Experiences with
Nitrofurantoin

Who can take nitrofurantoin

Most adults can take nitrofurantoin, including during pregnancy and breastfeeding. Most children can also take it.

Nitrofurantoin is not suitable for some people. To make sure it's safe for you, tell your doctor if you have:

ever had an allergic reaction to nitrofurantoin or any other medicine
porphyria, a rare blood disorder
glucose-6-phosphate dehydrogenase (G6PD) deficiency, a rare condition that affects your red blood cells
severe kidney disease
diabetes
any condition causing severe weakness
anaemia or vitamin B deficiency

Dosage

The dose of nitrofurantoin you take depends on whether it's to treat or prevent a urinary tract infection, your age, and how bad the infection is.

Nitrofurantoin tablets and capsules come as 50mg or 100mg strengths. The modified release (MR) capsules are 100mg. The liquid comes as 25mg in 5ml.

The usual adult dose of nitrofurantoin is:

to treat a urinary tract infection – either 100mg, taken twice a day, or 50mg taken 4 times a day. Severe infections may need a higher dose of 100mg taken 4 times a day
to prevent a urinary tract infection – 50mg to 100mg, taken once a day at night

Doses are usually lower for children. Your child's doctor will work out the correct dose based on your child's weight or age.

Try to space your doses evenly throughout the day. If you're taking nitrofurantoin twice a day, leave 12 hours between each dose – for example, take it at 8am and 8pm.

If you're taking it 4 times a day, this will usually be first thing in the morning, at about midday, late in the afternoon, and at bedtime.

Carry on taking this medicine until you finish the course, even if you feel better. If you stop your treatment early, your problem could come back.

Swallow nitrofurantoin tablets or capsules whole with a drink of water. Do not chew or break them.

Nitrofurantoin also comes as a liquid for younger children or people who find it difficult to swallow tablets.

If you're taking nitrofurantoin as a liquid, the medicine will come with a syringe or spoon to help you take the right amount. If you do not have a syringe or spoon, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

Take nitrofurantoin with or after a meal or snack. This helps your body absorb the medicine, as well as helping to prevent stomach upset.

How long to take it for

If you're taking nitrofurantoin to:

treat a urinary tract infection, you usually need to take it for 3 to 7 days
stop urinary tract infections coming back, you may need to take it for several months
prevent an infection when having surgery, you'll usually need to take it on the day of the operation and for the next 3 days

If you forget to take it

If you forget to take a dose of nitrofurantoin, take it as soon as you remember, unless it's nearly time for your next dose. In this case, just leave out the missed dose and take your next dose at the usual time.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

If you take too much

Taking an extra dose of nitrofurantoin is unlikely to harm you.

You've taken more than your prescribed dose of nitrofurantoin and:

you're worried or get severe side effects
you've taken more than 1 extra dose

Go to 111.nhs.uk or call 111

Call 111 if you're asking about a child under the age of 5 years.

If you go to A&E, take the nitrofurantoin box or leaflet inside the packet plus any remaining medicine with you.

Common side effects

There are things you can do to help cope with these common side effects of nitrofurantoin.

Keep taking the medicine, but speak to a doctor if the advice on how to cope does not help and a side effect is still bothering you or does not go away.

Nitrofurantoin may cause your pee to turn dark yellow or a brownish colour. This is normal and is not a reason to stop taking the medicine. Your pee will return to its usual colour once you stop taking nitrofurantoin.

Serious side effects are rare and happen in less than 1 in 1,000 people.

Call a doctor or contact 111 straight away if you have:

a cough or a high temperature – these can be signs of lung problems
pale poo and dark pee together, or the whites of your eyes turn yellow or your skin turns yellow (this may be less obvious on brown or black skin) – this can be a sign of liver or gallbladder problems
bruising or bleeding you cannot explain (including nosebleeds), sore throat, a high temperature and feeling tired or generally unwell – these can be signs of blood problems
severe headaches

Go to 111.nhs.uk or call 111.

you get chest pain or difficulty breathing – these can be signs of lung problems
you get pins and needles, tingling sensations, numbness or weakness – these can be signs of nerve problems

In rare cases, it's possible to have a serious allergic reaction to nitrofurantoin (anaphylaxis).

These are not all the side effects of nitrofurantoin. For a full list see the leaflet inside your medicines packet.

Nitrofurantoin and pregnancy

Nitrofurantoin may be taken during pregnancy, but it is generally best avoided in the third trimester because there's a small chance it could cause problems with your baby's red blood cells.

Most babies will not have this problem, but your doctor may recommend a different antibiotic if you are in the third trimester of pregnancy.

If your doctor or health visitor says your baby is healthy, you can take nitrofurantoin while breastfeeding.

Nitrofurantoin passes into breast milk in small amounts and is unlikely to cause side effects in your baby. But it's best to take nitrofurantoin only for a short time. If you need to take it for longer than a few weeks, talk to your doctor or pharmacist.

Do not take nitrofurantoin while breastfeeding if your baby has:

jaundice – signs include yellowing of the whites of the eyes and the skin (this may be less obvious on brown or black skin), dark pee and pale poo
glucose-6-phosphate dehydrogenase (G6PD) deficiency, a rare condition that affects red blood cells

If your baby is not feeding as well as usual, has a stomach upset, or has oral thrush (a fungal infection in their mouth), or if you have any other concerns about your baby, talk to your doctor, pharmacist, health visitor or midwife.

Nitrofurantoin and fertility

There's no evidence to suggest that taking nitrofurantoin reduces fertility in either men or women.

Cautions with other medicines

There are some medicines that do not mix well with nitrofurantoin.

Tell your doctor if you're taking any of these medicines before you start taking nitrofurantoin:

indigestion remedies known as antacids, particularly those that contain magnesium
cystitis remedies you can buy from a pharmacy
antibiotics known as quinolones, including nalidixic acid, ciprofloxacin, levofloxacin, norfloxacin, ofloxacin and moxifloxacin

Typhoid vaccines given by mouth may not work properly if you're taking nitrofurantoin. It does not affect typhoid vaccines given by injection.

It's not possible to say that complementary medicines or herbal remedies are safe to take with nitrofurantoin. They're not tested in the same way as pharmacy and prescription medicines.