Nalidixic Acid Dosage

Applies to the following strengths: 250 mg/5 mL; 250 mg; 500 mg; 1 g

Usual Adult Dose for Urinary Tract Infection

Initial therapy: 1 g orally 4 times a day for 1 or 2 weeks
Prolonged therapy: May reduce to 2 g/day after initial therapy

Comments:

Underdosing during initial therapy may lead to the emergence of bacterial resistance.

Use: For the treatment of urinary tract infections due to susceptible gram-negative microorganisms, including most Escherichia coli, Enterobacter species, Klebsiella pneumoniae, Morganella morganii, Proteus mirabilis, P vulgaris, Providencia rettgeri

Usual Pediatric Dose for Urinary Tract Infection

3 months to 12 years:

Initial therapy: 55 mg/kg/day orally in 4 equally divided doses for 1 or 2 weeks
Maximum adult dose: 4 g/day
Prolonged therapy: May reduce to 33 mg/kg/day after initial therapy
Maximum adult dose: 2 g/day

13 years or older:

Initial therapy: 1 g orally 4 times a day for 1 or 2 weeks
Prolonged therapy: May reduce to 2 g/day after initial therapy

Comments:

Underdosing during initial therapy may lead to the emergence of bacterial resistance.

Use: For the treatment of urinary tract infections due to susceptible gram-negative microorganisms, including most E coli, Enterobacter species, K pneumoniae, M morganii, P mirabilis, P vulgaris, P rettgeri

Renal Dose Adjustments

CrCl greater than 20 mL/min: No adjustment recommended.
CrCl 20 mL/min or less: Dose should be halved.

Comments:

This drug should be used with caution in patients with renal dysfunction.

Liver Dose Adjustments

Liver disease: Caution recommended.

Precautions

CONTRAINDICATIONS:

Known hypersensitivity to the active component or to related compounds
Infants younger than 3 months
Porphyria
History of convulsive disorders
Coadministration with melphalan or other related cancer chemotherapeutic alkylating agents

Safety and efficacy have not been established in patients younger than 3 months.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

Perform disc susceptibility testing with the 30-mcg disc before using this drug, and during therapy if warranted by clinical response.
May administer with or without meals
Do not administer antacids (containing calcium, aluminum, magnesium), sucralfate, divalent or trivalent cations (e.g., iron), multivitamins containing zinc, or didanosine (chewable/buffered tablets) within 2 hours before or 2 hours after this drug.

Storage requirements:

Store at room temperature, up to 30C (86F).

General:

This drug should be used with caution in patients with epilepsy, severe cerebral arteriosclerosis, or glucose-6-phosphate dehydrogenase deficiency.
To reduce the development of drug-resistant organisms and maintain effective therapy, antibiotics should be used only to treat or prevent infections proven or strongly suspected to be caused by susceptible bacteria.
Culture and susceptibility information should be considered when selecting/modifying antibacterial therapy or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy.
If clinical response is unsatisfactory or if relapse occurs, cultures and sensitivity tests should be repeated.

Monitoring:

Hematologic: Blood counts (periodically if therapy exceeds 2 weeks)
Hepatic: Liver function tests (periodically if therapy exceeds 2 weeks)
Renal: Renal function (periodically if therapy exceeds 2 weeks)

Patient advice:

Avoid missing doses and complete the entire course of therapy.
Drink plenty of fluids.
Stop this drug if tendon pain, inflammation, or rupture occurs; rest and do not exercise until diagnosis of tendinitis or tendon rupture excluded.
Stop this drug and contact physician if symptoms of peripheral neuropathy (including pain, burning, tingling, numbness, weakness) develop.
Consult physician at once if watery and bloody stools (with or without stomach cramps and fever) develop.
Do not drive, operate machinery, or engage in other tasks that require mental alertness or coordination until you know how the drug affects you.
Avoid excessive sunlight or artificial ultraviolet light during therapy; stop this drug if phototoxicity occurs.