CKS is no longer commissioned by the National Institute for Health and Clinical Excellence (NICE). NICE remains committed to providing a replacement service for CKS and is currently reviewing its options. In the meantime, although CKS content is now not being maintained, it still remains relevant and will continue to be made available. CKS content was generated under a programme of topic creation and update. To check if the topic you are viewing is current or out of date, please refer to the topic publication details by clicking on the 'How up-to-date is this topic?' link in the left hand menu on individual topic pages.
Urinary tract infection (lower) - women - Management
What are the precautions for nitrofurantoin?
- Peripheral neuropathy
- Nitrofurantoin should be used with caution in people with anaemia, diabetes mellitus, electrolyte imbalance, debilitating conditions, and vitamin B (particularly folate) deficiency since these conditions may enhance the occurrence of peripheral neuropathy.
- The manufacturer of nitrofurantoin advises stopping the drug at the first signs of neural involvement (paraesthesiae).
- People with a deficiency of glucose-6-phosphate dehydrogenase
- This is found in 10% of black people and a variable percentage of ethnic groups of Mediterranean, near Eastern, and Asian origin. It is rare in Caucasians.
- Avoid nitrofurantoin in these people as it may cause haemolysis.
- Discontinue nitrofurantoin if there is any sign of haemolysis (which ceases when the drug is withdrawn).
- If the person develops unexplained pulmonary, hepatotoxic, haematological, or neurologic syndromes, discontinue treatment with nitrofurantoin.
[Goldshield Pharmaceuticals, 2002b; Goldshield Pharmaceuticals, 2002c; Goldshield Pharmaceuticals, 2007]
© NHS Institute for Innovation and Improvement