nitrofurantoin
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.
What is Nitrofurantoin (Macrobid)?
What is Nitrofurantoin (Macrobid) used for?
Treatment or prevention of urinary tract infections
How Nitrofurantoin (Macrobid) works
Nitrofurantoin (Macrobid) is a nitrofuran antibiotic. The medication collects in your urine. It kills bacteria in the urinary tract by damaging or blocking proteins the bacteria need to survive.
Drug Facts
More on Nitrofurantoin (Macrobid) essentials
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What are the side effects of Nitrofurantoin (Macrobid)?
Common Side Effects
- Nausea (8%)
- Headache (6%)
- Gas (2%)
Other Side Effects
- Diarrhea
- Vomiting
- Upset stomach
- Stomach pain
- Dizziness
- Drowsiness
- Itchiness
- Fever
- Chills
- "Pins and needles" feeling in the arms and legs
Serious Side Effects
- Severe allergic reaction: hives, rash, muscle aches, chills, fever, swelling of the lips or tongue, difficulty breathing
- Severe diarrhea
- Trouble breathing or new or worsening cough
- Liver problems: stomach bloating, severe stomach pain with vomiting, yellowing of your skin or the whites of your eyes, dark urine
Source: DailyMed
More on Nitrofurantoin (Macrobid) side effects
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Changes in facial skin color
chills
general feeling of discomfort or illness
hoarseness
joint or muscle pain
shortness of breath
skin rash
sudden trouble in swallowing or breathing
swelling of the face, mouth, hands, or feet
troubled breathing
Less common
Black, tarry stools
blood in the urine or stools
burning, numbness, tingling, or painful sensations
dizziness
drowsiness
headache
pinpoint red spots on the skin
unsteadiness or awkwardness
unusual bleeding or bruising
unusual tiredness or weakness
weakness in the arms, hands, legs, or feet
Rare
Abdominal or stomach pain
blindness
blistering, peeling, or loosening of the skin and mucous membranes
blue-yellow color blindness
bluish color of the fingernails, lips, skin, palms, or nail beds
blurred vision or loss of vision, with or without eye pain
bulging soft spot on the head of an infant
change in the ability to see colors, especially blue or yellow
confusion
cracks in the skin
darkening of the urine
decreased vision
diarrhea, watery and severe, which may also be bloody
general tiredness and weakness
light-colored stools
loss of appetite
loss of heat from the body
mental depression
mood or mental changes
nausea or vomiting
pale skin
pale stools
red skin lesions, often with a purple center
red, irritated eyes
red, swollen skin
red, thickened, or scaly skin
skin rash
sores, ulcers, or white spots on the lips or in the mouth
swollen or painful glands
tenderness of salivary glands
unpleasant breath odor
upper right abdominal pain
visual changes
vomiting of blood
wheezing or tightness in the chest
yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known
Dizziness or lightheadedness
feeling of constant movement of self or surroundings
lack or loss of strength
loss of hair, temporary
sensation of spinning
uncontrolled eye movements
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Nitrofurantoin (Macrobid)
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
Pharmacist tips for Nitrofurantoin (Macrobid)
Finish all of the nitrofurantoin (Macrobid) your healthcare provider prescribed for you, even if you start to feel better. Stopping the antibiotic too soon can cause your infection to come back and be harder to treat.
Take nitrofurantoin (Macrobid) with food. This helps your body absorb the medication properly and lessen stomach-related side effects.
Nitrofurantoin (Macrobid) can turn your urine a dark yellow or brown color. This is harmless and will disappear when you stop the medication.
If you have mild diarrhea after taking nitrofurantoin (Macrobid), remember to drink plenty of fluids to prevent dehydration. You can also try taking probiotic supplements to help lessen this side effect. Separate the probiotic from nitrofurantoin (Macrobid) by at least 2 hours. This prevents the antibiotic from killing the "good" bacteria found in the probiotic and allows the probiotic to work as it should.
Avoid taking nitrofurantoin (Macrobid) at the same time as any antacids, supplements, or multivitamins containing magnesium. These products can prevent your body from absorbing the antibiotic well.
