Nitrofurantoin

Generic Name: Nitrofurantoin

Trade Name: Furadantin, Macrobid
It is primarily bacteriostatic but may be bactericidal at higher concentration and in acidic urine
because at lower PH it's activity is enhanced.
It acts against Gram positive and Gram negative bacteria.
Mechanism of action
Susceptible bacteria enzymatically reduce nitrofurantoin to generate reactive intermediates
which damages DNA and affect protein synthesis.
interfere with various enzymes in
Nitrofurantoin toxic electrophilic intermidiates
DNA,RNA and proteinsynthesis

Route of admission: well absorbed orally

Route of metabolism
rapidly metabolized in liver.
40% is excreted unchanged in urine
Plasma half life: 30-60 minutes
Side effects:
Gl intolerance: Nausea, epigastric pain and diarrhoea
Peripheral neuritis
Leucopenia
Haemolytic anaemia in G-6-P-D patient.
Indications:
Uncomplicated lower UTI not associated with prostatitis
Acute infection of E.coli
Long term suppressive treatment of chronic lower UTI
Perinephric Abscess
Contraindications :It is contraindicated in renal failure (azotaemic patient), in pregnancy(38
weeks or more) and hemolysis in newborn with G6PD deficiency, if used at term.
Dose: 50-100 mg TDS (5-7mg/kg/day) is given for 5-10 days
Drug interaction
Nitrofurantoin antagonizes bactericidal action of Naldixic acid.
Probenecid inhibits it's tubular secretion and reduces concentration attained in urine.