NegGram Side Effects

Generic name: nalidixic acid

Medically reviewed by Drugs.com. Last updated on Sep 8, 2023.

Note: This document provides detailed information about NegGram.

Applies to nalidixic acid: oral suspension, oral tablet Side Effects associated with nalidixic acid. Some dosage forms listed on this page may not apply specifically to the brand name NegGram.

Applies to nalidixic acid: oral suspension, oral tablet.

Precautions

If you will be taking this medicine for more than 2 weeks, it is very important that your doctor check you or your child's progress at regular visits. Blood tests may be needed to check for unwanted effects.

If your or your child's symptoms do not improve within 2 days, or if they become worse, check with your doctor.

Do not breastfeed while you are using this medicine.

Do not use melphalan (e.g., Alkeran®) or other similar cancer medicines while you are taking this medicine. Using these medicines together may increase your risk for more serious side effects.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you or your child have a rash; itching; hives; hoarseness; shortness of breath; trouble with breathing; trouble with swallowing; or any swelling of your hands, face, or mouth after you take this medicine.

Nalidixic acid may cause diarrhea, and in some cases it can be severe. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

Tell your doctor right away if you or your child start having numbness, tingling, or burning pain in your hands, arms, legs, or feet. These may be symptoms of a condition called peripheral neuropathy.

This medicine may rarely cause inflammation or tearing of a tendon (the cord that attaches muscles to bones). The risk of having tendon problems may be increased if you are over 60 years of age or if you are also using steroid medicines (e.g., dexamethasone, prednisolone, prednisone, Medrol®). If you or your child get sudden pain in a tendon after exercise (e.g., in the ankle, back of the knee or leg, shoulder, elbow, or wrist), stop taking nalidixic acid (the active ingredient contained in NegGram) and check with your doctor right away. Rest and do not exercise until the doctor has made sure that you have not injured or torn the tendon.

This medicine may cause blurred vision or other vision problems. It may also cause some people to become dizzy, drowsy, or less alert than they are normally. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert or able to see well. If these reactions are especially bothersome, check with your doctor.

This medicine may increase the central nervous system (CNS) stimulant effects of caffeine-containing foods or beverages, such as chocolate, cocoa, tea, coffee, and cola drinks. Avoid eating or drinking large amounts of these foods or beverages while using this medicine. If you have questions about this, check with your doctor.

Nalidixic acid may cause your skin to be more sensitive to sunlight than it is normally. Exposure to sunlight, even for brief periods of time, may cause a skin rash, itching, redness or other discoloration of the skin, or a severe sunburn. When you begin using this medicine:

• Stay out of direct sunlight, especially between the hours of 10:00 a.m. and 3:00 p.m., if possible.
• Wear protective clothing, including a hat. Also, wear sunglasses.
• Apply a sun block product that has a skin protection factor (SPF) of at least 15. Some patients may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your doctor.
• Apply a sun block lipstick that has an SPF of at least 15 to protect your lips.
• Do not use a sunlamp, tanning bed, or tanning booth.

If you or your child have a severe reaction from the sun, stop using this medicine and check with your doctor right away.

This medicine may cause false test results with some urine glucose (sugar) tests. If you or your child are diabetic, check with your doctor before changing your diet or the dose of your diabetes medicine while you are using nalidixic acid.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Serious side effects of NegGram

Along with its needed effects, nalidixic acid may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking nalidixic acid:

Get emergency help immediately if any of the following symptoms of overdose occur while taking nalidixic acid:

Symptoms of overdose

• aggressive and violent behavior
• change in the ability to see colors, especially blue or yellow
• drowsiness
• headache
• loss of appetite
• rapid, deep breathing
• trouble with sleeping
• unable to sleep
• unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

Other side effects of NegGram

Some side effects of nalidixic acid may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For healthcare professionals

Applies to nalidixic acid: compounding powder, oral suspension, oral tablet.

Hypersensitivity adverse events

• Frequency not reported: Allergic reactions (including rash, pruritus, urticaria, angioedema, eosinophilia, arthralgia with joint stiffness and swelling, anaphylactoid reactions [including anaphylactic shock]), serious and occasionally fatal hypersensitivity (anaphylactoid) reactions^[Ref]

Dermatologic

• Frequency not reported: Rash, erythema multiforme, Stevens-Johnson syndrome, photosensitivity reactions (consisting of erythema and bullae on exposed skin surfaces), phototoxicity (moderate to severe)^[Ref]

Rash was reported most often.

Photosensitivity reactions appeared to be related to the amount of sun exposure rather than amount of drug taken. Most reactions were reported following intense sun exposure during the summer. Large bullae developed most commonly on the dorsum of the hands and feet. Photosensitivity reactions usually resolved 2 weeks to 2 months after drug discontinuation. In some cases, bullae continued to appear with additional sun exposure or with mild skin trauma for up to 3 months after discontinuation of nalidixic acid. Recurrence of bullae have been reported after 1 year.^[Ref]

Gastrointestinal

• Frequency not reported: Nausea, vomiting, abdominal pain, diarrhea, Clostridium difficile associated diarrhea^[Ref]

Nervous system

• Rare (less than 0.1%): Convulsions/seizures, sensory or sensorimotor axonal polyneuropathy affecting small and/or large axons (resulting in paresthesias, hypoesthesias, dysesthesias, weakness)
• Frequency not reported: Drowsiness, weakness, headache, dizziness, vertigo, peripheral neuropathy, paresthesia

Infants and children:

• Frequency not reported: Increased intracranial pressure with bulging anterior fontanel, papilledema, headache, 6th cranial nerve palsy^[Ref]

Brief convulsions were usually associated with excessive doses. In general, the convulsions were reported in patients with predisposing factors such as epilepsy or cerebral atherosclerosis.^[Ref]

Psychiatric

• Rare (less than 0.1%): Toxic psychosis, psychotic reactions (involving delirium, photophobia, paranoia, visual hallucinations)^[Ref]

Toxic psychosis was usually associated with excessive doses.

Psychotic reactions involving delirium, photophobia, paranoia, and visual hallucinations have rarely been reported with nalidixic acid. Seizures may also be involved and hyperglycemia was often present.^[Ref]

Musculoskeletal

• Frequency not reported: Arthralgias, myalgias, tendon disorders (including tendon rupture)^[Ref]

Ocular

• Rare (less than 0.1%): Reversible subjective visual disturbances without objective findings (including overbrightness of lights/photophobia, change in color perception, difficulty in focusing, decrease in visual acuity, double vision)^[Ref]

Visual disturbances usually resolved with dosage reduction or drug discontinuation.^[Ref]

Hematologic

• Rare (less than 0.1%): Thrombocytopenia, leukopenia, eosinophilia, hemolytic anemia (sometimes associated with glucose 6-phosphate deficiency)^[Ref]

Hemolytic anemia secondary to nalidixic acid most commonly occurred in patients with G6PD deficiency but was also reported in patients without this deficiency. Direct Coombs' tests were generally positive. Death from nalidixic acid induced hemolytic anemia has been reported.^[Ref]

Metabolic

• Rare (less than 0.1%): Metabolic acidosis, lactic acidosis^[Ref]

Metabolic acidosis has been reported in a few patients, generally after an overdose of nalidixic acid. Lactic acidosis resulting in death occurred in a diabetic woman.^[Ref]

Hepatic

• Rare (less than 0.1%): Cholestasis^[Ref]

See also:

Further information

NegGram side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

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