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Nitrofurantoin Side Effects

For the Consumer

Applies to nitrofurantoin: oral capsule, oral suspension, oral tablet

As well as its needed effects, nitrofurantoin may cause unwanted side effects that require medical attention.

Major Side Effects

If any of the following side effects occur while taking nitrofurantoin, check with your doctor immediately:

More common:
  • Changes in facial skin color
  • chest pain
  • chills
  • cough
  • fever
  • general feeling of discomfort or illness
  • hives
  • hoarseness
  • itching
  • joint or muscle pain
  • shortness of breath
  • skin rash
  • sudden trouble in swallowing or breathing
  • swelling of the face, mouth, hands, or feet
  • troubled breathing
Less common:
  • Black, tarry stools
  • blood in the urine or stools
  • burning, numbness, tingling, or painful sensations
  • dizziness
  • drowsiness
  • headache
  • pinpoint red spots on the skin
  • sore throat
  • unsteadiness or awkwardness
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • weakness in the arms, hands, legs, or feet
Rare
  • Abdominal or stomach pain
  • blindness
  • blistering, peeling, or loosening of the skin and mucous membranes
  • blue-yellow color blindness
  • bluish color of the fingernails, lips, skin, palms, or nail beds
  • blurred vision or loss of vision, with or without eye pain
  • bulging soft spot on the head of an infant
  • change in the ability to see colors, especially blue or yellow
  • confusion
  • cracks in the skin
  • darkening of the urine
  • decreased vision
  • diarrhea
  • diarrhea, watery and severe, which may also be bloody
  • eye pain
  • general tiredness and weakness
  • light-colored stools
  • loss of appetite
  • loss of heat from the body
  • mental depression
  • mood or mental changes
  • nausea or vomiting
  • pale skin
  • pale stools
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • red, swollen skin
  • red, thickened, or scaly skin
  • skin rash
  • sores, ulcers, or white spots on the lips or in the mouth
  • swollen or painful glands
  • tenderness of salivary glands
  • unpleasant breath odor
  • upper right abdominal pain
  • visual changes
  • vomiting of blood
  • wheezing or tightness in the chest
  • yellow eyes or skin

Minor Side Effects

Some nitrofurantoin side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

More common:
  • Diarrhea
  • gas
Incidence not known:
  • Dizziness or lightheadedness
  • feeling of constant movement of self or surroundings
  • lack or loss of strength
  • loss of hair, temporary
  • sensation of spinning
  • uncontrolled eye movements

For Healthcare Professionals

Applies to nitrofurantoin: compounding powder, oral capsule, oral suspension

Cardiovascular

Frequency not reported: Chest pain, changes in EKG (e.g., nonspecific ST/T wave changes, bundle branch block) associated with pulmonary reactions, and vasculitis (sometimes associated with pulmonary reactions)[Ref]

Dermatologic

Rare (less than 0.01% to 0.1%): Exfoliative dermatitis, erythema multiforme (including Stevens-Johnson syndrome)
Frequency not reported: Transient alopecia, angioedema, maculopapular rash, erythematous rash, eczematous rash, pruritus, urticaria[Ref]

Gastrointestinal

Common (1% to 10%): Nausea, emesis, anorexia, flatulence
Uncommon (0.1% to 1%): Abdominal pain, diarrhea, dyspepsia, constipation
Rare (less than 0.1%): Parotitis, pseudomembranous colitis
Frequency not reported: Sialadenitis, pancreatitis[Ref]

Genitourinary

Frequency not reported: Dark colored urine[Ref]

Hematologic

Rare (less than 0.1%): Cyanosis secondary to methemoglobinemia, aplastic anemia
Frequency not reported: Hemolytic anemia, leukopenia, agranulocytosis, granulocytopenia, megaloblastic anemia, eosinophilia, decreased hemoglobin, glucose-6-phosphate dehydrogenase deficiency anemia, thrombocytopenia[Ref]

Hepatic

Rare (less than 0.1%): Hepatic reactions (including hepatitis, cholestatic jaundice, chronic active hepatitis, hepatic necrosis), hepatotoxicity with concurrent pulmonary reactions
Frequency not reported: Elevated AST (SGOT), elevated ALT (SGPT), elevated bilirubin, hepatic toxicity (presented with jaundice, abdominal pain, malaise, nausea, and anorexia)[Ref]

Hypersensitivity

Frequency not reported: Chronic, subacute, or acute pulmonary hypersensitivity reactions, lupus-like syndrome associated with pulmonary reactions, anaphylaxis[Ref]

Metabolic

Frequency not reported: Increased serum phosphorus, increased alkaline phosphatase, increased lactate dehydrogenase, increased creatine phosphokinase[Ref]

Nervous system

Common (1% to 10%): Headache
Uncommon (0.1% to 1%): Dizziness, drowsiness
Rare (less than 0.1%): Vertigo, benign intracranial hypertension (pseudotumor cerebri), bulging fontanels
Frequency not reported: Peripheral neuropathy, neuropathy (generally beginning as paresthesia of the lower extremities and the hands and progressing to muscle weakness and wasting), cerebellar dysfunction[Ref]

Ocular

Uncommon (0.1% to 1%): Amblyopia
Rare (less than 0.1%): Optic neuritis, retinopathy (due to intraretinal crystals)
Frequency not reported: Nystagmus, diplopia[Ref]

Other

Uncommon (0.1% to 1%): Fever, chills, malaise
Rare (0.01% to 0.1%): Bulging fontanels in infants
Frequency not reported: Asthenia, arthralgia, myalgia, drug fever[Ref]

Psychiatric

Frequency not reported: Psychotic reactions, confusion, depression[Ref]

Renal

Rare (less than 0.1%): Acute interstitial nephritis[Ref]

Respiratory

Uncommon (0.1% to 1%): Acute pulmonary hypersensitivity reaction
Rare (less than 0.1%): Cyanosis
Frequency not reported: Chronic, subacute, or acute pulmonary hypersensitivity reactions, cough, dyspnea, pulmonary infiltration with consolidation or pleural effusion on x-ray[Ref]

Immunologic

Frequency not reported: Superinfections caused by resistant organisms (e.g., Pseudomonas species, Candida species)[Ref]

References

1. Cerner Multum, Inc. "Australian Product Information." O 0

2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

3. "Product Information. Nitrofurantoin (nitrofurantoin)." AA Pharma Inc, Vaughan , ON.

It is possible that some side effects of nitrofurantoin may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

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