For the liquid form: Shake the bottle well before using it. Be sure to use a medication dose cup, spoon, or oral syringe to measure out your dose. Using household teaspoons might cause you or your child to take the wrong amount of nitrofurantoin (Macrobid).
If you're pregnant, make sure your provider knows your due date. Nitrofurantoin (Macrobid) might harm your unborn baby if it's taken within the last 2 to 4 weeks of your pregnancy.
If you're breastfeeding a baby who's younger than 1 month of age, speak with your provider about the risks and benefits of taking nitrofurantoin (Macrobid). There's a potential risk that the medication can cause harm to your baby.
More on Nitrofurantoin (Macrobid) tips
Frequently asked questions about Nitrofurantoin (Macrobid)
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What are the risks and warnings for Nitrofurantoin (Macrobid)?
Nitrofurantoin (Macrobid) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Lung damage
Risk factors: Using nitrofurantoin (Macrobid) for 6 months or longer
In some rare cases, nitrofurantoin (Macrobid) can damage your lungs. Your risk is higher if you're taking this medication for more than 6 months. Talk to your healthcare provider as soon as possible if you're having difficulty breathing or have a new cough that doesn't go away.
Liver damage
Risk factors: History of liver problems
Very rarely, some people taking nitrofurantoin (Macrobid) have had severe or life-threatening liver damage. Your risk might be higher if you have or have had liver problems. If you experience unexplained stomach pain, nausea, vomiting, dark urine, pale stools, or yellowing of your skin or whites of your eyes, contact your healthcare provider right away. You'll likely need to get blood tests done so your provider can check your liver health.
Nerve damage (neuropathy)
Risk factors: Kidney problems | Low number of red blood cells (anemia) | Low vitamin B levels | Electrolyte imbalances | High blood sugar (diabetes)
Nitrofurantoin (Macrobid) can damage the nerves in your arms, legs, and rarely eyes. This effect isn't very common, but certain medical conditions, including kidney problems, can raise your risk of this happening. In some cases, the damage is permanent. Tell your healthcare provider if you experience numbness, tingling, or a prickling sensation in any part of your body while using this medication. If you're taking nitrofurantoin (Macrobid) for a long period of time, you'll likely need to get blood tests done regularly so your provider can check your kidney function and risk of nerve damage.
Breakdown of red blood cells (hemolytic anemia)
Risk factors: G6PD deficiency | Black people | People of Mediterranean or Middle Eastern ethnicity
Nitrofurantoin (Macrobid) can damage your red blood cells and cause hemolytic anemia. Your risk is higher if you're lacking a specific protein in your body called glucose-6-phosphate dehydrogenase (G6PD). Black people and those of Mediterranean or Middle Eastern ethnicity are more likely to have this deficiency. Tell your healthcare provider about the medical conditions you have before starting this antibiotic. Let your provider know if you feel unexplainably weak, dizzy, or tired while taking nitrofurantoin (Macrobid).
Severe diarrhea
Risk factors: Use of multiple antibiotics | Long-term use of antibiotics | 65 years or older | Recent hospital stay | People with a weakened immune system | Previous infection from or known exposure to Clostridioides difficile
Like all antibiotics, nitrofurantoin (Macrobid) can cause diarrhea. This is because nitrofurantoin (Macrobid) can change the amount of "good" bacteria that's normally in your gut, which affects how well they keep dangerous bacteria away. In rare cases, this diarrhea is caused by an overgrowth of bacteria called Clostridioides difficile (commonly called C. diff). C. diff-related diarrhea is very contagious and can lead to life-threatening dehydration. If you experience watery or bloody stools, stomach cramps, or fever, contact your provider right away. If you have C. diff, be sure to wash your hands with soap for 20 seconds often, and try to use a different bathroom from anyone living with you until you're better.
Nitrofurantoin (Macrobid) dosage forms
Typical dosing for Nitrofurantoin (Macrobid)
Treatment of UTI
Macrobid capsules and its generics: For people over 12 years old, the typical dose is 100 mg by mouth every 12 hours with food for 7 days.
Macrodantin capsules, Furadantin oral suspension, and their generics: For adults, the typical dose is 50 mg to 100 mg by mouth four times a day with food. For children ages 1 month and older, the dose will depend on their body weight; it's typically taken as 1.25 mg/kg to 1.75 mg/kg by mouth four times a day with food. This medication is typically taken for 7 days or for at least 3 days after you have a urine test that shows it's free of bacteria.
