Macrobid vs. Macrodantin: What’s the Difference Between These UTI Treatments?
Key takeaways:
Macrobid (nitrofurantoin monohydrate/macrocrystals) and Macrodantin (nitrofurantoin macrocrystals) are antibiotics that treat urinary tract infections (UTIs).
One of the key differences between Macrobid and Macrodantin is how often you take them. Macrobid is taken 2 times a day, but Macrodantin is taken 4 times a day.
You may be able to get a 5-day supply of generic Macrobid for as low as $5 at certain pharmacies. Generic Macrodantin may be as low as $7.
Table of contents
Pain and burning with urination can be uncomfortable and frustrating. If you have ever experienced these symptoms, they could be signs of a urinary tract infection (UTI). When these symptoms appear, it’s a good idea to see your healthcare provider. If you have a UTI, they’ll likely give you a course of antibiotics.
Two options they could recommend for you are Macrobid or Macrodantin. They’re FDA-approved prescription antibiotics that contain different versions of the active ingredient nitrofurantoin. In fact, nitrofurantoin has been around since 1953 — with new formulations being designed over the years. It’s considered a first-choice medication for treating uncomplicated UTIs.
Nitrofurantoin has grown in popularity in recent years too since it has a lower risk of resistance than several other antibiotics. And even though Macrobid and Macrodantin share a similar active ingredient, there are some key differences between the medications you should know before choosing between the two.
What is Macrobid?
Macrobid (nitrofurantoin monohydrate/macrocrystals) is an oral medication that’s FDA-approved to treat uncomplicated UTIs in adults and children, ages 12 and older. Macrobid can also be used off-label to prevent UTIs. It comes as 100 mg capsules.
What is Macrodantin?
Like Macrobid, Macrodantin (nitrofurantoin macrocrystals) is an oral medication. It’s FDA-approved to treat or prevent UTIs in adults and children, ages 1 month and older. It’s available as 25 mg, 50 mg, and 100 mg capsules.
A liquid version of Macrodantin is also available: Furadantin (nitrofurantoin oral suspension). This can be a helpful option for people who have trouble swallowing pills, including young children. It comes as a 25 mg per 5 mL oral suspension.
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How are Macrobid and Macrodantin dosed and given?
Macrobid and Macrodantin are both taken by mouth with food, but they’re dosed differently.
Macrobid’s approved dose is 100 mg by mouth 2 times a day (every 12 hours) for 7 days for treating UTIs in adults and children. But your healthcare provider may recommend a shorter course of 5 days.
The usual dose of Macrodantin is 50 mg to 100 mg. It’s given 4 times a day by mouth for 3 to 7 days to treat UTIs in adults. But studies show that treatment for 3 days is not as effective. Macrodantin is also taken 4 times a day by children, but dosing depends on body weight.
When it comes to preventing UTIs (rather than treating them), adults can take Macrodantin 50 mg to 100 mg at bedtime. Macrodantin’s dose for UTI prevention in children is also based on body weight.
Is there an advantage to using Macrobid instead of Macrodantin?
In terms of effectiveness, not really. Studies show that Macrobid and Macrodantin are similarly effective for treating UTIs. Dosing and convenience is what separates the two. Macrobid is taken less frequently, so it may be easier to fit into your daily routine. But Macrodantin can be used in younger children.
Your healthcare provider can help you choose the best medication for you.
What’s the actual difference between these two forms of nitrofurantoin?
The difference between these two medications is the forms of nitrofurantoin that they each contain. Macrodantin contains one form called nitrofurantoin macrocrystals. These are large crystals that slow down medication absorption into your body. This helps make it better tolerated than the original form of nitrofurantoin that used microcrystals (smaller crystals). In clinical studies, nitrofurantoin microcrystals caused more stomach side effects than nitrofurantoin macrocrystals.
Macrobid, however, contains two forms of nitrofurantoin — nitrofurantoin macrocrystals and nitrofurantoin monohydrate. These two forms work together to release the medication even more slowly over time to cause fewer stomach-related side effects than Macrodantin.
Why is this? Well, after the monohydrate powder mixes with fluid in your stomach and intestines, it forms a gel. This helps release the medication slowly over time, making it gentler than Macrodantin on the stomach. Otherwise, Macrobid and Macrodantin appear to have similar side effects.
What are the known side effects of Macrobid and Macrodantin?
Overall, Macrobid and Macrodantin share similar side effects. Macrobid may be a bit easier on your stomach than Macrodantin. Otherwise, the most common ones are:
Don’t be alarmed if your urine turns brown. This commonly happens after taking Macrobid and Macrodantin. But it’s not harmful. Your urine color will return to normal after you finish your treatment.
Although rare, Macrobid and Macrodantin can also cause some serious side effects. Lung damage has been reported — especially in people taking these medications for 6 months or longer. Seek medical attention immediately if you experience any of the following symptoms:
Fever
Chills
Cough
Other rare but serious side effects include:
Liver problems
Numbness and pain in the hands and feet (peripheral neuropathy)
Severe diarrhea and inflammation of the colon (Clostridioides difficile or C. diff)
How do Macrobid and Macrodantin compare in price?
Macrobid and Macrodantin are both available as brand-name and generic medications. Macrobid is slightly less expensive than Macrodantin.
You may be able to get a 5-day supply (10 capsules) of generic Macrobid 100 mg for as low as $5 at certain pharmacies with a free GoodRx coupon. You may also be able to get generic Macrodantin 100 mg for as low as $7 at certain pharmacies.
How do healthcare providers decide which medication to prescribe?
Your provider may take a variety of factors into account. Cost and medication availability may be one consideration. And since Macrobid is taken less frequently, and tends to cause fewer stomach-related side effects, you may have better adherence to Macrobid than Macrodantin. For this reason, Macrobid is often preferred over Macrodantin for older children and adults. But Macrodantin is a better option for younger children.
The bottom line
Macrobid and Macrodantin are both effective options for treating UTIs. Their main differences are related to how often they are taken. Macrobid may also have fewer stomach-related side effects than Macrodantin. You can discuss the medication options with your healthcare provider if you experience a UTI.
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References
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