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Furadantin (Nitrofurantoin) - Side Effects and Adverse Reactions

 
 



ADVERSE REACTIONS:

 

Respiratory:

CHRONIC, SUBACUTE, OR ACUTE PULMONARY HYPERSENSITIVITY REACTIONS MAY OCCUR.
 
CHRONIC PULMONARY REACTIONS MAY OCCUR GENERALLY IN PATIENTS WHO HAVE RECEIVED CONTINUOUS TREATMENT FOR SIX MONTHS OR LONGER.  MALAISE, DYSPNEA ON EXERTION, COUGH, AND ALTERED PULMONARY FUNCTION ARE COMMON MANIFESTATIONS WHICH CAN OCCUR INSIDIOUSLY.  RADIOLOGIC AND HISTOLOGIC FINDINGS OF DIFFUSE INTERSTITIAL PNEUMONITIS OR FIBROSIS, OR BOTH, ARE ALSO COMMON MANIFESTATIONS OF THE CHRONIC PULMONARY REACTION.  FEVER IS RARELY PROMINENT.
 
THE SEVERITY OF CHRONIC PULMONARY REACTIONS AND THEIR DEGREES OF RESOLUTION APPEAR TO BE RELATED TO THE DURATION OF THERAPY AFTER THE FIRST CLINICAL SIGNS APPEAR.  PULMONARY FUNCTION MAY BE IMPAIRED PERMANENTLY, EVEN AFTER CESSATION OF THERAPY.  THE RISK IS GREATER WHEN CHRONIC PULMONARY REACTIONS ARE NOT RECOGNIZED EARLY.
 
In subacute pulmonary reactions, fever and eosinophilia occur less often than in the acute form.  Upon cessation of therapy, recovery may require several months.  If the symptoms are not recognized as being drug-related and nitrofurantoin therapy is not stopped, the symptoms may become more severe.
 
Acute pulmonary reactions are commonly manifested by fever, chills, cough, chest pain, dyspnea, pulmonary infiltration with consolidation of pleural effusion on x-ray, and eosinophilia.  Acute reactions usually occur within the first week of treatment and are reversible with cessation of therapy.  Resolution often is dramatic.  (See WARNINGS.) 
 
Changes in EKG (e.g., non-specific ST/T wave changes, bundle branch block) have been reported in association with pulmonary reactions.
 
Cyanosis has been reported rarely.

Hepatic:

Hepatic reactions, including hepatitis, cholestatic jaundice, chronic active hepatitis, and hepatic neurosis, occur rarely.  (See WARNINGS.)

Neurologic:

Peripheral neuropathy, which may become severe or irreversible, has occurred.  Fatalities have been reported.  Conditions such as renal impairment (creatinine clearance under 60 mL per minute or clinically significant elevated serum creatinine), anemia, diabetes mellitus, electrolyte imbalance, vitamin B deficiency, and debilitating diseases may increase the possibility of peripheral neuropathy (See WARNINGS.)
 
Asthenia, vertigo, nystagmus, dizziness, headache, and drowsiness have also been reported with the use of nitrofurantoin.
 
Benign intracranial hypertension (pseudotumor cerebri), confusion, depression, optic neuritis, and psychotic reactions have been reported rarely.  Bulging fontanels, as a sign of benign intracranial hypertension in infants, have been reported rarely.

Dermatologic:

Exfoliative dermatitis and erythema multiforme (including Stevens-Johnson syndrome) have been reported rarely.  Transient alopecia also has been reported.

Allergic:

A lupus-like syndrome associated with pulmonary reactions to nitrofurantoin has been reported.  Also, angioedema; maculopapular, erythematous, or eczematous eruptions; pruritus; urticaria; anaphylaxis; arthralgia; myalgia; drug fever; and chills have been reported.  Hypersensitivity reactions present the most frequent spontaneously-reported adverse events in world-wide postmarketing experience with nitrofurantoin formulations.

Gastrointestinal:

Nausea, emesis, and anorexia occur most often.  Abdominal pain and diarrhea are less common gastrointestinal reactions.  These dose-related reactions can be minimized by reduction of dosage.  Sialadenitis and pancreatitis  have been reported.  There have been sporadic reports of pseudomembranous colitis with the use of nitrofurantoin. The onset of pseudomembranous colitis symptoms may occur during or after antimicrobial treatment.  (See WARNINGS.)

Hematologic:

Cyanosis secondary to methemoglobinemia has been reported rarely.

