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Nitrofurantoin.

P F D'Arcy

    Drug Intelligence & Clinical Pharmacy
    |July 1, 1985
    PubMed
    Summary

    Nitrofurantoin remains a highly effective antibiotic for urinary tract infections, with serious adverse reactions occurring at very low rates. Documented interactions are rare and generally not clinically significant.

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    Area of Science:

    • Pharmacology
    • Infectious Diseases
    • Clinical Pharmacy

    Background:

    • Nitrofurantoin has been a cornerstone treatment for urinary tract infections (UTIs) for over three decades.
    • It has consistently demonstrated efficacy against common UTI pathogens.
    • Despite its long-standing use, a comprehensive review of its safety profile and drug interactions is warranted.

    Purpose of the Study:

    • To review and analyze reported adverse reactions and drug interactions associated with nitrofurantoin therapy.
    • To calculate incidence rates for specific adverse events.
    • To evaluate the clinical significance of reported drug interactions.

    Main Methods:

    • Systematic review of published and unpublished data on nitrofurantoin.
    • Calculation of incidence rates for pulmonary, hepatic, neurological, and hematological reactions.
    Keywords:
    Alcohol DrinkingBiologyContraceptionContraceptive Agents, FemaleDiseasesDrugs--side effectsHematological EffectsHemic SystemHepatic EffectsIncidenceIngredients And ChemicalsMeasurementNeurologic EffectsOral ContraceptivesOrganic ChemicalsPhysiologyPulmonary EffectsResearch MethodologyTreatmentUrogenital EffectsUrogenital System

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  • Analysis of reported interactions with other medications and substances.

    • Main Results:

    • Serious adverse reactions to nitrofurantoin occur at very low incidence rates, ranging from 0.0007% (neurological) to 0.001% (pulmonary).
    • Reported interactions with alcohol, antacids, and oral contraceptives are unsubstantiated.
    • Interactions with nalidixic acid and oxolinic acid are not clinically significant; only one interaction with phenytoin was reported.

    Conclusions:

    • Nitrofurantoin possesses a favorable safety profile with a low incidence of serious adverse events.
    • Most reported drug interactions are either unfounded, anecdotal, or clinically insignificant.
    • Nitrofurantoin remains a safe and effective option for treating urinary tract infections.