nitrofurantoin

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).

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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