Nitrofurantoin Disease Interactions
There are 4 disease interactions with nitrofurantoin:
Hemolytic anemia has been reported in patients treated with nitrofurantoin, primarily in patients with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency. Therapy with nitrofurantoin should be avoided or administered cautiously in patients with G-6-PD deficiency. The development of hemolysis is an indication for withdrawal of nitrofurantoin therapy. Hemolysis ceases when the drug is withdrawn.
The use of nitrofurantoin is contraindicated in patients with anuria, oliguria, or significant renal impairment (CrCl < 60 mL/min). Urinary concentration of the drug is likely to be inadequate in these patients, increasing the risk of therapeutic failure. Since nitrofurantoin is eliminated by the kidney, risk of toxicity may also be increased.
The use of nitrofurantoin has rarely been associated with hepatotoxicity, including hepatitis, cholestatic jaundice, chronic active hepatitis, and hepatic necrosis. Most acute reactions are self-limiting and resolve spontaneously, although fatalities have been reported. Therapy with nitrofurantoin should be administered cautiously in patients with liver disease. Periodic monitoring of liver function is recommended during prolonged therapy. The drug should be withdrawn immediately if hepatitis or liver damage occurs and is felt to be drug-related. Since nitrofurantoin is partially metabolized by the liver, a reduced dosage may also be necessary to prevent toxicity.
The use of nitrofurantoin has occasionally been associated with the development of peripheral neuropathy, which may be severe and irreversible. Patients at risk include the elderly and those with renal impairment, anemia, diabetes mellitus, electrolyte imbalance, vitamin B12 deficiency, diabetes, and/or debilitating diseases. Therapy with nitrofurantoin should be administered cautiously in patients with one or more risk factors and/or preexisting peripheral neuropathy. Periodic monitoring of renal function is recommended during prolonged therapy.
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nitrofurantoin drug Interactions
There are 219 drug interactions with nitrofurantoin
Drug Interaction Classification
The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
|Major||Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.|
|Moderate||Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.|
|Minor||Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.|
Do not stop taking any medications without consulting your healthcare provider.
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