Prevention of UTI
Macrodantin capsules, Furadantin oral suspension, and their generics: For adults, the typical dose is 50 mg to 100 mg by mouth once a day at bedtime with food. For children ages 1 month and older, the dose will depend on their body weight; it's typically 1 mg/kg of body weight by mouth per day with food.
More on Nitrofurantoin (Macrobid) dosage forms
Nitrofurantoin (Macrobid) Reviews
GoodRx has partnered with PatientsLikeMe to provide reviews on the different aspects of Nitrofurantoin (Macrobid).
Effectiveness
Learn more about the effectiveness of Nitrofurantoin (Macrobid) based on real life experiences.
Overall Rating
Based on 13 people taking this medication
4.7
Effectiveness by condition:
urinary tract infection12 reviews
4.5
neurogenic bladder1 reviews
5.0
Severity of side effects
Based on 80 people taking this medication
0%
50%
100%
Top side effects
Diarrhea
3%
Abdominal cramps
2%
Nausea
2%
Tiredness
2%
Thrush
2%
Reasons people stopped taking Nitrofurantoin (Macrobid)
Based on 122 people who have taken this medication
Course of treatment ended
65%
Doctor's advice
19%
Other
8%
Did not seem to work
5%
Side effects too severe
5%
Personal research
2%
How long people take Nitrofurantoin (Macrobid)
Based on 107 people taking this medication
0%
50%
100%
Interactions between Nitrofurantoin (Macrobid) and other drugs
More on Nitrofurantoin (Macrobid) interactions
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Cholera Vaccine, Live
- Fluconazole
How much does Nitrofurantoin (Macrobid) cost?
Nitrofurantoin (Macrobid) contraindications
History of liver damage or jaundice linked with nitrofurantoin use
Severe kidney problems
Urinating less than usual or not at all
Females at 38 to 42 weeks of a pregnancy and during labor and delivery
Children under 1 month of age
What are alternatives to Nitrofurantoin (Macrobid)?
Treatment or prevention of urinary tract infections
Urinary tract infections (UTIs) in women
Lower respiratory tract infection (e.g., Pneumocystis pneumonia, infections related to bronchitis)
Travelers' diarrhea - tablet or liquid only
Ear infections - tablet or liquid only
What is the latest news about Nitrofurantoin (Macrobid)?
Nitrofurantoin (Macrobid) images
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References
Best studies we foundAlembic Pharmaceuticals Inc. (2023). NITROFURANTOIN capsule. DailyMed.
Almatica Pharma LLC. (2020). MACROBID- nitrofurantoin monohydrate/macrocrystalline capsule. DailyMed.
Casper Pharma LLC. (2021). FURADANTIN- nitrofurantoin suspension. DailyMed.
Center for Disease Control and Prevention. (2022). E. coli (Escherichia coli).
Center for Disease Control and Prevention. (2024). Clinical Safety: Hand Hygiene for Healthcare Workers.
Center for Disease Control and Prevention. (2021). Pneumocystis pneumonia.
Center for Disease Control and Prevention. (2010). Klebsiella.
Ehlers, S., et al. (2022). Staphylococcus saprophyticus. StatPearls.
Flores-Mireles, A. L., et al. (2015). Urinary tract infections: Epidemiology, mechanisms of infection and treatment options. Nature Reviews. Microbiology.
Matuszkiewicz-Rowińska, J., et al. (2015). Urinary tract infections in pregnancy: Old and new unresolved diagnostic and therapeutic problems. Archives of Medical Science.
Muller, A. E., et al. (2016). Nitrofurantoin's efficacy and safety as prophylaxis for urinary tract infections: A systematic review of the literature and meta-analysis of controlled trials. Clinical Microbiology and Infection.
National Heart, Lung, and Blood Institute. (2022). Hemolytic anemia.
National Organization for Rare Disorders. (2017). Glucose-6-phosphate dehydrogenase deficiency.
Squadrito, F. J., et al. (2022). Nitrofurantoin. StatPearls.
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