Macrofuran
Macrofuran Uses, Dosage, Side Effects, Food Interaction and all others data.
Macrofuran interferes with cell metabolism and cell wall synthesis by inhibiting several enzyme systems including acetyl coenzyme A. It is bactericidal to most gram-positive and gram-negative urinary tract pathogens.
Macrofuran interferes with vital processes in bacteria, which leads to their death. Macrofuran rapidly reaches therapeutic concentrations in the urine and is also cleared rapidly.
| Trade Name | Macrofuran |
| Availability | Prescription only |
| Generic | Nitrofurantoin |
| Nitrofurantoin Other Names | 5-Nitrofurantoin, Nitrofurantoin, Nitrofurantoin macrocrystal, Nitrofurantoin macrocrystalline, nitrofurantoina, nitrofurantoine, nitrofurantoinum |
| Related Drugs | amoxicillin, doxycycline, ciprofloxacin, cephalexin, ceftriaxone, levofloxacin, Augmentin, Keflex, sulfamethoxazole / trimethoprim, Bactrim |
| Type | |
| Formula | C8H6N4O5 |
| Weight | Average: 238.159 Monoisotopic: 238.033819309 |
| Protein binding | Nitrofurantoin could be up to 90% protein bound in plasma. |
| Groups | Approved, Vet approved |
| Therapeutic Class | Systemic Urinary Anti- infective |
| Manufacturer | |
| Available Country | Egypt |
| Last Updated: | September 19, 2023 at 7:00 am |
Uses
Macrofuran is specifically used for the treatment & prophylaxis of urinary tract infections when due to susceptible strains of Escherichia coli, Enterococci, Staphylococcus aureus, Staphylococcus saprophyticus and certain susceptible strains of Klebsiella and Enterobacter species.
Macrofuran is also used to associated treatment for these conditions: Acute Cystitis, Urinary Tract Infection
How Macrofuran works
Macrofuran is converted by bacterial nitroreductases to electrophilic intermediates which inhibit the citric acid cycle as well as synthesis of DNA, RNA, and protein.
Dosage
Macrofuran dosage
Tablet:
- Adults: 50-100 mg four times a day - the lower dosage level is recommended for uncomplicated urinary tract infections.
- Children: 5-7 mg/kg/day in four divided doses (contraindicated under one month of age). Therapy should be continued for one week or for at least 3 days after sterility of the urine is obtained.
- For long-term suppressive therapy in adults:a reduction of dosage to 50-100 mg at bedtime may be adequate. For long-term suppressive therapy in children, doses as low as 1 mg/kg per 24 hours, given in a single dose or in two divided doses, may be adequate.
SR Capsule:
- Adults and Children over 12 years: One 100 mg capsule every 12 hours for seven days.
- Genito-urinary surgical prophylaxis: One capsule twice daily on day of procedure and for next 3 days.
Suspension:
Children: 5-7 mg/kg/day in four divided doses (contraindicated under 1 month of age). The average dose of Macrofuransuspension for pediatric patients can be calculated as follows:-
- For 7 to 11 kg Body Weight patient: ½ (2.5 ml) teaspoonfuls (4 times daily)
- For 12 to 21 kg Body Weight patient: 1 (5 ml) teaspoonfuls (4 times daily)
- For 22 to 30 kg Body Weight patient: 1 ½ (7.5 ml) teaspoonfuls (4 times daily)
- For 31 to 41 kg Body Weight patient: 2 (10 ml) teaspoonfuls (4 times daily)
Therapy should be continued for one week or for at least 3 days after sterility of the urine is obtained.
For long-term suppressive therapy in children, doses as low as 1 mg/kg per 24 hours, given in a single dose or in two divided doses, may be adequate.
Macrofuran should be taken with food.
Side Effects
The most frequent clinical adverse events are nausea, headache, and flatulence. Other less occurred adverse events are diarrhea, dyspepsia, abdominal pain, constipation, emesis, dizziness, drowsiness
Toxicity
Symptoms of overdose include vomiting. In case of overdose, induce vomiting if it has not already occurred and increase fluid intake to promote urination. In extreme cases, nitrofurantoin can be removed from circulation by dialysis.
Precaution
If acute, sub-acute, or chronic pulmonary reactions occur, Macrofuran should be discontinued. Antacid preparations containing magnesium trisilicate should not be taken while taking Macrofuran
Interaction
Reduced excretion with probenecid or sulfinpyrazone. Absorption reduced by magnesium trisilicate. Antagonistic effects with quinolone antibacterials. Reduced effects with carbonic anhydrase inhibitors or urinary alkalinisers.
Food Interaction
- Take with food. Food decreases irritation and increases bioavailability.
Macrofuran Drug Interaction
Moderate: bifidobacterium infantis / lactobacillus acidophilusUnknown: aspirin, diphenhydramine, ubiquinone, duloxetine, apixaban, omega-3 polyunsaturated fatty acids, fluticasone nasal, pregabalin, metoprolol, polyethylene glycol 3350, mirabegron, acetaminophen / hydrocodone, levothyroxine, acetaminophen, cyanocobalamin, ascorbic acid, cholecalciferol, alprazolam, cetirizine
Macrofuran Disease Interaction
Major: colitis, G-6-PD deficiency, hepatotoxicity, renal dysfunctionModerate: peripheral neuropathy, respiratory
Volume of Distribution
Data regarding the volume of distribution in humans is scarce but it has been reported as 0.46L/kg in dogs.
