nitrofurantoin (Rx)

Brand and Other Names:Macrobid, Macrodantin, more...Furadantin
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

capsule, macrocrystals

  • 25mg
  • 50mg
  • 100mg

capsule, monohydrate/macrocystals

  • 100 mg

oral suspension

  • 25mg/5mL

Urinary Tract Infection

Susceptible strains of Escherichia coli, Enterobacter spp, Klebsiella spp, Staphylococcus aureus, and S saprophyticus

Macrocrystals (Macrodantin, Furadantin, and equivalents): 50-100 mg PO q6hr for 7 days or for 3 days after obtaining sterile urine

Monohydrate/macrocrystals (Macrobid and equivalents): 100 mg PO q12hr for 7 days or for 3 days after obtaining sterile urine

Long-term prophylaxis/suppression: 50-100 mg macrocrystals PO HS for up to 12 months

Dosing Considerations

Avoid for long-term UTI suppression; possible pulmonary toxicity; safer alternatives are available

Not drug of choice in elderly because of unfavorable side-effect profile

Loses effectiveness in patients with CrCl <60 mL/min due to inadequate urine concentration (Beers criteria)

Monitor renal function; renally excreted; decreased renal function more likely in elderly

Monitor liver function and possible pulmonary reactions

Take with food or milk

Dual release macrocrystals indicated only for patients >12 years for acute UTIs (cystitis) caused by E coli or S saprophyticus

Dosage Forms & Strengths

capsule, macrocrystals

  • 25mg
  • 50mg
  • 100mg

capsule, monohydrate/macrocrystals

  • 100 mg

oral suspension

  • 25mg/5mL

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

  • Macrocrystals (Macrodantin, Furadantin, and equivalents): 50-100 mg PO q6hr for 7 days or for 3 days after obtaining sterile urine
  • Monohydrate/macrocrystals (Macrobid and equivalents): 100 mg PO q12hr for 7 days or for 3 days after obtaining sterile urine
  • Long-term prophylaxis/suppression: 50-100 mg macrocrystals PO HS for up to 12 months

Dosing Considerations

Avoid for long-term UTI suppression; possible pulmonary toxicity; safer alternatives are available

Loses effectiveness in patients with CrCl <60 mL/min due to inadequate urine concentration (Beers criteria)

Monitor renal function; renally excreted; decreased renal function more likely in elderly

Monitor liver function

Take with food or milk

Dual release macrocrystals indicated only for patients >12 years for acute UTIs (cystitis) caused by E coli or S saprophyticus

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Interactions

Interaction Checker

and nitrofurantoin

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              Serious - Use Alternative (8)

              • BCG vaccine live

                nitrofurantoin decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

              • cholera vaccine

                nitrofurantoin, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.

              • darolutamide

                darolutamide will increase the level or effect of nitrofurantoin by Other (see comment). Avoid or Use Alternate Drug. Darolutamide is a BCRP inhibitor. Avoid coadministration with BCRP inhibitors. If use is unavoidable, closely monitor for adverse reactions and consider dose reduction of BCRP substrate drug (refer BCRP substrate prescribing information).

              • lasmiditan

                lasmiditan increases levels of nitrofurantoin by Other (see comment). Avoid or Use Alternate Drug. Comment: Lasmiditan inhibits BCRP in vitro. Avoid coadministration of lasmiditan with BCRP substrates.

              • pexidartinib

                nitrofurantoin and pexidartinib both increase Other (see comment). Avoid or Use Alternate Drug. Pexidartinib can cause hepatotoxicity. Avoid coadministration of pexidartinib with other products know to cause hepatoxicity.

              • pretomanid

                nitrofurantoin, pretomanid. Either increases toxicity of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Pretomanid regimen associated with hepatotoxicity. Avoid alcohol and hepatotoxic agents, including herbal supplements and drugs other than bedaquiline and linezolid.

              • selinexor

                selinexor, nitrofurantoin. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.

              • typhoid vaccine live

                nitrofurantoin decreases effects of typhoid vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.

              Monitor Closely (35)

              • acalabrutinib

                acalabrutinib increases levels of nitrofurantoin by Other (see comment). Use Caution/Monitor. Comment: Acalabrutinib may increase exposure to coadministered BCRP substrates by inhibition of intestinal BCRP.

              • aluminum hydroxide

                aluminum hydroxide decreases levels of nitrofurantoin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • apalutamide

                apalutamide will decrease the level or effect of nitrofurantoin by increasing elimination. Use Caution/Monitor. Apalutamide weakly induces BCRP and may decrease systemic exposure of drugs that are BCRP substrates.

