infections

Macrobid is a brand-name prescription drug. It’s also available as the generic drug nitrofurantoin. Macrobid comes as a capsule you take by mouth. It belongs to a class of drugs called nitrofurans.

Macrobid is an antibiotic. It’s used in adults to treat several types of bacterial infections, including UTIs. It works by preventing bacterial cells from forming properly.

Common side effects

The more common side effects of Macrobid can include:

  • nausea
  • vomiting
  • headache
  • gas
  • diarrhea
  • constipation

Serious side effects

In some cases, Macrobid can cause serious side effects. These can include:

  • Serious allergic reaction. Symptoms can include:
    • hives or rash
    • trouble breathing or swallowing
    • swelling of your lips, tongue, or face
    • throat tightness
    • a rapid heart rate
  • Liver damage. Symptoms can include:
    • nausea
    • vomiting
    • pain or tenderness in your abdomen
    • fever
    • dark urine
    • yellowing of your skin or the whites of your eyes
  • Other infections. Macrobid kills only certain types of bacteria, so other types may continue to grow and cause other infections. Your doctor can tell you more. Symptoms of infections can include:
    • fever
    • body aches
    • tiredness

Drug interactions

An interaction is when a substance changes the way a drug works. This can be harmful or keep the drug from working well. Before starting Macrobid, be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. This can help your doctor prevent possible interactions.

Examples of drugs that can interact with Macrobid include probenecid, spironolactone, and the typhoid vaccine.

Other health conditions of concern

If you have certain health conditions, Macrobid may not be the best choice for you. Be sure to discuss your full health history with your doctor before they prescribe you Macrobid. Conditions that could cause problems with Macrobid can include kidney disease and liver disease.

Pregnancy and breastfeeding

Macrobid is a category B pregnancy drug. It may damage the red blood cells of newborn babies. If you’re pregnant, talk with your doctor to see if this drug is safe for you. You should not take this drug if you’re more than 38 weeks pregnant.

Macrobid can pass to a child through breast milk. If you’re breastfeeding, talk with your doctor about whether you should stop breastfeeding or if you should take a different drug for your UTI.

Read more: Drug information for Macrobid “

Does a short course of nitrofurantoin cure acute uncomplicated cystitis?

Yes. In fact, it is now the preferred treatment in women because of increasing resistance among uropathogens to trimethoprim-sulfamethoxazole (TMP-SMX) and other fluoroquinolones.

In this randomized trial, 338 women 18 to 45 years old who had acute uncomplicated urinary tract infection (UTI) were randomized to open-label treatment with nitrofurantoin (Macrobid), 100 mg twice daily for 5 days, or trimethoprim-sulfamethoxazole, one double-strength tablet twice daily for 3 days. Clinical cure 30 days after therapy was achieved in 84% of the women taking nitrofurantoin and in 79% of women taking trimethoprim-sulfamethoxazole.

EXPERT COMMENTARY

This study is important because UTI is routinely treated empirically. The usual drugs prescribed for uncomplicated UTI are TMP-SMX, extended-release ciprofloxacin (Cipro), or a first- or second-generation cephalosporin. Empiric use of fluoroquinolones such as ciprofloxacin has replaced trimethoprim-sulfamethoxazole in the treatment of uncomplicated cystitis. Such replacements are inappropriate for empiric therapy, and indiscriminate use of fluoroquinolones has led to increased resistance among Staphylococcus aureus organisms.

Nor has there been proper concern about the way antibiotics alter the endogenous bacteria of the body. Overuse of antibiotics such as the β-lactams (cephalosporin and expanded-spectrum penicillins), fluoroquinolones, and macrolides has added not only to the emergence of resistant bacteria strains but also to an increase in adverse events.

Resistance to TMP-SMX ranged from 12% to 21%

In this study, the authors isolated and identified bacteria responsible for infection, and the outcome reflects the national bacterial etiology in this age group (18 to 45 years). The number one bacterium isolated in the study was Escherichia coli (82%) as the sole uropathogen (TABLE). These data confirm that E coli remains the bacterium most likely to cause acute uncomplicated UTI.

