3-32. NITROUFURANTOIN (MACRODANTIN)
This drug, a synthetic antibacterial agent, is used as a short-time preventive
measure and also in long-term suppressive therapy for individuals with chronic urinary
tract infections. The dosage of this drug is 5 to 100 mg four times a day for a three-day
period. After this period, the urine is sterile. This medication is a urinary antiseptic.
That is, nitroufurantoin is an agent that kills or prevents the growth of microorganisms
when applied to living tissue.
a. Possible Adverse Reactions. Included are the following:
(1) Gastric disturbances. The patient may experience nausea, vomiting,
and diarrhea. To lower gastric irritation, give the medication with milk. The severity of
the reaction is related to the strength of the medication dose.
(2) Hypersensitivity reactions. The patient may experience pulmonary
pneumonitis. Signs and symptoms of this condition may disappear when the drug is
b. Contraindications to Nitrofurantoin. Included are the following:
Anuria (patient of average adult size voids less than 100 ml of urine
Infants of less than one month.
Known sensitivity to nitrofurantoin.
3-33. METHENAMINE MANDELATE (MANDELAMINE)
This drug is clinically indicated as a prophylactic and suppressive treatment of
bacteriuria via urine acidification. The dosage of this drug is 1 gm four times a day for
three days after the urine is sterile. Adverse reactions to the drug include the following:
a. Mild gastric irritation.
b. Inflammation of the urinary tract in higher doses.
c. Hypersensitivity reaction such as a rash.