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Compare Nitrofurantoin vs. Bactrim

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Nitrofurantoin (Macrobid) and sulfamethoxazole/trimethoprim (Bactrim) are both antibiotics used to treat urinary tract infections (UTIs). However, there are some differences between them. Nitrofurantoin is a nitrofuran antibiotic, while sulfamethoxazole/trimethoprim is a combination of a sulfonamide and an antifolate. Nitrofurantoin is taken orally, typically every 12 hours for 5 to 7 days, and is available in both capsule and oral suspension forms. In contrast, sulfamethoxazole/trimethoprim is usually taken twice daily for 3 to 14 days and is available as tablets, a liquid suspension, and an injection. Nitrofurantoin has fewer drug interactions and is safe for those with sulfa allergies, but it can cause side effects like nausea and headache. Sulfamethoxazole/trimethoprim can cause side effects such as nausea, diarrhea, and rash, and it interacts with more medications, including dofetilide. Additionally, sulfamethoxazole/trimethoprim is not recommended during pregnancy, while nitrofurantoin should be avoided in the last weeks of pregnancy. Both medications have generic versions available, making them more affordable options.

  • Nitrofurantoin (Macrobid)
    Sulfamethoxazole/trimethoprim
  • Nitrofurantoin (Macrobid)
    Sulfamethoxazole/trimethoprim

  • Summary of Nitrofurantoin vs. Bactrim

    Summary for Nitrofuran antibiotic
    Prescription only

    Nitrofurantoin (Macrobid) is an antibiotic used to treat or prevent a urinary tract infection (UTI). Some side effects include nausea, headache, and gas. It can also make your urine turn dark yellow or brown. Nitrofurantoin (Macrobid) doesn't have many interactions with other medications. There's a lower-cost generic version of nitrofurantoin (Macrobid) available.

    Summary for Sulfonamide antibiotic
    Prescription only

    Sulfamethoxazole/trimethoprim (sometimes known as SMZ/TMP) is a combination medication containing an antifolate and sulfa antibiotic. It's used to treat different types of infections, such as urinary tract infections (UTIs), ear infections, and lung infections. This antibiotic has two different brand names, Bactrim and Septra, and it's also available as a lower-cost generic. It's a tablet that's taken by mouth, typically twice daily for most types of infections. This antibiotic also comes as a suspension under the brand name Sulfatrim for people who can't swallow tablets and as an injection for people in the hospital. Common side effects include nausea, diarrhea, and rash.

  • Indications of Nitrofurantoin vs. Bactrim

    Indications for
    •Treatment or prevention of urinary tract infections
    Indications for
    •Urinary tract infection (UTI)
    •Lower respiratory tract infection (e.g., Pneumocystis pneumonia, infections related to bronchitis)
    •Diarrhea caused by Shigella (shigellosis)
    •Travelers' diarrhea - tablet or liquid only
    •Ear infections - tablet or liquid only

  • Pros and Cons of Nitrofurantoin vs. Bactrim

    Pros and Const for Nitrofuran antibiotic
    Pros
    •Works well to treat and prevent UTIs
    •Available as both a capsule and a flavored oral suspension
    •Safe to take if you're allergic to other antibiotics like penicillin or sulfa medications (e.g., Bactrim, Septra (sulfamethoxazole / trimethoprim))
    Cons
    •Might need to take up to four times a day (depending on the formulation)
    •Can interact with certain types of antacids, travel vaccines, and lab tests
    •Can harm your lungs, liver, and nerves if taken for a long period of time
    Pros and Const for Sulfonamide antibiotic
    Pros
    •Treats many types of bacterial infections
    •Can be given to children as young as 2 months old to treat certain infections
    •Available as a lower-cost generic
    Cons
    •Can upset your stomach and make your skin more sensitive to the sun
    •Not the best choice for people with liver or kidney problems
    •Not recommended if you're pregnant
    •Can't take if you have a sulfa allergy

  • Common Side Effects of Nitrofurantoin vs. Bactrim

    Common Side Effects for
    •Nausea (8%)
    •Headache (6%)
    •Gas (2%)
    Common Side Effects for
    •Nausea
    •Vomiting
    •Diarrhea
    •Loss of appetite
    •Rash
    •Hives
    •Skin sensitivity to sun or light

  • Warnings of Nitrofurantoin vs. Bactrim

    Common Side Effects for
    •Lung damage
    •Liver damage
    •Nerve damage (neuropathy)
    •Breakdown of red blood cells (hemolytic anemia)
    •Severe diarrhea
    Common Side Effects for
    •Not for use during pregnancy
    •Severe allergic reactions and skin reactions
    •Low platelet counts and risk for bleeding
    •Diarrhea from Clostridioides difficile infection
    •Low sodium levels and high potassium levels
    •Blood cell-related problems
    •Problems with processing phenylalanine - for people with phenylketonuria (PKU) only

  • Prices with our coupons for Nitrofurantoin vs. Bactrim

    Learn more about Nitrofurantoin
    Learn more about Sulfamethoxazole/trimethoprim

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