The problem is that E coli has developed resistance to the antibiotics most commonly prescribed to treat this condition. In this study, 12% of the E coli isolates were resistant to trimethoprim-sulfamethoxazole. Even more alarming, 21% of non-E coli strains were resistant to trimethoprim-sulfamethoxazole. In contrast, 99.6% of E coli isolates and 90% of non-E coli isolates were sensitive to nitrofurantoin.

TABLE

Bacteria isolated from the study population (n=338)

BACTERIUM NUMBER OF ISOLATES
Escherichia coli 276
Non-E coli 61
Staphylococcus aureus 5
Klebsiella species, Proteus mirabilis, Enterobacter species, and Streptococcus agalactiae made up the remainder of the isolates (1% to 3%).

Adverse effects did not deter use

In the trimethoprim-sulfamethoxazole group, 31% of women experienced adverse effects, as did 28% in the nitrofurantoin group. Side effects included those commonly seen with oral antibiotic therapy: nausea, diarrhea, headache, lightheadedness, and vaginal itching.

Adherence was good; only 1% of women taking trimethoprim-sulfamethoxazole and 2% of women taking nitrofurantoin discontinued the drug.

An advantage for women taking nitrofurantoin is that it is concentrated in the urine, with little uptake in tissue and other bodily fluids. Therefore, it has very little effect on the endogenous vaginal microflora and little chance of causing vaginitis.

Weaknesses of the study

This study was not blinded; therefore, clinical evaluation may have been biased.

The population involved in the study was rather homogenous—mostly white college students. A mix of races would have been more informative.

Another limitation is that the investigators chose cefotaxime (Claforan) as one of the comparative antibiotics in the microbiologic arm, but gave no reason for this choice. Cefotaxime is administered either intravenously or intramuscularly and therefore has questionable relevance to this study. The other antibiotics chosen in addition to the two study drugs were ciprofloxacin and amoxicillin-clavulanate—both commonly used to treat acute uncomplicated cystitis.

What this evidence means for clinical practice

A 5-day course of nitrofurantoin is highly effective in treating uncomplicated UTI in women. It should be the initial empiric treatment of this infection because it is effective, safe, and well tolerated.

If a 3-day course of trimethoprim-sulfamethoxazole is used, the clinician should be aware that, as E coli resistance to this agent increases, its efficacy decreases.—Sebastian Faro, MD, PhD

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INDICATIONS nitrofurantoin side effects forum.

Nitrofurantoin is used for treating and preventing urinary tract infections caused by certain bacteria. Nitrofurantoin is an antibiotic for specific use in the urinary tract. It works by killing sensitive bacteria.

INSTRUCTIONS nitrofurantoin side effects forum.

Use Nitrofurantoin as directed by your doctor.

  • Take Nitrofurantoin by mouth with food.
  • Do not take an antacid that has magnesium trisilicate in it while you are taking Nitrofurantoin. Check with your pharmacist if you are unsure which antacids have magnesium trisilicate in them.
  • Drinking extra fluids while you are taking Nitrofurantoin is recommended.
  • To clear up your infection completely, take Nitrofurantoin for the full course of treatment. Keep taking it even if you feel better in a few days.
  • If you miss a dose of Nitrofurantoin, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Nitrofurantoin.

STORAGE nitrofurantoin side effects forum.

Store Nitrofurantoin at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Nitrofurantoin out of the reach of children and away from pets.

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About nitrofurantoin

Type of medicine An antibacterial
Used for Urinary tract infection (UTI) in adults and in children over 3 months of age
Also called Macrobid®; Genfura®
Available as Tablets, capsules, prolonged-release capsules, oral liquid medicine

A urine infection is often called a urinary tract infection (or simply, UTI) by doctors. Most urine infections are caused by germs (bacteria) that come from your own bowel. They are usually easily treated with a short course of an antibacterial medicine such as nitrofurantoin. Occasionally, longer-term treatment is needed to prevent infections from coming back. Nitrofurantoin works by killing the bacteria causing the infection.

