Niftas (Nitrofurantoin)
Also sold as: Niftas, Nitrofur, Macrobid, Furadantin
Pregnancy
Cat B
Lactation
Caution
Schedule
H
Forms
Tablet 100mg (MR) +1
Indications
- Uncomplicated UTI (1st-line per IDSA)
- UTI prophylaxis (recurrent)
- NOT for pyelonephritis (no tissue penetration)
Adult Dosing
Uncomplicated UTI
100 mg MR PO BD × 5 days (women) or 7 days (men)
UTI prophylaxis
50-100 mg PO at bedtime
Pediatric Dosing
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| CrCl > 60 | Standard |
| CrCl 30-60 | Acceptable for short course (5 days) per FDA 2015 update |
| CrCl < 30 | AVOID — ineffective concentrations + toxicity risk |
Pregnancy & Lactation
Pregnancy: Category B
Avoid at term (38-42 weeks) — neonatal hemolytic anemia. Earlier in pregnancy generally safe.
Lactation: Caution
Avoid in G6PD-deficient infants
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| Antacids (Mg) | Reduced absorption | Moderate |
| Probenecid | Reduced urinary concentration → reduced efficacy | Moderate |
| Quinolones | Antagonism | Moderate |
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Side Effects
Common
- Nausea
- Headache
- Brown/yellow urine (harmless)
Serious / Discontinue If
- Pulmonary fibrosis (chronic use, rare)
- Hepatotoxicity
- Peripheral neuropathy
- Hemolytic anemia (G6PD)
- Anaphylaxis
Contraindications
- CrCl <30
- Pregnancy at term
- G6PD deficiency
- Anuria/oliguria
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Niftas 100 | Intas | 10 tab ₹85 |
| Nitrofur 100 | Cipla | 10 tab ₹65 |
Patient Counseling Points
- Take with food
- Drink plenty of water
- Brown urine is normal
- Report breathing difficulty (lung toxicity)
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References
- BNF
- Lexicomp
- Indian National Formulary
- Specialty society guidelines