              • bazedoxifene/conjugated estrogens

                nitrofurantoin will decrease the level or effect of bazedoxifene/conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • bupivacaine implant

                nitrofurantoin, bupivacaine implant. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Local anesthetics may increase the risk of developing methemoglobinemia when concurrently exposed to drugs that also cause methemoglobinemia.

              • calcium carbonate

                calcium carbonate decreases levels of nitrofurantoin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • conjugated estrogens

                nitrofurantoin will decrease the level or effect of conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • dapsone topical

                nitrofurantoin increases toxicity of dapsone topical by altering metabolism. Modify Therapy/Monitor Closely. May induce methemoglobinemia.

              • didanosine

                didanosine will increase the level or effect of nitrofurantoin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Applies to didanosine chewable tablets and powder for oral solution; administer 2 hr before or several hours after didanosine oral solution or chewable tablet administration

              • digoxin

                nitrofurantoin will increase the level or effect of digoxin by altering intestinal flora. Applies only to oral form of both agents. Use Caution/Monitor.

              • eluxadoline

                eluxadoline increases levels of nitrofurantoin by decreasing metabolism. Use Caution/Monitor. Eluxadoline may increase the systemic exposure of coadministered BCRP substrates.

              • estradiol

                nitrofurantoin will decrease the level or effect of estradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • estrogens conjugated synthetic

                nitrofurantoin will decrease the level or effect of estrogens conjugated synthetic by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • estropipate

                nitrofurantoin will decrease the level or effect of estropipate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • ethinylestradiol

                nitrofurantoin will decrease the level or effect of ethinylestradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • fostemsavir

                fostemsavir will increase the level or effect of nitrofurantoin by Other (see comment). Modify Therapy/Monitor Closely. Fostemsavir inhibits BCRP transporters. If possible, avoid coadministration or modify dose of BCRP substrate coadministered with fostemsavir.

              • glecaprevir/pibrentasvir

                glecaprevir/pibrentasvir will increase the level or effect of nitrofurantoin by decreasing metabolism. Use Caution/Monitor. Glecaprevir/pibrentasvir may increase plasma concentration of BCRP substrates.

              • levonorgestrel oral/ethinylestradiol/ferrous bisglycinate

                nitrofurantoin will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. Antibiotics may decrease hormonal contraceptive efficacy.

              • mestranol

                nitrofurantoin will decrease the level or effect of mestranol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.

              • mipomersen

                mipomersen, nitrofurantoin. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.

              • oxybutynin

                oxybutynin increases levels of nitrofurantoin by unspecified interaction mechanism. Use Caution/Monitor.

              • oxybutynin topical

                oxybutynin topical increases levels of nitrofurantoin by unspecified interaction mechanism. Use Caution/Monitor.

              • oxybutynin transdermal

                oxybutynin transdermal increases levels of nitrofurantoin by unspecified interaction mechanism. Use Caution/Monitor.

              • ponatinib

                ponatinib increases levels of nitrofurantoin by Other (see comment). Use Caution/Monitor.

              • regorafenib

                regorafenib will increase the level or effect of nitrofurantoin by Other (see comment). Modify Therapy/Monitor Closely. Regorafenib likely inhibits BCRP (ABCG2) transport. Coadministration with a BCRP substrate may increase systemic exposure to the substrate and related toxicity.

              • safinamide

                safinamide will increase the level or effect of nitrofurantoin by Other (see comment). Use Caution/Monitor. Safinamide and its major metabolite may inhibit intestinal BCRP. Monitor BCRP substrates for increased pharmacologic or adverse effects.

              • sodium bicarbonate

                sodium bicarbonate decreases levels of nitrofurantoin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • sodium citrate/citric acid

                sodium citrate/citric acid decreases levels of nitrofurantoin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.

              • sodium picosulfate/magnesium oxide/anhydrous citric acid

                nitrofurantoin decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.

              • sofosbuvir/velpatasvir

                sofosbuvir/velpatasvir will increase the level or effect of nitrofurantoin by Other (see comment). Use Caution/Monitor. Velpatasvir is an inhibitor of the drug transporter BCRP. Coadministration may increase systemic exposure of drugs that are BCRP substrates.

              • stiripentol

                stiripentol will increase the level or effect of nitrofurantoin by Other (see comment). Modify Therapy/Monitor Closely. Stiripentol is a BCRP transport inhibitor. Consider dosage reduction for BCRP substrates if adverse effects are experienced when coadministered.

              • tafamidis

                tafamidis will increase the level or effect of nitrofurantoin by Other (see comment). Use Caution/Monitor. Tafamidis inhibits breast cancer resistant protein (BCRP) in vitro and may increase exposure of BCRP substrates following tafamidis or tafamidis meglumine administration. Dosage adjustment of these BCRP substrates may be necessary.