Before taking nitrofurantoin

Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking nitrofurantoin it is important that your doctor knows:

  • If you are pregnant or breastfeeding. Although nitrofurantoin can be taken during pregnancy, it is still important that you tell your doctor about being pregnant.
  • If you have any problems with the way your liver works, or if you have any problems with the way your kidneys work.
  • If you have sugar diabetes (diabetes mellitus).
  • If you have been told you have anaemia, or if you have low levels of vitamin B or folic acid.
  • If you have any breathing problems.
  • If you have a problem where your nerves cause pain or numbness, called peripheral neuropathy.
  • If you have been told you have one of the following rare inherited conditions: porphyria or glucose-6-phosphate dehydrogenase (G6PD) deficiency.
  • If you are taking any other medicines. This includes any medicines which are available to buy without a prescription, as well as herbal and complementary medicines.
  • If you have ever had an allergic reaction to a medicine.

How to take nitrofurantoin

  • Before you start the treatment, read the manufacturer’s printed information leaflet from inside the pack. It will give you more information about nitrofurantoin, and will also provide you with a full list of the side-effects which you could experience from taking it.
  • Take nitrofurantoin tablets/capsules exactly as your doctor tells you to. Your dose will depend upon whether you are being treated because you have an infection, or to prevent an infection from coming back. The directions for taking your doses will be printed on the label of the pack of tablets/capsules to remind you about what the doctor said to you.
  • Take each of your doses with a snack or after eating a meal. Space them out evenly throughout the day – this means that tablets/capsules prescribed four times a day should ideally be taken every six hours, those prescribed twice a day should be taken every 12 hours, and those prescribed once a day should be taken every 24 hours.
  • Keep taking the tablets/capsules until the course is finished. It is important you do this even if you feel well, otherwise your infection may come back. Most people taking nitrofurantoin are prescribed a short course of treatment which usually lasts between 3-7 days. If you have had several urine infections in a short period of time, your doctor will prescribe a longer course of treatment for you, often for six months.
  • If you forget to take a dose at your usual time, take it as soon as you remember. Try to take the correct number of doses each day but do not take two doses at the same time to make up for a missed dose.

Getting the most from your treatment

  • Most people improve within a few days of starting treatment. If your symptoms do not improve despite taking nitrofurantoin, go back to see your doctor, as you may need an alternative antibiotic. This is because some bacteria are resistant to some types of antibiotics.
  • Nitrofurantoin can turn your urine a yellow/brown colour. This is quite harmless.
  • If you buy any medicines, check with a pharmacist that they are suitable for you to take with nitrofurantoin. Some antacids can interfere with nitrofurantoin and stop it from working properly.
  • If you are taking the contraceptive ‘pill’ at the same time as this antibiotic, the effectiveness of the ‘pill’ can be reduced if you have a bout of sickness (vomiting) or diarrhoea which lasts for more than 24 hours. If this should happen, ask your doctor or pharmacist for advice about what additional contraceptive precautions to use over the following few days. There is no need to use additional precautions for any bouts of sickness or diarrhoea which last for less than 24 hours.
  • If you are due to have any medical or dental treatment, tell the person carrying out the treatment that you are taking nitrofurantoin. This is because it can affect the results of some diagnostic tests.
  • Nitrofurantoin can stop the oral typhoid vaccine from working. If you are due to have any vaccinations while you are taking nitrofurantoin, please make sure the person treating you knows that you are taking it.

Can nitrofurantoin cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the ones associated with nitrofurantoin. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following continue or become troublesome.

Nitrofurantoin side-effects What can I do if I experience this?
Feeling sick (nausea) or being sick (vomiting), loss of appetite Stick to simple foods – avoid fatty or spicy meals. Remember to take nitrofurantoin with food
Diarrhoea Drink plenty of water to replace lost fluids
Feeling dizzy or sleepy Do not drive and do not use tools or machines while affected
Itchy rash, allergic-type reactions, swollen salivary glands Speak with your doctor or a pharmacist for further advice

Important: your doctor will have discussed with you the possibility of a less common side-effect that may affect your lungs. You should let your doctor know straightaway if you experience any of the following:

  • Any difficulty breathing, pains in your chest, coughing, chills, or a high temperature (fever).

If you experience any other symptoms which you think may be due to the medicine, speak with your doctor or pharmacist for further advice.

How to store nitrofurantoin

  • Keep all medicines out of the reach and sight of children.
  • Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

Never take more than the prescribed dose. If you suspect that you or someone else might have taken an overdose of this medicine, go to the accident and emergency department of your local hospital at once. Take the container with you, even if it is empty.

This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.

Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.

If you have any questions about this medicine ask your pharmacist.

