CLINICAL USE

Antibacterial agent

DOSE IN NORMAL RENAL FUNCTION

Treatment: 50–100 mg every 6 hoursProphylaxis: 50–100 mg at night

PHARMACOKINETICS

  • Molecular weight                           :238.2
  • %Protein binding                           :60–90
  • %Excreted unchanged in urine     : 30–40
  • Volume of distribution (L/kg)       :0.3–0.7
  • half-life – normal/ESRD (hrs)      :0.3–1/1

    DOSE IN RENAL IMPAIRMENT

    GFR (mL/MIN)

  • 20 to 50     : Dose as in normal renal function. Use with caution
  • 10 to 20     :
  • Contraindicated .
  • <10           :
  • Contraindicated .

    DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

  • CAPD                :Dialysed. Avoid – contraindicated
  • HD                     :Dialysed. Avoid – contraindicated
  • HDF/high flux   :Dialysed. Avoid – contraindicated
  • CAV/VVHD      :Dialysed. Avoid – contraindicated

    IMPORTANT DRUG INTERACTIONS

    Potentially hazardous interactions with other drugs

  • None known

    ADMINISTRATION

    Reconstition

    –

    Route

    Oral

    Rate of Administration

    –

    Comments

    Urine may be coloured a dark yellow or brownMacrocrystalline form has slower dissolution and absorption rates, produces lower serum concentration and takes longer to achieve peak concentration in the urine

    OTHER INFORMATION

    Avoid nitrofurantoin in patients with impaired renal function (GFR<20 mL/min) as the drug is ineffective due to inadequate urine concentration; toxic plasma concentrations can occur causing adverse effects, e.g. neuropathy, blood dyscrasiasNitrofurantoin gives false positive urinary glucose (if testing for reducing substances).

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