Nitrofurantoin (Nitrofurantoinum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Other synthetic antibacterial agents

Included in the formulation
  • Furadonin
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    Olainfarm, AO     Latvia
  • Furadonin
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    BORISOVSKIY FACTORY OF MEDPREPARATES, OJSC     Republic of Belarus
  • Furadonin
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    FARMTECHNOLOGIYA, LLC     Republic of Belarus
  • Furadonin of Avexime
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    AVEKSIMA, JSC     Russia
  • FURADONIN AVEKSIMA
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    AVEKSIMA, JSC     Russia
  • Furadonin-LekT
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    Tyumen Chemical - Pharmaceutical Plant, OJSC     Russia
    • АТХ:

    J.01.X.E.01   Nitrofurantoin

    Pharmacodynamics:

    Antibacterial agent of a wide spectrum, bactericidal. The effect of the drug is due to the formation of highly reactive amino derivatives due to the reduction of the 5-nitro group with the participation of bacterial flavoproteins. Amino derivatives cause inactivation or alteration of proteins by bacterial ribosomes, suppression of metabolism and synthesis of bacterial DNA, RNA, cell wall, also conformational changes in proteins and other macromolecules, which leads to the death of microorganisms. Nitrofurantoin inhibits aerobic metabolism in the bacterial cell.

    The drug reaches therapeutic concentrations only in the urine, in connection with which nitrofurantoin used to treat infections of the urinary tract.

    Nitrofurantoin is active against Esfromherichia coli, Klebsiella spp., Enterobacter spp., Proteus spp., Staphylococcus spp., Streptococcus spp., Shigella dysenteriae, Shigella flexneri, Shigella boydii, Shigella sonnei.

    Pharmacokinetics:

    Quickly and completely absorbed from the gastrointestinal tract, binds to plasma proteins by 60%. Bioavailability is 50% (food increases bioavailability). The drug is metabolized in muscle tissue and in the liver. The half-life is 20-25 minutes. The drug penetrates through the blood-brain and placental barriers, excreted in breast milk. Excreted by the kidneys, 30-50% are excreted unchanged.

    Indications:

    Inflammatory-infectious diseases of the urinary tract, including pyelonephritis, cystitis, which are caused by sensitive microorganisms.

    ICD-10

    XIV.N10-N16.N10   Acute tubulointerstitial nephritis

    XIV.N10-N16.N11   Chronic tubulointerstitial nephritis

    XIV.N30-N39.N30   Cystitis

    XIV.N30-N39.N34   Urethritis and urethral syndrome

    XIV.N30-N39.N39.0   Urinary tract infection without established localization

    XIV.N40-N51.N41   Inflammatory diseases of the prostate

    Contraindications:

    Renal failure, severe renal impairment, insufficiency of glucose-6-phosphate dehydrogenase, anuria, oliguria, hypersensitivity to the drug, acute porphyria, chronic hepatitis, heart failure II-III stage, liver cirrhosis, pulmonary fibrosis, age under 1 month, pregnancy, breast-feeding.

    Carefully:

    In patients with anemia, diabetes mellitus, violation of electrolyte balance, insufficiency of B vitamins, marked renal failure (due to increased risk of peripheral neuropathy).

    Pregnancy and lactation:

    Category FDA - B. Do not use during pregnancy and lactation.

    Dosing and Administration:

    Orally with meals, with plenty of water. 100-150 mg 3-4 times a day, the course of treatment is 7-10 days. With preventive and anti-relapse treatment - 3-12 months 1-2 mg / kg. Doses for children - at a rate of 5-8 mg / kg per day (3-4 times).

    The maximum daily dose is 600 mg, the maximum single dose is 300 mg.

    Side effects:

    On the part of the digestive system: hepatitis, abdominal pain, vomiting and nausea, anorexia, cholestatic jaundice, pancreatitis, diarrhea, pseudomembranous colitis.

    From the side of the nervous system: headache, peripheral neuropathy, dizziness, nystagmus, asthenia, drowsiness.

    Allergic reactions: itching, anaphylactic shock, Quincke's edema, hives, rash.

    On the part of the blood: granulocytopenia, leukopenia, agranulocytosis, megaloblastic anemia, hemolytic anemia, thrombocytopenia.

    From the skin: erythema multiforme, exfoliative dermatitis.

    On the part of the respiratory system: interstitial pneumonitis or fibrosis, pain in the chest, dyspnea, cough, bronchoobstructive syndrome, asthma attacks in patients with history of asthma, decreased rates of external respiration function, eosinophilia.

    Other: superinfection of the genito-urinary tract (often caused by Pseudomonas aeruginosa), influenza-like symptoms, arthralgia, drug fever.

    Overdose:

    Vomiting, nausea. Treatment: reception of a large amount of fluid leads to an increase in the excretion of the drug with urine. Effective dialysis.

    Interaction:

    The drug is not compatible with fluoroquinolones.

    Preparations, (probenecid, sulfinpyrazone), can inhibit renal tubular secretion, while the level of nitrofurantoin in the urine decreases (decreases the antibacterial effect) and rises in the blood (toxicity increases).

    Antacids containing magnesium trisilicate reduce the absorption of the drug.

    Nalidixic acid reduces the antibacterial effect.

    The drugs that cause hemolysis increase the risk of toxic effects of nitrofurantoin.

    Means that have a neurotoxic effect increase the risk of neurotoxic action of nitrofurantoin.

    Special instructions:

    The risk of peripheral neuropathy is increased in patients with anemia, diabetes mellitus, violation of electrolyte balance, insufficiency of B vitamins, marked renal failure.

    Nitrofurantoin should not be used to treat diseases of the cortex of the kidneys, with purulent paranephric and prostatitis. Nitrofurantoin Do not prescribe in combination with drugs that cause impaired renal function.

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