Macrobid
GENERAL
Half-life: 0.7 to 1.7 hours
Excretion: 40% to 45% urinary
Take with food
May cause dizziness or drowsiness
Do not use antacids with magnesium trisilicate while on macrobid
May turn urine brown
If loose stools or diarrhea develops, discontinue and notify prescribing physician
Category B for pregnancy
Excretion: 40% to 45% urinary
Take with food
May cause dizziness or drowsiness
Do not use antacids with magnesium trisilicate while on macrobid
May turn urine brown
If loose stools or diarrhea develops, discontinue and notify prescribing physician
Category B for pregnancy
Susceptibilities
Lower urinary tract infections from: S aureus, group D Streptococci, Viridans group streptococci, S agalactiae, Citrobacter, Klebsiella, and coagulase negative staphylococci.
monitoring
Long term: periodic LFT's, renal function tests, pulmonary function
mechanism
Inactivates ribosomal proteins
medication interactions
Reduced absorption with antacids containing magnesium trisilicate.
Uricosuric drugs (e.g., probenecid, sulfinpyrazone) inhibit renal tubular secretion resulting in increased toxicity with decreased urine macrobid levels
Uricosuric drugs (e.g., probenecid, sulfinpyrazone) inhibit renal tubular secretion resulting in increased toxicity with decreased urine macrobid levels
contraindications
Pregnant** at end of term due to hemolytic anemia from glutathione system immaturity
Breastfeeding <3mo or any age w/ G6PD deficiency
<3 mo in age due to hemolytic anemia from glutathione system immaturity
Anuria, oliguria, or significant renal dysfunction CrCl < than 60 mL/min (some sources as low as 45ml/min)
G6PD) deficiency
Acute porphyria
Breastfeeding <3mo or any age w/ G6PD deficiency
<3 mo in age due to hemolytic anemia from glutathione system immaturity
Anuria, oliguria, or significant renal dysfunction CrCl < than 60 mL/min (some sources as low as 45ml/min)
G6PD) deficiency
Acute porphyria
warnings/precautions
Meets BEERS CRITERIA for elderly adults
C. diff reports (as nearly all ABX)
Brown discoloration of the urine.
Hemolytic Anemia: hemolysis in G6PD deficiency found in ~10 percent of Blacks and a small percentage of ethnic groups of Mediterranean and Near-Eastern origin.
Hepatitis, cholestatic jaundice
Peripheral neuropathy (including optic neuritis), possibly severe or irreversible w/ increased risk if: CrCl <60mL/min, anemia, diabetes, electrolyte imbalance, vitamin B deficiency, and/or debilitating disease.
Pulmonary fibrosis
Reduced sperm count and testicular histology abnormality association
C. diff reports (as nearly all ABX)
Brown discoloration of the urine.
Hemolytic Anemia: hemolysis in G6PD deficiency found in ~10 percent of Blacks and a small percentage of ethnic groups of Mediterranean and Near-Eastern origin.
Hepatitis, cholestatic jaundice
Peripheral neuropathy (including optic neuritis), possibly severe or irreversible w/ increased risk if: CrCl <60mL/min, anemia, diabetes, electrolyte imbalance, vitamin B deficiency, and/or debilitating disease.
Pulmonary fibrosis
Reduced sperm count and testicular histology abnormality association
side effects
COMMON (1-10%): Nausea, emesis, anorexia, flatulence, headache,
UNCOMMON (<1%): Abdominal pain, diarrhea, dyspepsia, constipation, dizziness, drowsiness, blurry vision, fevers, chills, mailase, acute pulmonary hypersensitivity reaction
RARE (<0.1%): Exfoliative dermatitis, erythema multiforme (including Stevens-Johnson syndrome), parotitis, pseudomembranous colitis, cyanosis secondary to methemoglobinemia, aplastic anemia, hepatitis, vertigo, pseudotumor cerebri, optic neuritis, intraretinal crystals causing retinopathy, bulging fontanels, acute interstitial nephritis, cyanosis
VERY RARE (<0.01%):
UNKNOWN PREVALENCE: ST changes, alopecia, dark urine, hemolytic anemia, bone marrow suppression, neuropathy, diplopia, nystagmus, arthralgia, myalgia, confusion, depression, psychotic reaction.
