Nitrofurantoin

Sounds like 'night-roh-few-ran-to-in'

Nitrofurantoin is an antibiotic that is used to treat and prevent infections of the urinary tract. Find out how to take it safely and possible side effects. Nitrofurantoin is also called Nifuran or Macrobid.

Type of medicine Also called
  • Antibiotic (used to treat infections of the urinary tract)
  • Nifuran
  • Macrobid

What is nitrofurantoin?

Nitrofurantoin is an antibiotic that is used to treat and prevent infections of the urinary tract, such as bladder infections. It works by killing or stopping the growth of the bugs that cause the infection. In people who get urinary tract infections often, nitrofurantoin can be used to prevent infections.

In New Zealand nitrofurantoin is available in 2 forms:

  • immediate release tablets (Nifuran 50 mg and 100mg)
  • slow release capsules (Macrobid 100 mg).

Dose

  • The dose of nitrofurantoin will be different for different people. Your doctor will determine the correct dose for you, based on your condition. 
  • Always take your nitrofurantoin exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much nitrofurantoin to take, how often to take it, and any special instructions.

How to take nitrofurantoin

  • Timing: Nitrofurantoin is best taken with food. Take each dose with food or milk. If taken on an empty stomach, it may cause stomach upset. Space your doses evenly throughout the day:
    • Four times a day should ideally be taken four to six hours apart.
    • Twice a day should be taken every 12 hours, in the morning and the evening.
    • Once a day should be taken every night.
  • Missed dose: If you forget to take nitrofurantoin, take it as soon as you remember, but if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the dose.

It is best to take the antibiotic for the number of days your doctor has told you to. Do not stop taking it, even if you feel your infection has cleared up. Talk to your doctor first.

Precautions – before taking nitrofurantoin

  • Do you have any problems with the way your kidney or liver works?
  • Are you pregnant or breastfeeding? 
  • Do you have any breathing problems?
  • Do you have diabetes?
  • Do you have problems where your nerves cause pain or numbness (called peripheral neuropathy)?
  • Have you have been told you have one of the following rare inherited conditions: porphyria or glucose-6-phosphate dehydrogenase (G6PD) deficiency?

If so, it’s important that you tell your doctor before you start taking nitrofurantoin. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Side effects

Like all medicines nitrofurantoin can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Side effects What should I do?
  • Feeling sick (nausea)
  • Headache
  • Bloating and gas in the stomach
  • This is quite common when you first start taking nitrofurantoin and usually goes away with time
  • Try taking nitrofurantoin with a meal.
  • Tell your doctor if this continues
  • Dark yellow or brown urine
This is common when you are taking nitrofurantoin and is not harmful, but talk to your doctor if you are worried.
  • Cough, chest pain, shortness of breath
  • Tell your doctor
  • Signs of problems with your liver such as yellowing of the eyes or skin, tummy pain 
  • Tell your doctor
  • Signs of problems with your lungs such as cough, chest pain, shortness of breath and trouble breathing, 
    joint or muscle pain, fever (high temperature), and chills.  
  • Nitrofurantoin can cause serious lung problems (called pulmonary reactions).
  • This may occur within the first month of treatment or after long-term use of nitrofurantoin (generally for 6 months or longer).
  • Tell your doctor immediately or ring HealthLine 0800 611 116 if you develop symptoms of lung problems.
  • Signs of an allergic reaction such as skin rash, itching, swelling of the lips, face, and mouth or difficulty breathing such as chest tightness, or wheezing
  • This usually occurs within the first week of starting treatment.
  • Tell your doctor immediately or ring HealthLine 0800 611 116 if you develop signs of  an allergic reaction.

Interactions

Nitrofurantoin may interact with a few medications and herbal supplements, so check with your doctor or pharmacist before starting nitrofurantoin or before starting any new medicines.

Learn more

Nitrofurantoin New Zealand Formulary Patient Information 
Nifuran Medsafe Consumer Information Sheet

References

  1. Nitrofurantoin New Zealand Formulary 
  2. Antibiotics: choices for common infections BPAC, 2017
  3. Nitrofurantoin - Not Suitable In Renal Impairment Medsafe Prescriber Update 36(4): 51-52, December 2015
  4. Nitrofurantoin - Do the Benefits Outweigh the Risks Long-Term? Medsafe Prescriber Update 33(2): 17-18, June 2012
  5. Nifuran Medsafe Datasheet
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 25 Feb 2019