Elimination Route
Macrofuran reaches a Cmax of 0.875-0.963mg/L with an AUC of 2.21-2.42mg*h/L. It is 38.8-44.3% bioavailable. Taking nitrofurantoin with food increases the absorption and duration of therapeutic concentrations in the urine.
Half Life
The half life of nitrofurantoin is 0.72-0.78h.
Clearance
The clearance of nitrofurantoin is 16.7-19.4L/h.
Elimination Route
27-50% of an oral dose is excreted in the urine as unchanged nitrofurantoin. 90% of the total dose is eliminated in the urine.
Pregnancy & Breastfeeding use
Pregnancy Category B. There are no adequate and well-controlled studies in pregnant women. This drug should be used during pregnancy only if clearly needed.
Macrofuran has been detected in human breast milk in trace amounts. Because of the potential for serious adverse reactions from Macrofuran in nursing infants under one month of age, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother
Contraindication
Anuria, oliguria, or significant impairment of renal function are contraindications. This drug is contraindicated in pregnant patients at 38-42 weeks, during labor and delivery. Macrofuran is also contraindicated in those patients with known hypersensitivity to Macrofuran
Acute Overdose
Occasional incidents of acute overdosage of Macrofuran have not resulted in any specific symptoms other than vomiting. Induction of emesis is recommended
Storage Condition
Store at 15-30° C
Innovators Monograph
You find simplified version here Macrofuran
Macrofuran contains Nitrofurantoin see full prescribing information from innovator Macrofuran Monograph, Macrofuran MSDS, Macrofuran FDA label
FAQ
What is Macrofuran used for?
Macrofuran is an antibacterial medication used to treat bladder infections, but is not as effective for kidney infections. Macrofuran is used to treat urinary tract infections.
How safe is Macrofuran?
Macrofuran is not suitable for everyone. To make sure it's safe for you, tell your doctor if you have: ever had an allergic reaction to nitrofurantoin or any other medicines in the past. Macrofuran is effective in the prevention of UTI. Its use may be associated with increased non-severe adverse effects; severe adverse effects occur infrequently. The risk of severe toxicity seems to increase with the duration of Macrofuran prophylaxis.
How does Macrofuran work?
Macrofuran works by killing bacteria or preventing their growth. Macrofuran kills the bacteria by entering their cells and damaging their genetic material.
What are the common side effects of Macrofuran?
Common side effects of Macrofuran are include:
- feeling sick (nausea)
- being sick (vomiting) and diarrhoea.
- loss of appetite.
- headaches.
- dizziness or feeling sleepy.
Is Macrofuran safe during pregnancy?
It's usually safe to take Macrofuran during pregnancy . It's very unlikely that Macrofuran is harmful during pregnancy. It goes straight into your pee, so very little of the medicine passes through to the unborn baby.
Is Macrofuran safe during breastfeeding?
The use of Macrofuran in breastfeeding mothers is generally safe, as only small amounts transfer into the breast milk.
Can I drink alcohol with Macrofuran?
Yes, you can drink alcohol with Macrofuran.
Can I drive after taking Macrofuran?
Macrofuran may cause you to become drowsy, so you should avoid driving when you are taking it. You should also stay away from operating heavy machinery.
When should be taken of Macrofuran?
Macrofuran take usually be first thing in the morning, at about midday, late in the afternoon, and at bedtime.
How many time can I take Macrofuran daily?
Macrofuran taken twice a day or 50mg taken 4 times a day.
How much Macrofuran can I take daily?
The usual dose of Macrofuran to: treat a urinary tract infection is either 100mg taken twice a day or 50mg taken 4 times a day. Severe infections may need a higher dose of 100mg taken 4 times a day.
How long does Macrofuran take to work?
Macrofuran should start working within three to five days, although it may take up to a week for symptoms to clear. Be sure to complete the full course of medication.
How long does Macrofuran stay in my system?
Maximum urinary excretion usually occurs 4-5 hours after administration of macrocrystalline Macrofuran. Macrofuran has an elimination half-life of about 30 minutes or less.
Can I take Macrofuran for a long time?
The Macrofuran works as well as other long-term antibiotics for preventing recurrent urinary tract infections in women. However gastrointestinal side effects were more common in people on Macrofuran.
Who should not take Macrofuran?
You should not take Macrofuran if you have severe kidney disease, urination problems, or a history of jaundice or liver problems caused by Macrofuran You also should not take Macrofuran if you are allergic to it, or if you have, severe kidney disease; a history of jaundice or liver problems caused by taking nitrofurantoin; if you are urinating less than usual or not at all; or if you are in the last 2 to 4 weeks of pregnancy.
What happens if I miss a dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happen If I stop taking Macrofuran?
If you stop taking the Macrofuran suddenly or don't take it at all: Your urinary tract infection may not go away and may get worse. If you stop taking this Macrofuran suddenly, the bacteria that caused your urinary tract infection could become resistant to this drug. That means it won't work for you anymore.
What happen If I suddenly stop taking Macrofuran?
If you take too much: You could have dangerous levels of the drug in your body. Symptoms of an overdose of this drug can include: nausea. vomiting.
Can Macrofuran affects my heart ?
Elderly patients are more likely to have age-related heart, which may require caution in patients receiving Macrofuran.
Can Macrofuran affect my kidneys?
Macrofuran is a well-known cause of acute renal impairment from acute interstitial nephritis
Can Macrofuran affects my liver?
Macrofuran is currently one of the most common causes of drug induced liver injury. Liver injury from Macrofuran can cause either an acute or chronic hepatitis-like syndrome.
What happens if I take Macrofuran on an empty stomach?
If taken on an empty stomach, it may cause stomach upset.