Ever Have a UTI That Just Won’t Go Away?

By Akanksha Singh

It is a truth universally acknowledged that urinary tract infections (UTIs) happen.

Jane Austen said that.

Okay, no, she didn’t. But more than half of all people with vaginas will have at least one UTI in their lifetime, with UTIs making up close to 25% of all infections they get. What’s more is that an estimated 25% of people with acute UTIs experience another within six months of the first infection.

Which, as you may have guessed, or may know from experience yourself, can be a lot.

Fret not, though, I had a chat with Dr. Dana Rice, urologist and creator of the UTI tracker app to discuss UTIs in detail. A lot of detail.

*drumroll*

UTI is *really* a colloquial catch-all for a range of infections

UTI is a generalized term to refer to bacterial or fungal growth in the genitourinary tract. “Many people refer to UTI as a cystitis or bladder infection,” says Dr. Rice, adding, “often patients will confuse irritative voiding symptoms with infections.”

So always, always see a health professional instead of Googling the daylights out of your symptoms.

And vaginas are especially prone to UTIs

There are many sources of infection, but people with vaginas are more prone to infections. “Why?” You ask? It’s because in women, the urethra is fairly short and straight. This makes it easier for bacteria to travel to the bladder. “Often, bacteria can be introduced into the urethral area and then travel in a retrograde fashion to the bladder,” says Dr. Rice.

UTI symptoms

UTI symptoms largely depend on what parts of the urinary tract are infected. Your kidneys, ureters, bladder, and urethra all make up your urinary tract. Most UTIs occur in the lower tract, impacting your urethra and bladder. That said, when they occur, upper tract UTIs involving your ureters and kidneys are more severe. Typically, burning while peeing, needing to pee a lot, and pelvic pain are common symptoms.

Common causes for UTIs

Since UTIs are caused by bacteria, there are a number of things that make you more susceptible to infection, typically as a result of reduced bladder emptying or irritating your urinary tract.

Some causes include:

  • Sexual intercourse
  • Poop traveling to your vagina or urethra
  • Chemical irritants in the vagina (spermicides, douching products)
  • Hormonal changes
  • Previous UTIs

So, yup, everything from sex to douching can cause UTIs. Dr. Rice also stresses that transposition of fecal matter and hormone changes make you more susceptible to UTIs. PSA: wipe front to back, people!

If you’re careful hygiene-wise, and you’re certain hormones aren’t responsible for your UTIs, chances are your previous UTIs are causing recurrence.

UTIs are recurrent when they happen more than 3 times in a 6 month period

Basically, if your urine culture tests negative for a UTI after treatment and you develop another shortly after, we’re talking recurring UTIs — have a chat with your doctor to determine the best next course of action.

Antibiotic resistance is one of the leading causes of recurrence

“Antibiotic resistance organisms are now found in the community,” says Dr. Rice, “meaning any bacterial infection may have antibiotic resistance from the time you contract the bacteria.”

Yikes.

Urine cultures help let you know what antibiotic your body’s sensitive to. It’s also ridiculously important to actually complete the full course of antibiotics prescribed by your physician, and to know what medication or antibiotics you’ve taken in the past to help with future treatment.

But, just so ya know: there are no home remedies for curing a UTI

Cranberry juice does not treat UTIs and there are zero home remedies for treatment (tons of prevention ones though; read on). None. Zip. Zilch. Head straight to your doctor for an antibiotic treatment plan suitable to you.

Preventing UTIs is easy (kinda), so you don’t have to worry about recurrence to begin with

Depending on what’s causing your UTI(s), prevention is pretty straightforward. Be sure to:

  • Pee after sex
  • Stay hydrated
  • Pee whenever you have to, and make sure you ‘go’ fully
  • Maintain vaginal health with topical hormones and oral supplements as directed by your physician
  • If you’re prone to recurring UTIs, keep track of your UTIs, sexual health, medication, and how often you pee to help your physician help you. The UTI tracker app lets you do that, if you’re looking for something specifically for your vag’s health.

Ever had a UTI you just couldn’t seem to shake? Have any prevention tips you swear by? Share your stories with us in the comments below.

Akanksha Singh is a full-time writer and part-time coffee fiend based in Bombay, India. She also tweets sporadically and ‘grams incessantly.

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