Experiences with
Nitrofurantoin

Who can take nitrofurantoin

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

Who may not be able to take nitrofurantoin

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
a lung condition
problems with your liver
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 slow release 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 as slow release capsules, twice a day, or 50mg taken as standard tablets or capsules, 4 times a day. Severe infections may need a higher dose of 100mg taken as standard tablets or capsules, 4 times a day
to prevent a urinary tract infection – 50mg to 100mg taken as standard tablets or capsules, 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 need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the nitrofurantoin packet or leaflet inside it, any remaining medicine, and any other medicines you take.

Common side effects

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

Taking nitrofurantoin with or after a meal or snack should help prevent this. It may also help if you avoid rich or spicy food.

Have frequent sips of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having strong-smelling pee. Do not take any other medicines to treat vomiting without speaking to a pharmacist or doctor.

If you take the combined pill or progestogen-only pill and you're being sick, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you take the combined pill or progestogen-only pill and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Eat when you would usually expect to be hungry. If it helps, eat smaller meals more often than usual. Snack when you're hungry. Have nutritious snacks that are high in calories and protein, such as dried fruit and nuts.

Make sure you rest and drink plenty of fluids. Do not drink too much alcohol. Painkillers you can buy without a prescription, such as paracetamol and ibuprofen, are safe to take with nitrofurantoin. Speak to your doctor if these do not help or the headaches are severe.

If nitrofurantoin makes you feel dizzy, stop what you're doing and sit or lie down until you feel better. Do not drive a car or ride a bike while you're feeling dizzy or sleepy.

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

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

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

a cough, coughing up blood or mucus, shortness of breath, pain when you breathe 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

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

Meds - serious side effects A&E safety messaging

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

Meds New IA (H4) - serious allergic reaction

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.

Nitrofurantoin and breastfeeding

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.

Meds New IA (H2) - Pregnancy non-urgent care card

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.

Mixing nitrofurantoin with herbal remedies and supplements

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.

Meds New IA (H2) - Cautions with other medicines alert