UNCOMMON (<1%): Abdominal pain, diarrhea, dyspepsia, constipation, dizziness, drowsiness, blurry vision, fevers, chills, mailase, acute pulmonary hypersensitivity reaction
RARE (<0.1%): Exfoliative dermatitis, erythema multiforme (including Stevens-Johnson syndrome), parotitis, pseudomembranous colitis, cyanosis secondary to methemoglobinemia, aplastic anemia, hepatitis, vertigo, pseudotumor cerebri, optic neuritis, intraretinal crystals causing retinopathy, bulging fontanels, acute interstitial nephritis, cyanosis
VERY RARE (<0.01%):
UNKNOWN PREVALENCE: ST changes, alopecia, dark urine, hemolytic anemia, bone marrow suppression, neuropathy, diplopia, nystagmus, arthralgia, myalgia, confusion, depression, psychotic reaction.
dosage
ADULT
CYSTITIS: Regular release: 50 to 100 mg po q6h x3-7d; Dual release: 100 mg po BID x7d
UTI PROPHYLAXIS: Regular release: 50 to 100 mg po qhs
PEDIATRIC
CYSTITIS: Regular release >3mo 5 to 7 mg/kg/day (up to 400 mg/day) po q6h x3-7d; Dual release >12yr: 100mg po bid x3-7d
UTI PROPHYLAXIS: >3mo 1 mg/kg/day (up to 100 mg/day) po qd or bid
RENAL DOSING: Do not give if CrCl <60ml/min. No special dosing necessary if >60ml/min.
DIALYSIS: Is dializable
HEPATIC DOSING: May need reduced dosing if hepatic dysfunction
CYSTITIS: Regular release: 50 to 100 mg po q6h x3-7d; Dual release: 100 mg po BID x7d
UTI PROPHYLAXIS: Regular release: 50 to 100 mg po qhs
PEDIATRIC
CYSTITIS: Regular release >3mo 5 to 7 mg/kg/day (up to 400 mg/day) po q6h x3-7d; Dual release >12yr: 100mg po bid x3-7d
UTI PROPHYLAXIS: >3mo 1 mg/kg/day (up to 100 mg/day) po qd or bid
RENAL DOSING: Do not give if CrCl <60ml/min. No special dosing necessary if >60ml/min.
DIALYSIS: Is dializable
HEPATIC DOSING: May need reduced dosing if hepatic dysfunction
GENERAL
Half-life: 0.7 to 1.7 hours
Excretion: 40% to 45% urinary
Take with food
May cause dizziness or drowsiness
Do not use antacids with magnesium trisilicate while on macrobid
May turn urine brown
If loose stools or diarrhea develops, discontinue and notify prescribing physician
Category B for pregnancy
MECHANISM: Inactivates ribosomal proteins
INDICATION: Lower urinary tract infections from: S aureus, group D Streptococci, Viridans group streptococci, S agalactiae, Citrobacter, Klebsiella, and coagulase negative staphylococci.
CONTRAINDICATIONS:
Pregnant** at end of term due to hemolytic anemia from glutathione system immaturity
Breastfeeding <3mo or any age w/ G6PD deficiency
<3 mo in age due to hemolytic anemia from glutathione system immaturity
Anuria, oliguria, or significant renal dysfunction CrCl < than 60 mL/min (some sources as low as 45ml/min)
G6PD) deficiency
Acute porphyria
MONITORING
Long term: periodic LFT's, renal function tests, pulmonary function
DRUG INTERACTIONS:
Reduced absorption with antacids containing magnesium trisilicate.
Uricosuric drugs (e.g., probenecid, sulfinpyrazone) inhibit renal tubular secretion resulting in increased toxicity with decreased urine macrobid levels
WARNINGS/PRECAUTIONS:
Meets BEERS CRITERIA for elderly adults
C. diff reports (as nearly all ABX)
Brown discoloration of the urine.
Hemolytic Anemia: hemolysis in G6PD deficiency found in ~10 percent of Blacks and a small percentage of ethnic groups of Mediterranean and Near-Eastern origin.
Hepatitis, cholestatic jaundice
Peripheral neuropathy (including optic neuritis), possibly severe or irreversible w/ increased risk if: CrCl <60mL/min, anemia, diabetes, electrolyte imbalance, vitamin B deficiency, and/or debilitating disease.
Pulmonary fibrosis
Reduced sperm count and testicular histology abnormality association
SIDE EFFECTS
COMMON (1-10%): Nausea, emesis, anorexia, flatulence, headache,
UNCOMMON (<1%): Abdominal pain, diarrhea, dyspepsia, constipation, dizziness, drowsiness, blurry vision, fevers, chills, mailase, acute pulmonary hypersensitivity reaction
RARE (<0.1%): Exfoliative dermatitis, erythema multiforme (including Stevens-Johnson syndrome), parotitis, pseudomembranous colitis, cyanosis secondary to methemoglobinemia, aplastic anemia, hepatitis, vertigo, pseudotumor cerebri, optic neuritis, intraretinal crystals causing retinopathy, bulging fontanels, acute interstitial nephritis, cyanosis
VERY RARE (<0.01%):
UNKNOWN PREVALENCE: ST changes, alopecia, dark urine, hemolytic anemia, bone marrow suppression, neuropathy, diplopia, nystagmus, arthralgia, myalgia, confusion, depression, psychotic reaction.
