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Nitrofurantoin Disease Interactions

There are 6 disease interactions with nitrofurantoin.

Major

Antibiotics (applies to nitrofurantoin) colitis

Major Potential Hazard, Moderate plausibility. Applicable conditions: Colitis/Enteritis (Noninfectious)

Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.

References

  1. "Product Information. Omnipen (ampicillin)." Wyeth-Ayerst Laboratories (2002):
  2. "Product Information. Ceftin (cefuroxime)." Glaxo Wellcome (2002):
  3. "Product Information. Zinacef (cefuroxime)." Glaxo Wellcome (2002):
  4. "Product Information. Cleocin (clindamycin)." Pharmacia and Upjohn (2002):
  5. "Product Information. Macrobid (nitrofurantoin)." Procter and Gamble Pharmaceuticals (2002):
  6. "Product Information. Macrodantin (nitrofurantoin)." Procter and Gamble Pharmaceuticals (2002):
  7. "Product Information. Amoxil (amoxicillin)." SmithKline Beecham (2001):
  8. "Product Information. Merrem (meropenem)." Astra-Zeneca Pharmaceuticals (2001):
  9. "Product Information. Coly-Mycin M Parenteral (colistimethate)." Parke-Davis (2001):
  10. "Product Information. Lincocin (lincomycin)." Pharmacia and Upjohn (2001):
  11. "Product Information. Cubicin (daptomycin)." Cubist Pharmaceuticals Inc (2003):
  12. "Product Information. Xifaxan (rifaximin)." Salix Pharmaceuticals (2004):
  13. "Product Information. Doribax (doripenem)." Ortho McNeil Pharmaceutical (2007):
  14. "Product Information. Penicillin G Procaine (procaine penicillin)." Monarch Pharmaceuticals Inc (2009):
  15. "Product Information. Vibativ (telavancin)." Theravance Inc (2009):
  16. "Product Information. Teflaro (ceftaroline)." Forest Pharmaceuticals (2010):
  17. "Product Information. Penicillin G Sodium (penicillin G sodium)." Sandoz Inc (2022):
  18. "Product Information. Dalvance (dalbavancin)." Durata Therapeutics, Inc. (2014):
  19. "Product Information. Orbactiv (oritavancin)." The Medicines Company (2014):
  20. "Product Information. Bicillin C-R (benzathine penicillin-procaine penicillin)." A-S Medication Solutions (2017):
  21. "Product Information. Baxdela (delafloxacin)." Melinta Therapeutics, Inc. (2017):
  22. "Product Information. Polymyxin B Sulfate (polymyxin B sulfate)." AuroMedics Pharma LLC (2022):
  23. "Product Information. Zemdri (plazomicin)." Achaogen (2018):
  24. "Product Information. Seysara (sarecycline)." Allergan Inc (2018):
  25. "Product Information. Nuzyra (omadacycline)." Paratek Pharmaceuticals, Inc. (2018):
  26. "Product Information. Aemcolo (rifamycin)." Aries Pharmaceuticals, Inc. (2018):
  27. "Product Information. Fetroja (cefiderocol)." Shionogi USA Inc (2019):
  28. "Product Information. Biaxin (clarithromycin)." AbbVie US LLC (2019):
  29. "Product Information. Zithromax (azithromycin)." Pfizer U.S. Pharmaceuticals Group (2021):
  30. "Product Information. E.E.S.-400 Filmtab (erythromycin)." Arbor Pharmaceuticals (2018):
View all 30 references
Major

Nitrofurantoin (applies to nitrofurantoin) G-6-PD deficiency

Major Potential Hazard, High plausibility.

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.

References

  1. "Product Information. Macrobid (nitrofurantoin)." Procter and Gamble Pharmaceuticals (2002):
  2. "Product Information. Macrodantin (nitrofurantoin)." Procter and Gamble Pharmaceuticals (2002):
Major

Nitrofurantoin (applies to nitrofurantoin) hepatotoxicity

Major Potential Hazard, Moderate plausibility. Applicable conditions: Liver Disease

The use of nitrofurantoin has rarely been associated with hepatotoxicity, including hepatitis, cholestatic jaundice, chronic active hepatitis, and hepatic necrosis. Nitrofurantoin macrocrystals capsules are contraindicated in patients with a previous history of cholestatic jaundice/hepatic dysfunction associated with nitrofurantoin. 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.

