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MacroBID Nitrofurantoin

Nitrofurantoin is an antibiotic that’s commonly used to treat infections of the bladder, kidney, and urinary tract.

Because of how nitrofurantoin is processed by the body, it’s filtered into the urine really quickly, meaning that the medicine is most concentrated in the place where it’s needed, making it an ideal treatment for conditions such as cystitis.

Nitrofurantoin is usually given in doses of either 50mg or 100mg that are taken several times a day for between 3-7 days for an acute UTI.

Make sure that your symptoms are being caused by an infection before taking nitrofurantonin.

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MacroBID Nitrofurantoin
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  • NSAIDs (Non-steroidal anti-inflammatory drugs) e.g. ibuprofen
  • Ketoconazole, itraconazole, posaconazole or voriconazole (used to treat infections caused by a fungus)
  • Digoxin (used to treat heart problems)
  • Diazepam (used to treat anxiety, relax muscles or in epilepsy) 
  • Ulipristal (used as emergency contraception or treatment for fibroids) 
  • Phenytoin or fosphenytoin (used in epilepsy) 
  • Medicines that are used to thin your blood, such as warfarin or other Vitamin K blockers. 
  • Rifampicin (used to treat tuberculosis) 
  • Atazanavir, rilpivirine, tripranavir, saquinavir, nelfinavir, raltegravir (used to treat hiv infection)
  • Ledipasvir (used for hepatitis c treatment) 
  • Ciclosporin or tacrolimus (in cases of organ transplantation) 
  • St John's Wort (hypericum perforatum) (used to treat mild depression) 
  • Cilostazol (used to treat intermittent claudication) 
  • Clopidogrel (used to prevent blood clots (thrombi)) 
  • Vitamin B12, cyanocobalamin, hydroxocobalamin erlotinib, dabrafenib, lapatinib or pazopanib (for cancer treatment)
  • Clarithromycin (an antibiotic)
  • Methotrexate (for cancer or rheumatoid arthritis treatment) 
  • Escitalopram (an antidepressant) 
  • Clozapine (for schizophrenia)
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  • Pain
  • Burning or stinging when you urinate
  • Needing to urinate often and urgently but only passing small amounts of dark cloudy or strong smelling urine
  • Pain low in your belly (directly above the pubic bone).
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  • Back pain
  • Loin or flank pain
  • Vaginal discharge or itch
  • Pain during sexual intercourse
  • High fever (>38.5 degrees centigrade),
  • More than 2 episodes of vomiting
  • Flu-like symptoms (fever, nausea, vomiting, rashes and collapse)
  • Any serious medical condition which may require immediate hospitalisation.
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  • Back pain (symptom of a possible kidney infection)
  • Flu-like symptoms (including nausea and vomiting, rash, fever, collapse)
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  • Both treatments cannot be ordered together, and should not be taken at the same time.
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  • You will read the Patient Information Leaflet supplied with your medication
  • You will contact us and inform your GP of your medication if you experience any side effects of treatment, if you start new medication, or if your medical conditions change during treatment
  • The treatment is solely for your own use
  • You are over the age of 18 and you have entered your own information for our identity verification checks
  • You have answered all the above questions accurately and truthfully
  • You understand our doctors take your answers in good faith and base their prescribing decisions accordingly, and that incorrect information can be hazardous to your health
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Dr. Diana Gall GMC No. 7685129

Dr Diana Gall graduated from medical school in 2005 and has since undertaken further intensive training in many different areas of medicine. Dr Driana has reached consultant level and has practiced medicine all over Europe.

Shamir Patel GPHC No. 2049338

Shamir is a well-respected pharmacist with extensive experience running online pharmacies in the UK.

What is nitrofurantoin?

Nitrofurantoin is a type of antibiotic. Antibiotics treat different types of infections depending on which bacteria is causing it, and some are more suitable for some conditions than others. Nitrofurantoin is one of the most appropriate antibiotics to treat infections of the bladder, kidneys, and urinary tract.

Nitrofurantoin is filtered out by the body and into your urine really quickly, meaning that the drug is highly concentrated in the area that most needs it – part of the reason why nitrofurantoin is one of the best antibiotics for infections in and around the bladder area.

How do I know if I have an infection?

Nitrofurantoin will only work if your symptoms are being caused by an infection. Symptoms of a UTI include:

  • A burning sensation when urinating
  • Frequent urge to urinate
  • Little urine being produced
  • Pain in the lower abdomen
  • Pain in the back
  • Cloudy, dark, bloody or strong-smelling urine
  • Fatigue
  • Shakiness
  • Fever
  • Chills
    • If you think you’re experiencing any of these symptoms, the first thing you should do is request a sample pot from your GP. You can then drop this in and request for it to be sent off for analysis to see if there are any signs of infections such as nitrates and bacteria. If the results come back showing that you have an infection, you can start treatment with nitrofurantoin (provided that you’re able to take it).

      Do make sure your symptoms are caused by an infection before starting treatment with nitrofurantoin. Taking antibiotics when you don’t need them can be dangerous for a point in the future when you do need them.