              • tafamidis meglumine

                tafamidis meglumine will increase the level or effect of nitrofurantoin by Other (see comment). Use Caution/Monitor. Tafamidis inhibits breast cancer resistant protein (BCRP) in vitro and may increase exposure of BCRP substrates following tafamidis or tafamidis meglumine administration. Dosage adjustment of these BCRP substrates may be necessary.

              • tetracaine

                tetracaine, nitrofurantoin. Other (see comment). Use Caution/Monitor. Comment: Monitor for signs of methemoglobinemia when methemoglobin-inducing drugs are coadministered.

              • trimagnesium citrate anhydrous

                trimagnesium citrate anhydrous decreases levels of nitrofurantoin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Multivalent cation-containing products may reduce bioavailability of nitrofurantoin; administer nitrofurantoin at least 2 hr before or 6 hr after magnesium; use alternatives if available.

              Minor (13)

              • balsalazide

                nitrofurantoin will decrease the level or effect of balsalazide by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • biotin

                nitrofurantoin will decrease the level or effect of biotin by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • didanosine

                didanosine, nitrofurantoin. Either increases toxicity of the other by pharmacodynamic synergism. Minor/Significance Unknown. Enhanced risk of peripheral neuropathy.

              • magnesium chloride

                magnesium chloride decreases levels of nitrofurantoin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • magnesium citrate

                magnesium citrate decreases levels of nitrofurantoin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • magnesium hydroxide

                magnesium hydroxide decreases levels of nitrofurantoin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • magnesium oxide

                magnesium oxide decreases levels of nitrofurantoin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • magnesium sulfate

                magnesium sulfate decreases levels of nitrofurantoin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • metoclopramide

                metoclopramide decreases levels of nitrofurantoin by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • pantothenic acid

                nitrofurantoin will decrease the level or effect of pantothenic acid by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • pyridoxine

                nitrofurantoin will decrease the level or effect of pyridoxine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • pyridoxine (Antidote)

                nitrofurantoin will decrease the level or effect of pyridoxine (Antidote) by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

              • thiamine

                nitrofurantoin will decrease the level or effect of thiamine by altering intestinal flora. Applies only to oral form of both agents. Minor/Significance Unknown.

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              Adverse Effects

              Frequency Not Defined

              Suspected adverse reactions, contact Casper Pharma LLC. at 1-844-5-CASPER (1-844-522-7737) or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch

              Anorexia

              Arthralgia

              Chest pains

              Chills

              Cough

              Clostridium difficile colitis

              Cyanosis secondary to methemoglobinemia

              Diarrhea

              Dizziness

              Drowsiness

              Dyspnea

              Exfoliative dermatitis

              Fatigue

              Fever

              Flatulence

              Headache

              Hemolytic anemia

              Hepatitis

              Increased LFTs

              Itching

              Nausea

              Numbness

              Paresthesia

              Rash

              Sore throat

              Stomach upset

              Vomiting

              Weakness

              Urine discoloration

              Vasculitis

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              Warnings

              Contraindications

              Renal failure (anuria, oliguria, or CrCl <60 mL/min)

              Pregnancy at term (38-42 weeks of gestation)

              History of hepatic dysfunction/cholestatic jaundice with nitrofurantoin

              Neonates (<28 days)

              Hypersensitivity

              Cautions

              Caution in patients with G6PD deficiency (may increase risk for hemolytic anemia)

              Avoid long-term use in the elderly (may increase risk for pulmonary toxicity)

              Renal impairment

              Discontinue if paresthesia or hemolysis develop

              Risk of occasional hepatotoxicity and pulmonary toxicity

              Protect from light

              Peripheral neuropathy may occur; risk may increase in patients diagnosed with anemia, diabetes, vitamin B deficiency, or electrolyte imbalance (use caution)

              Acute/chronic pulmonary reactions (eg., cough, interstitial pneumonitis or fibrosis) reported

              Bacterial superinfections may occur with prolonged treatment

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              Pregnancy & Lactation

              Pregnancy category: B; contraindicated at term

              Crosses placenta, but not well distributed

              Lactation: Enters breast milk; discontinue drug or do not nurse

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Inactivates or alters bacterial ribosomal proteins and other macromolecules that may interfere with metabolism and cell-wall synthesis

              Absorption

              Well absorbed; macrocrystalline form absorbed more slowly due to slower dissolution (causes less GI distress)

              Bioavailability: Increased with food

              Distribution

              Crosses placenta, but not well distributed

              Protein bound: Approximately 60-90%

              Vd: 0.8 L/kg

              Metabolism

              Reduced by bacterial flavoproteins to reactive intermediates

              Body tissues (except plasma) metabolize 60% of drug to inactive metabolites

              Elimination

              Half-life: 20-60 min; prolonged with renal impairment

              Excretion: Urine (40%); feces (small amounts)

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
              nitrofurantoin oral
              -
              25 mg/5 mL suspension
              nitrofurantoin oral
              -
              25 mg/5 mL suspension
              nitrofurantoin oral
              -
              25 mg/5 mL suspension

              Copyright © 2010 First DataBank, Inc.

