Nitrofurention dose
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nitrofurantoin dosing guidelines 2024 UTI
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Here is a complete dosing reference for Nitrofurantoin:
Nitrofurantoin - Dosing Reference
Formulations Available
- Macrocrystals (Macrodantin): 25 mg, 50 mg, 100 mg capsules
- Dual-release (Macrobid): 100 mg capsule (25 mg macrocrystals + 75 mg monohydrate)
- Oral suspension: 25 mg/5 mL
Adult Dosing (age ≥12 years)
| Indication | Macrocrystals | Dual-release (Macrobid) | Duration |
|---|---|---|---|
| UTI treatment | 50-100 mg every 6 hrs | 100 mg every 12 hrs | 5-7 days |
| UTI prophylaxis (recurrent) | 50-100 mg once nightly (QHS) | - | Long-term |
| Post-coital prophylaxis | Single dose 50-100 mg | - | As needed |
Urine concentrations of ~200 mcg/mL are achieved with standard dosing. Keep urine pH below 5.5 to maximize activity.
Pediatric Dosing (>1 month; oral suspension or macrocrystals)
| Indication | Dose |
|---|---|
| UTI treatment | 5-7 mg/kg/day divided every 6 hours PO; max 400 mg/day |
| UTI prophylaxis | 1-2 mg/kg/dose once nightly (QHS); max 100 mg/day |
Renal Dose Adjustment
- Traditional guideline: Avoid if CrCl <60 mL/min (drug does not reach adequate urine concentrations; toxicity risk from accumulation)
- More recent data: Short-term use may be acceptable down to CrCl >30 mL/min - use clinical judgment
- Contraindicated in severe/significant renal disease (GFR <30-60 mL/min depending on source)
Contraindications
- GFR below 60 mL/min (traditional) or <30 mL/min (newer data)
- Infants <1 month old
- Pregnancy at term (38-42 weeks) - category X at term
- Prior cholestatic jaundice or hepatic dysfunction from nitrofurantoin
- Active hepatic dysfunction
Key Side Effects
| Category | Effects |
|---|---|
| GI (most common) | Anorexia, nausea, vomiting |
| Pulmonary | Infiltrates, fibrosis (especially with prolonged use) |
| Neurological | Peripheral neuropathy (prolonged use or renal impairment) |
| Hematological | Hemolytic anemia (especially in G6PD deficiency) |
| Hepatic | Hepatotoxicity, cholestatic jaundice |
Important Notes
- Take with food or milk to reduce GI side effects and improve absorption
- Does NOT work for upper UTI (pyelonephritis) - drug levels are insufficient in renal tissue and blood
- Magnesium salts decrease absorption
- Anticholinergics and high-dose probenecid can increase toxicity
- Can cause false-positive urine glucose with Clinitest
- No cross-resistance with other antibiotics - useful when TMP-SMX or fluoroquinolone resistance is present
Sources: Katzung's Basic and Clinical Pharmacology 16e; The Harriet Lane Handbook 23e (Johns Hopkins Hospital)
Nodosis
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Nodosis tablet composition uses dose side effects
Nodosis is an Indian brand-name tablet manufactured by Steadfast Medishield Pvt Ltd. Here is a full overview:
Nodosis Tablet
Composition
Sodium Bicarbonate 500 mg per tablet
Mechanism of Action
Sodium bicarbonate is an alkalinizing agent. It neutralizes excess acid in:
- The stomach (antacid effect)
- The blood (corrects metabolic acidosis)
- The urine (alkalinizes urine, helps dissolve uric acid crystals)
Uses / Indications
| Condition | Rationale |
|---|---|
| Metabolic acidosis | Replenishes bicarbonate buffer, corrects blood pH |
| Acid reflux / Heartburn | Neutralizes gastric acid |
| Hyperuricemia / Gout | Alkaline urine increases uric acid solubility and excretion |
| Uric acid kidney stones | Prevents stone formation by alkalinizing urine |
| Acid indigestion / Upset stomach | Fast antacid relief |
Dosing
- Taken with or after meals with a glass of water
- Dose and frequency are physician-directed based on the condition
- Typical adult use: 1-4 tablets per day in divided doses (varies by indication)
- Do not crush or chew - swallow whole
Side Effects
Common:
- Nausea, bloating, belching (CO₂ released from neutralization reaction)
- Increased thirst
Serious (seek medical help):
- Muscle cramps or weakness (hypocalcemia, hypokalemia)
- Confusion (severe alkalosis)
- Difficulty breathing
- Edema (sodium load - relevant in heart/kidney disease)
Contraindications & Precautions
- Kidney disease - sodium and bicarbonate load may worsen fluid retention or alkalosis
- Heart failure / hypertension - high sodium content
- Pregnancy / breastfeeding - consult physician
- Avoid combining with other antacids without medical advice (risk of milk-alkali syndrome with prolonged high-dose calcium + alkali use)
- Do not exceed recommended dose - chronic overuse can cause metabolic alkalosis
Drug Interactions
- Can affect absorption of many drugs by raising gastric and urinary pH (e.g., tetracyclines, iron, aspirin)
- Do not take within 2 hours of other medications
Note: "Nodosis" as a brand exists primarily in the Indian market. The active ingredient - sodium bicarbonate - is a well-established compound with decades of use in both OTC antacid products and IV correction of severe metabolic acidosis.
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