      Can I take Nitrofurantoin?

      Most people are able to take the antibiotic, but there are some people with underlying conditions that might have to avoid it altogether, or talk to their GP before taking it. People that should avoid the medicine are:

      • Those who are allergic to nitrofurantoin or any of its ingredients
      • Those with kidney problems
      • People with porphyria (a rare inherited blood disorder)
      • Women in the final stages of pregnancy

      If you have any of the above conditions, it’s safer for you to avoid taking nitrofurantoin wherever possible. However, if you fall into any of the following categories, you might still be able to take the medicine with advice from your doctor:

      • Diabetes
    • Illnesses that cause severe weakness
  • Anaemia
  • History of allergic reactions
  • Lung disease
  • Liver disease
  • Nervous system disease
  • Urine is dark yellow or brown

      There may be alternative medicines you can take to remove the infection, or your doctor might allow you to use the treatment under careful monitoring to make sure you don’t suffer with any adverse effects.

      There are also some medicines that might interact with nitrofurantoin, either affecting the antibiotic or the other medicines. Some of the drugs that might interact are:

      • Antacids (especially that contain magnesium)
      • Probenecid and Sulfinpyrazone (medicines for gout)
      • OTC remedies for cystitis
      • Quinolone antibiotics
      • Oral typhoid vaccine

      If you’re taking any of the above medicines, please speak to your doctor before taking nitrofurantoin.

      What are the side effects of nitrofurantoin?

      Most medicines carry the risk of side effects, and antibiotics are no exception to this rule. Some of the symptoms listed are more serious than others, but if you experience any of them to an alarming or distressing degree, please contact your doctor urgently to discuss alternative treatments or remedies to cope with the side effects. The most commonly reported effects are:

      • Problems with lungs
      • Change of sensation
      • Change in muscle use/strength
      • Headache
      • Mood changes
      • Confusion
      • Weakness
      • Blurred vision
      • Severe headache
      • Jaundice
      • Inflamed liver
      • Nausea
      • Vomiting
      • Stomach pain
      • Diarrhoea
      • Loss of appetite
      • Drowsiness
      • Dizziness
      • Headache
      • Temporary hair loss
      • Coloured urine (this should go away when you stop taking the antibiotics)
      • Rash of some description
      • Infections of the genitals or urinary tract (caused by bacteria that isn’t sensitive to nitrofurantoin)

      The most common side effect is gastrointestinal disturbances such as nausea and vomiting. If you feel that you need help with coping with this side effect, it might help to take the antibiotics with a meal, as this can reduce the risk of stomach upset.

      There are also some combinations of symptoms that you need to be aware of so that you can call for urgent medical help if you need it.

      If you notice pale stools and dark urine accompanied by jaundice, this indicates that there’s a problem with the kidneys or gallbladder. You should stop taking the medication until you speak to a doctor about your symptoms.

      If you experience strange feelings like pins and needles or tingling, this might be a sign of nerve issues. Call your doctor or 111 if it’s out of hours.

      If you’ve experiencing unexplained bleeding our bruising (sometimes accompanies by a sore throat, temperature, and generally feeling unwell), this might suggest that there’s an issue with your blood. Please seek urgent treatment to prevent any condition from progressing.

      How long does nitrofurantoin take to work?

      Patients taking nitrofurantoin usually feel better within a few days. If you’re taking the antibiotic for an acute infection, you’ll usually take them for anywhere between 3-7 days. If you don’t start to notice an improvement within 3 days, please get in touch with your doctor as it might be the wrong antibiotic for your infection.

      Can I drink alcohol with nitrofurantoin?

      Most antibiotics don’t react well with alcohol, but with nitrofurantoin, it’s safe to drink in moderation.

      What happens if I take too much nitrofurantoin?

      If you’ve accidentally taken a double-dose, there shouldn’t be any life threatening consequences. However, taking more of the medicine than you’re supposed to can increase the chances of you feeling some unpleasant side effects. Try not to take too much nitrofurantoin regularly. If you struggle to remember how much you’ve taken, it might help to buy a pill box that you can dispense your medicines into so you can see how many you’ve already had.

      Will nitrofurantoin give me thrush?

      With antibiotics such as these, there’s a chance that you might develop genital thrush. This is because the medicine upsets the balance of bacteria in your genitals. If this happens, it can be treated with a miconazole cream such as Daktarin.

      How can I prevent UTIs?

      Sometimes, UTIs can’t be prevented (for example, if someone is retaining urine due to an underlying condition), but following these steps can help you to prevent getting one in day-to-day life.

      • Always pee after sex to flush any bacteria
      • Wear loose clothing and cotton underwear around your genital area
      • Drink plenty of fluids to avoid highly concentrated urine –a breeding ground for bacteria
      • Choose showers instead of baths so bacteria are washed away instead of being allowed to sit near your genitals in a warm and damp environment
      • Avoid using scented products around the genitals
      • Empty your bladder as soon as you feel you need to, and try to empty it completely to avoid urine retention
      • Always wipe from front to back when you’ve finished on the toilet
  • Dosage Instructions
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    Take ONCE daily with food.
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