References

  1. Reinhart HH, Reinhart E, Korlipara P, Peleman R "Combined nitrofurantoin toxicity to liver and lung." Gastroenterology 102 (1992): 1396-9
  2. Stricker BH, Blok AP, Claas FH, Van Parys GE, Des Met VJ "Hepatic injury associated with the use of nitrofurans: a clinicopathological study of 52 reported cases." Hepatology 8 (1988): 599-608
  3. Maskell R "Nitrofurantoin induced chronic liver disease." J Antimicrob Chemother 19 (1987): 140
  4. Thuluvath PJ, McKendrick MW "Nitrofurantoin induced chronic liver disease." J Antimicrob Chemother 18 (1986): 291-2
  5. Miller AR, Addis BJ, Clarke PD "Nitrofurantoin and chronic active hepatitis." Ann Intern Med 97 (1982): 452
  6. Sharp JR, Ishak KG, Zimmerman HJ "Chronic active hepatitis and sever heptic necrosis associated with nitrofurantoin." Ann Intern Med 92 (1980): 14-9
  7. Black M, Rabin L, Schatz N "Nitrofurantoin-induced chronic active hepatitis." Ann Intern Med 92 (1980): 62-4
  8. Hoener B, Patterson SE "Nitrofurantoin disposition." Clin Pharmacol Ther 29 (1981): 808-16
  9. Mollison LC, Angus P, Richards M, Jones RM, Ireton J "Hepatitis due to nitrofurantoin." Med J Aust 156 (1992): 347-9
  10. Sippel PJ, Agger WA "Nitrofurantoin-induced granulomatous hepatitis." Urology 18 (1981): 177-8
  11. "Product Information. Macrobid (nitrofurantoin)." Procter and Gamble Pharmaceuticals (2002):
  12. "Product Information. Macrodantin (nitrofurantoin)." Procter and Gamble Pharmaceuticals (2002):
  13. Mulberg AE, Bell LM "Fatal cholestatic hepatitis and multisystem failure associated with nitrofurantoin." J Pediatr Gastroenterol Nutr 17 (1993): 307-9
  14. Burgert SJ, Burke JP, Box TD "Reversible nitrofurantoin-induced chronic active hepatitis and hepatic cirrhosis in a patient awaiting liver transplantation." Transplantation 59 (1995): 448-9
View all 14 references
Major

Nitrofurantoin (applies to nitrofurantoin) renal dysfunction

Major Potential Hazard, High plausibility.

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.

References

  1. Sachs J, Geer T, Noell P, Kunin CM "Effect of renal function on urinary recovery of orally administered nitrofurantoin." N Engl J Med 278 (1967): 1032-5
  2. Hoener B, Patterson SE "Nitrofurantoin disposition." Clin Pharmacol Ther 29 (1981): 808-16
  3. Schirmeister J, Stefani F, Willmann H, Hallauer W "Renal handling of nitrofurantoin in man." Chemotherapy 5 (1965): 223-6
  4. Goff JB, Schlegel JU, O'Dell RM "Urinary excretion of nalidixic acid, sulfamethizole and nitrofurantoin in patients with reduced renal function." J Urol 99 (1968): 371-5
  5. Glascock HW, Jr "Nitrofurantoin in renal failure." Ann Intern Med 69 (1968): 1077
  6. "Product Information. Macrobid (nitrofurantoin)." Procter and Gamble Pharmaceuticals (2002):
View all 6 references
Moderate

Nitrofurantoin (applies to nitrofurantoin) peripheral neuropathy

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Diabetes Mellitus, Anemia Associated with Vitamin B12 Deficiency, Folic Acid/Cyanocobalamin Deficiency, Electrolyte Abnormalities, Hypocalcemia

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.

References

  1. White WT, Harrison L, Dumas J "Nitrofurantoin unmasking peripheral neuropathy in a type 2 diabetic patient." Arch Intern Med 144 (1984): 821
  2. Yiannikas C, Pollard JD, McLeod JG "Nitrofurantoin neuropathy." Aust N Z J Med 11 (1981): 400-5
  3. Craven RS "Furadantin neuropathy." Aust N Z J Med 3 (1971): 246-9
Moderate

Nitrofurantoin (applies to nitrofurantoin) respiratory

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Pulmonary Impairment

Chronic pulmonary reactions, generally in patients who have received continuous treatment for 6 months or longer have been reported with the use of nitrofurantoin. Caution is recommended when prescribing this agent to patients with pulmonary dysfunction.

References

  1. "Product Information. Macrobid (nitrofurantoin)." Procter and Gamble Pharmaceuticals (2002):
  2. "Product Information. Macrodantin (nitrofurantoin)." Procter and Gamble Pharmaceuticals (2002):

Nitrofurantoin drug interactions

There are 179 drug interactions with nitrofurantoin.


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
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.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.