Nitrofurantoin

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

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

What is nitrofurantoin?

Nitrofurantoin is an antibiotic used to treat and prevent infections of the urinary tract (UTIs), 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. Read more about urinary tract infections in women.

In Aotearoa New Zealand, nitrofurantoin comes as:

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

Can I get nitrofurantoin from my pharmacy without a prescription?

From October 2022, some pharmacists will be able to sell Macrobid capsules for the treatment of UTIs. This is available without a prescription to women between 16 and 65 years of age, who are not pregnant and do not have any other complicating factors. Only pharmacists who have completed additional training can supply Macrobid capsules. They will need to ask you questions to make sure it's the best option for you and will need to record your name and address.

How to take nitrofurantoin

Always take nitrofurantoin exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much to take, how often to take it, and any special instructions.

  • Nifuran tablets
    • Take Nifuran tablets with food or milk.
    • Space your doses evenly throughout the day. For example, for Nifuran 50mg tablets with 4 times a day dosing, take your tablets first thing in the morning (before breakfast), at around midday (before lunch), late in the afternoon (before tea) and at bedtime.
    • If you're taking the tablets once a day, take your dose at bedtime.
  • Macrobid capsules
    • Take your capsules with or just after food or a meal.
    • Take your dose every 12 hours, in the morning and the evening, eg, take it at 8am and 8pm.
    • Swallow the capsule whole with a glass of water, don't crush it or chew it.
  • Missed dose: If you forget to take your dose, 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. Don't take double the dose or take 2 doses close together.
  • Finish the course: If you are taking nitrofurantoin for the treatment of an infection, it is best to take the antibiotic for the exact number of days your doctor has told you to. Don't stop taking it, even if you feel your infection has cleared up. Talk to your doctor first.

Things to consider while you are taking nitrofurantoin

Nitrofurantoin can interact with other medicines including antacids like Quick-Eze. Tell your doctor or pharmacist about all medicines you are taking including over the counter medicines, herbal and complementary medicines.

Let your doctor know if you have any problems with your kidneys.

Possible 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)
  • Stomach upset
  • Bloating and gas in the stomach
  • This is quite common when you first start taking nitrofurantoin and usually goes away with time.
  • Take nitrofurantoin with food.
  • Tell your doctor if this continues.
  • Dark yellow or brown urine
  • This is common when you are taking nitrofurantoin.
  • It is not harmful.
  • 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, or 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.  
  • Rarely, nitrofurantoin can cause lung problems.
  • 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.
  • Signs of an allergic reaction such as a 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.
Did you know that you can report a side effect to a medicine to CARM (Centre for Adverse Reactions Monitoring)? Report a side effect to a product.

Learn more

Nitrofurantoin NZ Formulary
Nifuran Medsafe Consumer Information Sheet, NZ

References

  1. Nitrofurantoin NZ Formulary 
  2. Antibiotics: choices for common infections BPAC, NZ, 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 NZ
Credits: Sandra Ponen, Pharmacist. Reviewed By: Angela Lambie, Pharmacist, Auckland Last reviewed: 01 Nov 2022