According to OBRA, nitrofurantoin is not the anti-infective of choice for the treatment of acute urinary tract infections or as prophylaxis in patients with impaired renal function (CrCl less than 60 mL/minute) because of ineffectiveness and the high risk of serious adverse effects. The federal Omnibus Budget Reconciliation Act (OBRA) regulates medication use in residents of long-term care facilities (LTCFs). The Beers panel recommends avoiding nitrofurantoin as a long-term bacterial suppressant and avoiding use in geriatric patients with a CrCl less than 30 mL/minute. According to the Beers Criteria, nitrofurantoin is considered a potentially inappropriate medication (PIM) in geriatric patients due to the possibility of pulmonary toxicity, hepatotoxicity, and peripheral neuropathy, especially with long-term use, lack of efficacy in patients with renal impairment, and the availability of safer alternatives. The concentration of the drug in the urine is inadequate for therapeutic effectiveness in patients with renal impairment (i.e., CrCl less than 60 mL/minute) and the risk for adverse reactions is greater in those with substantial renal impairment. Anuria, oliguria, or significant impairment of renal function, defined as a creatinine clearance (CrCl) less than 60 mL/minute or clinically significant elevated serum creatinine, are contraindications to nitrofurantoin use per the package labels. Nitrofurantoin is known to be substantially excreted by the kidney. In general, the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy in elderly patients should be considered when prescribing nitrofurantoin. Spontaneous reports also suggest an increased proportion of severe hepatic reactions, including fatalities, in geriatric patients. As in younger patients, chronic pulmonary reactions generally are observed in patients receiving therapy for 6 months or longer. Spontaneous reports suggest a higher proportion of pulmonary reactions, including fatalities, in geriatric patients these differences appear to be related to the higher proportion of older patients receiving long-term nitrofurantoin therapy. Use nitrofurantoin with caution in geriatric patients. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.Ĭopyright 1996-2021 Cerner Multum, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drug information contained herein may be time sensitive. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. You may report side effects to FDA at 1-80.Įvery effort has been made to ensure that the information provided by Cerner Multum, Inc. Call your doctor for medical advice about side effects. This is not a complete list of side effects and others may occur.
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#NITROFURANTOIN MONO MAC 100MG CAPS DRUG INTERACTIONS SKIN#
signs of liver or pancreas problems -upper stomach pain (that may spread to your back), nausea or vomiting, dark urine, yellowing of the skin or eyes.increased pressure inside the skull -severe headaches, ringing in your ears, dizziness, nausea, vision problems, pain behind your eyes or.pain, redness, or swelling in your lower jaw.joint pain or swelling with fever, swollen glands, and muscle aches.numbness, tingling, or burning pain in your hands or feet.fever, chills, cough, chest pain, trouble breathing.severe stomach pain, diarrhea that is watery or bloody (even if it occurs months after your last dose).