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 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.
Serious side effects of NegGram
Along with its needed effects, nalidixic acid (the active ingredient contained in NegGram) 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:
More common side effects
- skin rash
Less common side effects
- blurred or decreased vision
- change in color vision
- confusion
- double vision
- halos around lights
- lightheadedness
- overbright appearance of lights
- restlessness
- tremor
Rare side effects
- abdominal or stomach cramps or pain (severe)
- blistering, peeling, or loosening of the skin and mucous membranes
- bulging of fontanel (soft spot) on top of the head of an infant
- burning or tingling skin sensation
- changes in facial skin color
- chills
- convulsions (seizures)
- dark or amber urine
- diarrhea, watery and severe, which may also be bloody
- fever
- general feeling of discomfort or illness
- hallucinations (seeing, hearing, or feeling things that are not there)
- headache (severe)
- hives
- hoarseness
- increased frequency of breathing
- itching
- joint pain, stiffness, or swelling
- mood or other mental changes
- nausea or vomiting
- pale skin
- pale stools
- red skin lesions, often with a purple center
- shortness of breath
- sore throat
- sudden trouble in swallowing or breathing
- swelling of the face, mouth, hands, or feet
- unusual bleeding or bruising
- unusual tiredness or weakness
- visual changes
- yellow eyes or skin
Incidence not known
- black, tarry stools
- bone pain
- burning, numbness, tingling, or painful sensations
- chest pain
- cough
- difficulty with swallowing
- large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
- lower back or side pain
- painful or difficult urination
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- redness of the skin
- sores, ulcers, or white spots on the lips or in the mouth
- swollen glands
- tightness in the chest
- unsteadiness or awkwardness
- weakness in the arms, hands, legs, or feet
- welts
- wheezing
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:
More common side effects
- diarrhea
- dizziness
- feeling of constant movement of self or surroundings
- stomach pain
- weakness
Less common side effects
- increased sensitivity of the skin to sunlight
Incidence not known
- difficulty with moving
- muscle pain or stiffness
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]
References
1. Burt RA (1984) "Review of adverse reactions associated with cinoxacin and other drugs used to treat urinary tract infections." Urology, 23, p. 101-7
2. Bilsland D, Douglas WS (1990) "Sunbed pseudoporphyria induced by nalidixic acid." Br J Dermatol, 123, p. 547
3. Brauner GJ (1975) "Bullous photoreaction to nalidixic acid." Am J Med, 58, p. 576-80
4. Garrett MH (1969) ""Negram" and photosensitivity reactions." Med J Aust, 1, p. 83
5. Rubinstein A (1979) "Le-like disease caused by nalidixic acid." N Engl J Med, 301, p. 1288
6. Valdivieso R, Pola J, Losada E, Subiza J, Armentia A, Zapata C (1988) "Severe anaphylactoid reaction to nalidixic acid." Allergy, 43, p. 71-3
7. Ramsay CA, Obreshkova E (1974) "Photosensitivity from nalidixic acid." Br J Dermatol, 91, p. 523-8
8. Birkett DA, Garretts M, Stevenson CJ (1969) "Phototoxic bullous eruptions due to nalidixic acid." Br J Dermatol, 81, p. 342-4
9. "Product Information. Neggram (nalidixic acid)." Sanofi Winthrop Pharmaceuticals
10. Paulson DF (1982) "Comparison of cinoxacin and nalidixic acid in patients with cystitis." Urology, 20, p. 138-40
11. Iravani A, Richard GA, Baer H, Fennell R (1981) "Comparative efficacy and safety of nalidixic acid versus trimethoprim/sulfamethoxazole in treatment of acute urinary tract infections in college-age women." Antimicrob Agents Chemother, 19, p. 598-604
12. Poc TE, Marion GS, Jackson DS (1984) "Seizures due to nalidixic acid therapy." South Med J, 77, p. 539-40
13. Fraser AG, Harrower AD (1977) "Convulsions and hyperglycaemia asociated with nalidixic acid." Br Med J, 2, p. 1518
14. Kremer L, Walton M, Wardle EN (1967) "Nalidixic acid and intracranial hypertension." Br Med J, 4, p. 488
15. Leslie PJ, Cregeen RJ, Proudfoot AT (1984) "Lactic acidosis, hyperglycaemia and convulsions following nalidixic acid overdosage." Hum Toxicol, 3, p. 239-43
16. Bailey RR, Natale R, Linton AL (1972) "Nalidixic acid arthralgia." Can Med Assoc J, 107, p. 604
17. Carmichael AJ, Martin AM (1988) "Acute painful proximal myopathy associated with nalidixic acid." Br Med J, 297, p. 742
18. Tafani O, Mazzoli M, Landini G, Alterini B (1982) "Fatal acute immune haemolytic anaemia caused by nalidixic acid." Br Med J, 285, p. 936-7
19. Odeh M, Oliven A, Bassan H (1992) "Nalidixic acid-induced hemolytic anemia complicating halothane-induced hepatitis." Isr J Med Sci, 28, p. 294-6
20. Gilbertson C, Jones DR (1972) "Haemolytic anaemia with nalidixic acid." Br Med J, 4, p. 493
21. Phillips PJ, Need AG, Thomas DW, Conyers RA, Edwards JB, Lehmann D (1979) "Nalidixic acid and lactic acidosis." Aust N Z J Med, 9, p. 694-6
22. Nogue S, Bertran A, Mas A, Nadal P, Anguita A, Milla J (1979) "Metabolic acidosis and coma due to an overdose of nalidixic acid." Intensive Care Med, 5, p. 141-2
More about NegGram (nalidixic acid)
- Check interactions
- Compare alternatives
- Reviews (3)
- Drug images
- Dosage information
- During pregnancy
- Drug class: quinolones and fluoroquinolones
- Breastfeeding
Professional resources
Related treatment guides
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.