Uses of Nitrofur SR: - Bacterial infections of urinary tract Uncomplicated UTI, Urinary Tract Infection Severe renal impairment (anuria, oliguria, significantly elevated serum creatinine, CrCl <60 ml/min). Hypersensitivity to nitrofurans, G6PD deficiency, infants <3 mth. Pregnancy at term, during labour and delivery, or when the onset of labour is imminent.

Systemic Urinary Anti- infective

Nitrofurantoin interferes with cell metabolism and cell wall synthesis by inhibiting several enzyme systems including acetyl coenzyme A. It is bactericidal to most gram-positive and gram-negative urinary tract pathogens.

How to use Nitrofurantoin: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Nitrofurantoin is to be taken with food. Administration: Should be taken with food. Take w/ or immediately after meals. Sustained release macrocrystals indicated only for patients >12 years for acute UTIs (cystitis) caused by E coli or S saprophyticus Adult Dose: Oral Acute uncomplicated urinary tract infections Adult: 50-100 mg 4 times daily for 7 days or for 3 days after obtaining sterile urine. SR preparation: 100 mg bid for 7 days or for 3 days after obtaining sterile urine. Prophylaxis of uncomplicated urinary tract infections Adult: 50-100 mg at bedtime for up to 12 months. Child Dose: Urinary Tract Infection >1 month 5-7 mg/kg/day PO divided q6hr for 7 days UTI prophylaxis: 1-2 mg/kg PO qHS or 2 divided doses >12 years 50-100 mg PO q6hr for 7 days or for 3 days after obtaining sterile urine SR preparation: 100 mg PO q12hr for 7 days or for 3 days after obtaining sterile urine Long-term prophylaxis/suppression: 50-100 mg PO at bedtime for up to 12 months Renal Dose: Loses effectiveness in patients with CrCl <60 mL/min due to inadequate urine concentration Monitor renal function; renally excreted; decreased renal function more likely in elderly

Reduced excretion with probenecid or sulfinpyrazone. Absorption reduced by magnesium trisilicate. Antagonistic effects with quinolone antibacterials. Reduced effects with carbonic anhydrase inhibitors or urinary alkalinisers.

Severe renal impairment (anuria, oliguria, significantly elevated serum creatinine, CrCl <60 ml/min). Hypersensitivity to nitrofurans, G6PD deficiency, infants <3 mth. Pregnancy at term, during labour and delivery, or when the onset of labour is imminent.

Common - Nausea - Vomiting - Diarrhea Nausea, vomiting, anorexia, abdominal pain, diarrhoea; headache, drowsiness, vertigo, dizziness, nystagmus, benign intracranial hypertension; rash, urticaria, pruritus, fever, sialadenitis, angioedema, erythema multiforme, exfoliative dermatitis, pancreatitis, lupus-like syndrome, myalgia, arthralgia; acute pulmonary sensitivity reactions; megaloblastic anaemia, leucopenia, granulocytopenia or agranulocytosis, thrombocytopenia, aplastic anaemia, haemolytic anaemia (in G6PD-deficient patients); transient alopecia; brownish discolouration of urine. Potentially Fatal: Peripheral polyneuropathy, hepatotoxicity, anaphylaxis, Stevens-Johnson syndrome, interstitial pneumonitis, pulmonary fibrosis.

Pregnancy Category B. There are no adequate and well-controlled studies in pregnant women. This drug should be used during pregnancy only if clearly needed.Nitrofurantoin has been detected in human breast milk in trace amounts. Because of the potential for serious adverse reactions from Nitrofurantoin in nursing infants under one month of age, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother

Precaution: Elderly. Monitor hepatic and pulmonary function during prolonged therapy. Pre-existing pulmonary, hepatic, neurological, or allergic disorders, predisposition to peripheral neuropathy e.g. renal impairment, anaemia, DM, electrolyte imbalance, debility, vitamin B deficiency. Withdraw if signs of peripheral neuropathy occur. Lactation. Lactation: Enters breast milk; discontinue drug or do not nurse

Occasional incidents of acute overdosage of Nitrofurantoin have not resulted in any specific symptoms other than vomiting. Induction of emesis is recommended.

Do not store above 30°C. Keep away from light and out of the reach of children.

Systemic Urinary Anti- infective

Nitrofurantoin interferes with cell metabolism and cell wall synthesis by inhibiting several enzyme systems including acetyl coenzyme A. It is bactericidal to most gram-positive and gram-negative urinary tract pathogens.

Pregnancy Category B. There are no adequate and well-controlled studies in pregnant women. This drug should be used during pregnancy only if clearly needed. Nitrofurantoin has been detected in human breast milk in trace amounts. Because of the potential for serious adverse reactions from Nitrofurantoin in nursing infants under one month of age, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.