NegGram Side Effects
Generic name: nalidixic acid
Medically reviewed by Drugs.com. Last updated on Jun 7, 2022.
Note: This document contains side effect information about nalidixic acid. Some of the dosage forms listed on this page may not apply to the brand name NegGram.
Applies to nalidixic acid: compounding powder, oral suspension, oral tablet
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]
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]
Rare (less than 0.1%): Convulsions/seizures, sensory or sensorimotor axonal polyneuropathy affecting small and/or large axons (resulting in paresthesias, hypoesthesias, dysesthesias, weakness)
Infants and children:
Frequency not reported: Increased intracranial pressure with bulging anterior fontanel, papilledema, headache, 6th cranial nerve palsy[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 (the active ingredient contained in NegGram) Seizures may also be involved and hyperglycemia was often present.[Ref]
Rare (less than 0.1%): Toxic psychosis, psychotic reactions (involving delirium, photophobia, paranoia, visual hallucinations)[Ref]
Frequency not reported: Arthralgias, myalgias, tendon disorders (including tendon rupture)[Ref]
Visual disturbances usually resolved with dosage reduction or drug discontinuation.[Ref]
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]
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 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]
Rare (less than 0.1%): Cholestasis[Ref]
More about NegGram (nalidixic acid)
- Drug interactions
- Dosage information
- During pregnancy or Breastfeeding
- Reviews (3)
- Drug images
- Drug class: quinolones
Related treatment guides
1. Burt RA "Review of adverse reactions associated with cinoxacin and other drugs used to treat urinary tract infections." Urology 23 (1984): 101-7
2. Bilsland D, Douglas WS "Sunbed pseudoporphyria induced by nalidixic acid." Br J Dermatol 123 (1990): 547
3. Brauner GJ "Bullous photoreaction to nalidixic acid." Am J Med 58 (1975): 576-80
4. Garrett MH ""Negram" and photosensitivity reactions." Med J Aust 1 (1969): 83
5. Rubinstein A "Le-like disease caused by nalidixic acid." N Engl J Med 301 (1979): 1288
6. Valdivieso R, Pola J, Losada E, Subiza J, Armentia A, Zapata C "Severe anaphylactoid reaction to nalidixic acid." Allergy 43 (1988): 71-3
7. Ramsay CA, Obreshkova E "Photosensitivity from nalidixic acid." Br J Dermatol 91 (1974): 523-8
8. Birkett DA, Garretts M, Stevenson CJ "Phototoxic bullous eruptions due to nalidixic acid." Br J Dermatol 81 (1969): 342-4
9. "Product Information. NegGram (nalidixic acid)." Sanofi Winthrop Pharmaceuticals, New York, NY.
10. Paulson DF "Comparison of cinoxacin and nalidixic acid in patients with cystitis." Urology 20 (1982): 138-40
11. Iravani A, Richard GA, Baer H, Fennell R "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 (1981): 598-604
12. Poc TE, Marion GS, Jackson DS "Seizures due to nalidixic acid therapy." South Med J 77 (1984): 539-40
13. Fraser AG, Harrower AD "Convulsions and hyperglycaemia asociated with nalidixic acid." Br Med J 2 (1977): 1518
14. Kremer L, Walton M, Wardle EN "Nalidixic acid and intracranial hypertension." Br Med J 4 (1967): 488
15. Leslie PJ, Cregeen RJ, Proudfoot AT "Lactic acidosis, hyperglycaemia and convulsions following nalidixic acid overdosage." Hum Toxicol 3 (1984): 239-43
16. Bailey RR, Natale R, Linton AL "Nalidixic acid arthralgia." Can Med Assoc J 107 (1972): 604
17. Carmichael AJ, Martin AM "Acute painful proximal myopathy associated with nalidixic acid." Br Med J 297 (1988): 742
18. Tafani O, Mazzoli M, Landini G, Alterini B "Fatal acute immune haemolytic anaemia caused by nalidixic acid." Br Med J 285 (1982): 936-7
19. Odeh M, Oliven A, Bassan H "Nalidixic acid-induced hemolytic anemia complicating halothane-induced hepatitis." Isr J Med Sci 28 (1992): 294-6
20. Gilbertson C, Jones DR "Haemolytic anaemia with nalidixic acid." Br Med J 4 (1972): 493
21. Phillips PJ, Need AG, Thomas DW, Conyers RA, Edwards JB, Lehmann D "Nalidixic acid and lactic acidosis." Aust N Z J Med 9 (1979): 694-6
22. Nogue S, Bertran A, Mas A, Nadal P, Anguita A, Milla J "Metabolic acidosis and coma due to an overdose of nalidixic acid." Intensive Care Med 5 (1979): 141-2
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