![nitrofurantoin mono nitrofurantoin mono](http://images.rxlist.com/images/healthwise.1.0/medical/multum/nitrofuantoinmacro-mono100mg-eon.jpg)
This interaction may be due to surface absorption of the antibacterial onto the antacid. Depending on the severity of symptoms, patients may respond to supportive care more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen.Īspirin, ASA Citric Acid Sodium Bicarbonate: (Major) Antacids can delay both the rate and the extent of GI absorption of nitrofurantoin. If methemoglobinemia occurs or is suspected, discontinue articaine and any other oxidizing agents. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. Separate administration by at least 1 hour.Īnticholinergics: (Moderate) Antimuscarinics can delay gastric emptying, possibly increasing the bioavailability of nitrofurantoin.Īrticaine Epinephrine: (Moderate) Coadministration of articaine with oxidizing agents, such as nitrofurantoin, may increase the risk of developing methemoglobinemia. The drug may cause pulmonary fibrosis and peripheral neuropathy.Īntacids: (Moderate) Antacids can delay both the rate and the extent of GI absorption of nitrofurantoin.
![nitrofurantoin mono nitrofurantoin mono](http://sourcinghopde.weebly.com/uploads/1/3/3/2/133241709/114164110_orig.png)
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.