Miscellaneous:

As with other antimicrobial agents, superinfections caused by resistant organisms, e.g., Pseudomonas species or Candida species, can occur.  There are sporadic reports of Clostridium difficile superinfections, or pseudomembranous colitis, with the use of nitrofurantoin.

Laboratory Adverse Events:

The following laboratory adverse events have been reported with the use of nitrofurantoin; increased AST (SGOT), increased ALT (SGPT), decreased hemoglobin, increased serum phosphorus, eosinophilia, glucose-6-phosphate dehydrogenase deficiency anemia (see  WARNINGS), agranulocytosis, leukopenia, granulocytopenia, hemolytic anemia, thrombocytopenia, megaloblastic anemia.  In most cases, these hematologic abnormalities resolved following cessation of therapy.  Aplastic anemia has been reported rarely.



REPORTS OF SUSPECTED FURADANTIN SIDE EFFECTS / ADVERSE REACTIONS

Below is a sample of reports where side effects / adverse reactions may be related to Furadantin. The information is not vetted and should not be considered as verified clinical evidence.

Possible Furadantin side effects / adverse reactions in 86 year old female

Reported by a physician from Denmark on 2011-10-03

Patient: 86 year old female

Reactions: Bedridden, General Physical Health Deterioration, Mental Disorder, Eating Disorder

Adverse event resulted in: hospitalization

Suspect drug(s):
Fosamax
    Dosage: 70 mg;qw;po
    Administration route: Oral
    Start date: 2008-08-10
    End date: 2011-08-03

Simvastatin
    Dosage: 40 mg; po
    Administration route: Oral
    Start date: 2008-08-14
    End date: 2011-08-02

Bisoprolol Fumarate
    Dosage: 5 mg; po
    Administration route: Oral
    Start date: 2008-08-14
    End date: 2011-08-03

Furadantin
    Dosage: 100 mg; po
    Administration route: Oral
    Start date: 2011-08-02
    End date: 2011-08-03

Niferex (Polysaccharide-Iron Complex)
    Dosage: 100 mg; po
    Administration route: Oral
    Start date: 2011-08-02
    End date: 2011-08-05

Mianserin (Mianserin)
    Dosage: 60 mg; po
    Administration route: Oral
    Start date: 2008-08-10
    End date: 2011-08-02

Other drugs received by patient: Triobe; Calcevita; Levothyroxine Sodium; Lithionit



Possible Furadantin side effects / adverse reactions in 71 year old male

Reported by a health professional (non-physician/pharmacist) from France on 2011-10-13

Patient: 71 year old male

Reactions: Pulmonary Hypertension, Ventricular Extrasystoles, Bundle Branch Block Right, Cholestasis, Tricuspid Valve Incompetence, Hepatitis, Cholelithiasis, Hepatotoxicity, Mitral Valve Incompetence, Aortic Valve Incompetence, Atrioventricular Block First Degree

Adverse event resulted in: hospitalization

Suspect drug(s):
Prednisone
    Dosage: 50 mg/day

Imuran
    Dosage: 150 mg, 1x/day at lunch time
    Administration route: Oral
    Start date: 2011-05-01
    End date: 2011-07-01

Furadantin
    Dosage: 50 mg, unk
    Start date: 2011-07-01
    End date: 2011-07-01

Ramipril
    Dosage: 1.5 mg, 1x/day in the morning
    End date: 2011-07-01

Atorvastatin Calcium
    Dosage: 40 mg, 1x/day at night
    Administration route: Oral
    End date: 2011-07-01

Bisoprolol
    Dosage: 2.5 mg, 1x/day in the morning
    End date: 2011-07-01

Other drugs received by patient: Lantus; Princi-B; Aspirin; Calcium Carbonate; Nexium; Acetaminophen



Possible Furadantin side effects / adverse reactions in 85 year old female

Reported by a physician from France on 2011-11-08

Patient: 85 year old female

Reactions: Vomiting, Diarrhoea, Nausea, Dehydration, Condition Aggravated, Vertigo

Adverse event resulted in: hospitalization

Suspect drug(s):
Bactrim
    Indication: Urinary Tract Infection

Furadantin
    Dosage: 6 dosage forms daily
    Administration route: Oral
    Indication: Urinary Tract Infection
    Start date: 2011-08-24
    End date: 2011-08-26



See index of all Furadantin side effect reports >>

Drug label data at the top of this Page last updated: 2009-02-25

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