What are the risks of taking Macrobid (nitrofurantoin)?
| Macrobid can cause serious health problems, especially in certain high-risk groups. Some of the risks of taking Macrobid are listed below. CHRONIC OR ACUTE PULMONARY HYPERSENSITIVITY REACTIONS: Rarely, Macrobid (nitrofurantoin) can cause chronic or acute pulmonary hypersensitivity reaction. These acute pulmonary reactions or chronic pulmonary reactions can damage the lungs. The risk of pulmonary reactions occurring is higher in people over the age of 65 or those who have been taking Macrobid for longer than 6 months. Contact your healthcare provider right away in case of suspected adverse reactions. Symptoms that could indicate a pulmonary reaction include difficulty breathing and persistent cough. SEVERE HEPATIC REACTIONS: In a very small number of people, Macrobid (nitrofurantoin) can cause severe, even life-threatening liver damage. The risk of this occurring is higher in people with pre-existing liver problems. Tell your doctor immediately if you experience nausea, vomiting, stomach pain, dark urine, pale stools, or yellowing of the skin or eyes. Doctors can order blood tests to check liver function in patients treated with Macrobid. PERIPHERAL NEUROPATHY: Rarely, Macrobid (nitrofurantoin) can damage the nerves in the arms and legs. The risk is higher in people with a history of diabetes mellitus, decreased renal function, anemia (low red blood cells), vitamin B deficiency, and electrolyte imbalance. Tell your healthcare provider if you experience symptoms such as numbness, tingling, or prickling sensations in your fingers, toes, or any part of your body while on this medication. If you take Macrobid for an extended period, your doctor will likely order blood tests to monitor renal function and your risk of nerve damage. HEMOLYTIC ANEMIA: In people with an inherited condition called G6PD deficiency (deficiency of an enzyme called glucose-6-phosphate dehydrogenase), Macrobid (nitrofurantoin) can cause damage to the red blood cells. G6PD deficiency is more likely in Black people and people of Middle Eastern or Mediterranean descent. Tell your healthcare provider if you have this condition before starting Macrobid. Contact your doctor immediately if any unusual symptoms occur while on Macrobid (nitrofurantoin), such as unexplained weakness, dizziness, or fatigue. SEVERE DIARRHEA: Macrobid (nitrofurantoin), like other antibiotics, can cause severe diarrhea because it eliminates "good bacteria” from the gut. Rarely this diarrhea can be caused by Clostridioides difficile (bacteria commonly known as C. diff), usually kept under control by healthy gut bacteria. Diarrhea caused by C. diff is highly contagious and can lead to life-threatening dehydration. You should contact your healthcare provider immediately if you have severe watery or bloody stools with or without fever and stomach cramps. These symptoms can occur up to 2 months after antibiotic treatment. The risk is higher in people on long-term antibiotics, those taking multiple antibiotics, people with weakened immune systems, those with recent hospital stays, and those with previous C. diff infection. Taking probiotic supplements while on Macrobid (nitrofurantoin) may help prevent this complication.
Talk to your doctor or pharmacist about the risks of taking Macrobid. Call your doctor immediately if you experience unusual symptoms while on this medication.
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What should I tell my doctor before starting Macrobid (nitrofurantoin)?
Tell your doctor if you have had allergic reactions to Macrobid (nitrofurantoin), other antibiotics, or drugs. Your pharmacy can give you a list of active and inactive ingredients in nitrofurantoin capsules and suspension.
Give your doctor a complete medical history. Macrobid may not be suitable for people with certain medical conditions such as lung disease, liver disease, kidney disease, diabetes mellitus, anemia, vitamin B deficiency, electrolyte imbalance, or G6PD deficiency.
Give your doctor a complete list of all your medications, including prescription and over-the-counter drugs, nutritional supplements, vitamins, and herbal products — this can help avoid serious drug interactions.
Tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. Nitrofurantoin can cause problems in newborn babies if the mother takes this medicine during the last month of pregnancy.
What precautions should I take while on Macrobid (nitrofurantoin)?
Keep all your healthcare appointments. Your doctor may want to do certain tests to check your response to the medication and ensure it is not causing serious adverse reactions.
Call your doctor if you become pregnant while taking Macrobid (nitrofurantoin).
What are Macrobid (nitrofurantoin) interactions?
Taking Macrobid with other medications can affect how it works. Drug interactions can also increase the risk of serious adverse effects. Your physician may choose a different medication, change the dose or frequency of one or both medicines, and/or monitor you carefully for side effects if there are known interactions between Macrobid and your other medications.
There can be interactions between Macrobid and medicines, such as:
- Magnesium-containing antacids
- Other antibiotics like ciprofloxacin (Cipro), levofloxacin (Levaquin), delafloxacin (Baxdela), moxifloxacin
- Probenecid (Probalan, in Col-Probenecid), a medicine used to treat gout and gouty arthritis
This list may not describe all possible Macrobid interactions. Give your healthcare providers a complete list of your medications, including prescription drugs, over-the-counter medicines, dietary supplements, and herbal products. Also, tell your healthcare providers if you smoke, drink alcohol, or use illegal drugs because some of these substances can cause serious health complications or increase the risk of side effects when used with prescription medications.
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