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Active ingredients
Nitrofurantoin
Release form
Pills
Composition
Tablets 1 tab. nitrofurantoin 100 mg.
Pharmacological effect
Antimicrobial agent of broad-spectrum, nitrofuran derivative. It has a bacteriostatic and bactericidal effect in urinary tract infections. Nitrofurantoin is active against Escherichia coli, Klebsiella spp., Enterobacter spp., Proteus spp. Effective mainly for urinary tract infections.
Pharmacokinetics
Well absorbed from the digestive tract. Bioavailability is 50% (food increases bioavailability). The rate of absorption depends on the size of the crystals (the microcrystalline form is characterized by rapid solubility and absorption rate, a short time to reach Cmax in the urine). Plasma protein binding - 60%. Metabolized in the liver and muscle tissue. T1 / 2 - 20-25 min. Gets through the BBB, placental barrier, excreted in breast milk. Excreted completely by the kidneys (30-50% - unchanged).
Indications
Infectious and inflammatory diseases of the urinary tract (including pyelonephritis, cystitis) caused by microorganisms sensitive to nitrofurantoin.
Contraindications
Severe disorders of renal excretory function, renal failure, oliguria, glucose-6-phosphate dehydrogenase deficiency, pregnancy, early childhood (up to 1 month), hypersensitivity to nitrofurantoin, stage II-III heart failure, cirrhosis, chronic hepatitis, acute porphyria lactation.
Use during pregnancy and lactation
Nitrofurantoin is contraindicated for use during pregnancy and lactation (breastfeeding).
Dosage and administration
The dose for adults is 50-100 mg, the multiplicity of application - 4 times / day. The daily dose for children is 5-7 mg / kg in 4 doses. Duration of treatment is 7 days. If necessary, it is possible to continue treatment for another 3 days (only after monitoring urine for sterility). When conducting long-term maintenance treatment, the dose of nitrofurantoin should be reduced.
Side effects
On the part of the respiratory system: pain in the chest, cough, shortness of breath, pulmonary infiltrates, eosinophilia, interstitial pneumonitis or fibrosis, a decrease in respiratory function, an asthma attack in patients with asthma in history. On the part of the digestive system: epigastric discomfort, anorexia, nausea, vomiting; rarely - hepatitis, cholestatic jaundice, abdominal pain, diarrhea.From the side of the central nervous system and peripheral nervous system: peripheral neuropathy, headache, nystagmus, dizziness, drowsiness. On the part of the hemopoietic system: leukopenia, granulocytopenia, agranulocytosis, thrombocytopenia, hemolytic anemia, megaloblastic anemia (these changes are reversible). Allergic reactions: urticaria, angioedema, pruritus, rash; very rarely - anaphylactic shock. Dermatological reactions: exfoliative dermatitis, erythema multiforme. Others: drug fever, arthralgia, possible flu-like symptoms, superinfection of the urogenital tract, often caused by pyocyanic rod.
Interaction with other drugs
The simultaneous use of nalidixic acid and antacids containing magnesium trisilikat reduces the antibacterial effect of nitrofurantoin. Nitrofurantoin is incompatible with fluoroquinolones. With simultaneous use of drugs that block tubular secretion, reduce the antibacterial effect of nitrofurantoin (by reducing the concentration of nitrofurantoin in the urine) and increase its toxicity (increased concentration in the blood).
special instructions
The risk of developing peripheral neuropathy is increased in patients with anemia, diabetes mellitus, electrolyte imbalance, vitamin B deficiency, severe renal insufficiency. Nitrofurantoin should not be used to treat diseases of the cortical substance of the kidneys, with purulent paranephritis and prostatitis. Nitrofurantoin is not prescribed in combination with drugs that cause renal dysfunction.