Half-life: 0.7 to 1.7 hours
Excretion: 40% to 45% urinary
Take with food
May cause dizziness or drowsiness
Do not use antacids with magnesium trisilicate while on macrobid
May turn urine brown
If loose stools or diarrhea develops, discontinue and notify prescribing physician
Category B for pregnancy
MECHANISM: Inactivates ribosomal proteins
INDICATION: Lower urinary tract infections from: S aureus, group D Streptococci, Viridans group streptococci, S agalactiae, Citrobacter, Klebsiella, and coagulase negative staphylococci.
CONTRAINDICATIONS:
Pregnant** at end of term due to hemolytic anemia from glutathione system immaturity
Breastfeeding <3mo or any age w/ G6PD deficiency
<3 mo in age due to hemolytic anemia from glutathione system immaturity
Anuria, oliguria, or significant renal dysfunction CrCl < than 60 mL/min (some sources as low as 45ml/min)
G6PD) deficiency
Acute porphyria
MONITORING
Long term: periodic LFT's, renal function tests, pulmonary function
DRUG INTERACTIONS:
Reduced absorption with antacids containing magnesium trisilicate.
Uricosuric drugs (e.g., probenecid, sulfinpyrazone) inhibit renal tubular secretion resulting in increased toxicity with decreased urine macrobid levels
WARNINGS/PRECAUTIONS:
Meets BEERS CRITERIA for elderly adults
C. diff reports (as nearly all ABX)
Brown discoloration of the urine.
Hemolytic Anemia: hemolysis in G6PD deficiency found in ~10 percent of Blacks and a small percentage of ethnic groups of Mediterranean and Near-Eastern origin.
Hepatitis, cholestatic jaundice
Peripheral neuropathy (including optic neuritis), possibly severe or irreversible w/ increased risk if: CrCl <60mL/min, anemia, diabetes, electrolyte imbalance, vitamin B deficiency, and/or debilitating disease.
Pulmonary fibrosis
Reduced sperm count and testicular histology abnormality association
SIDE EFFECTS
COMMON (1-10%): Nausea, emesis, anorexia, flatulence, headache,
UNCOMMON (<1%): Abdominal pain, diarrhea, dyspepsia, constipation, dizziness, drowsiness, blurry vision, fevers, chills, mailase, acute pulmonary hypersensitivity reaction
RARE (<0.1%): Exfoliative dermatitis, erythema multiforme (including Stevens-Johnson syndrome), parotitis, pseudomembranous colitis, cyanosis secondary to methemoglobinemia, aplastic anemia, hepatitis, vertigo, pseudotumor cerebri, optic neuritis, intraretinal crystals causing retinopathy, bulging fontanels, acute interstitial nephritis, cyanosis
VERY RARE (<0.01%):
UNKNOWN PREVALENCE: ST changes, alopecia, dark urine, hemolytic anemia, bone marrow suppression, neuropathy, diplopia, nystagmus, arthralgia, myalgia, confusion, depression, psychotic reaction.
DOSAGE
ADULT
CYSTITIS: Regular release: 50 to 100 mg po q6h x3-7d; Dual release: 100 mg po BID x7d
UTI PROPHYLAXIS: Regular release: 50 to 100 mg po qhs
PEDIATRIC
CYSTITIS: Regular release >3mo 5 to 7 mg/kg/day (up to 400 mg/day) po q6h x3-7d; Dual release >12yr: 100mg po bid x3-7d
UTI PROPHYLAXIS: >3mo 1 mg/kg/day (up to 100 mg/day) po qd or bid
RENAL DOSING: Do not give if CrCl <60ml/min. No special dosing necessary if >60ml/min.
DIALYSIS: Is dializable
HEPATIC DOSING: May need reduced dosing if hepatic dysfunction
ADULT
CYSTITIS: Regular release: 50 to 100 mg po q6h x3-7d; Dual release: 100 mg po BID x7d
UTI PROPHYLAXIS: Regular release: 50 to 100 mg po qhs
PEDIATRIC
CYSTITIS: Regular release >3mo 5 to 7 mg/kg/day (up to 400 mg/day) po q6h x3-7d; Dual release >12yr: 100mg po bid x3-7d
UTI PROPHYLAXIS: >3mo 1 mg/kg/day (up to 100 mg/day) po qd or bid
RENAL DOSING: Do not give if CrCl <60ml/min. No special dosing necessary if >60ml/min.
DIALYSIS: Is dializable
HEPATIC DOSING: May need reduced dosing if hepatic dysfunction