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              Patient Handout

              Patient Education
              nitrofurantoin oral

              NITROFURANTOIN - ORAL

              (NYE-troe-fure-AN-toyn)

              COMMON BRAND NAME(S): Macrodantin

              USES: This medication is used to treat or prevent certain urinary tract infections.This medication is an antibiotic that works by stopping the growth of bacteria. It will not work for viral infections (e.g., common cold, flu). Unnecessary use or overuse of any antibiotic can lead to its decreased effectiveness.Nitrofurantoin should not be used by children less than one month of age due to the risk of a certain blood problem (hemolytic anemia).

              HOW TO USE: Take this medication by mouth, with food or milk, as directed by your doctor. This medication is usually taken four times daily to treat an infection or once daily at bedtime to prevent infections. Swallow the medication whole. Avoid using magnesium trisilicate-containing antacids while taking this medication. Magnesium trisilicate-containing antacids bind with nitrofurantoin, preventing its full absorption.Dosage and duration is based on your medical condition and response to therapy. For children, the dosage is also based on body weight.For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.When taking this medication to prevent infection, take it exactly as directed by your doctor. Do not skip doses or stop taking it without your doctor's approval. Inform your doctor if you notice signs of a new urinary tract infection (e.g., pain while you are urinating).If you are taking this medication to treat an infection, continue to take this medication until the full-prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may allow bacteria to continue to grow, which may result in a relapse of the infection. Inform your doctor if your condition persists or worsens.

              SIDE EFFECTS: Nausea, vomiting, loss of appetite, or headache may occur. Take this medication with food to help minimize nausea. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.This medication may cause your urine to turn dark yellow or brown in color. This effect is harmless and will disappear when the medication is stopped.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.This medication may rarely cause very serious (possibly fatal) lung problems. Lung problems may occur within the first month of treatment or after long-term use of nitrofurantoin (generally for 6 months or longer). Get medical help right away if you develop symptoms of lung problems, including: persistent cough, chest pain, shortness of breath/trouble breathing, joint/muscle pain, bluish/purplish skin.Tell your doctor right away if you have any serious side effects, including: new signs of infection (e.g., fever, persistent sore throat), easy bruising/bleeding, mental/mood changes, persistent or severe headaches, vision changes.This drug may rarely cause serious (possibly fatal) liver disease, blood or nerve problems. Tell your doctor right away if you notice any of the following serious side effects: persistent nausea/vomiting, dark urine, yellowing of eyes/skin, unusual/persistent fatigue, fast/pounding heartbeat, numbness/tingling of the arms/legs, muscle weakness.This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn't stop, abdominal or stomach pain/cramping, blood/mucus in your stool.If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection (e.g., oral or vaginal fungal infection). Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: Before taking nitrofurantoin, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, liver disease (including liver problems caused by nitrofurantoin in the past), a certain genetic condition (G-6-PD deficiency), certain blood disorders (e.g., anemia), lung diseases, certain nerve problems (peripheral neuropathy), certain eye diseases (optic neuritis), diabetes, untreated mineral imbalance, vitamin B deficiency.Nitrofurantoin may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.Kidney function declines as you grow older. This medication is removed by the kidneys. Older adults may be at a greater risk for side effects while using this drug, especially nerve, liver or lung problems (see Side Effects section).During pregnancy, this medication should be used only when clearly needed. This medication should not be used if you are near or at the time of delivery (weeks 38-42 of pregnancy) due to possible harm to the newborn, such as a certain blood problem (hemolytic anemia). Discuss the risks and benefits with your doctor.This medication passes into breast milk and may have undesirable effects on nursing infants less than one month old and infants with a certain genetic condition (G-6-PD deficiency). Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: See also the How to Use section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.A product that may interact with this drug is: sulfinpyrazone.This drug can affect the results of certain urine glucose tests (cupric sulfate-type). Make sure laboratory personnel and your doctors know you use this drug.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

              NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for another infection unless your doctor tells you to.Laboratory and/or medical tests (e.g., complete blood counts, tests for kidney and liver function, urine cultures) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

              MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised September 2021. Copyright(c) 2021 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Formulary

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              Tier Description
              1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.