Nitrofurantoin: analysis of its long-term effects and contraindications
DOI:
https://doi.org/10.59471/ijhsc2025267Keywords:
Nitrofurantoine, Adverse Reactions, ContraindicationsAbstract
Introduction: urinary tract infections are common and affect mostly women, where nitrofurantoin is widely used in this type of conditions. However, this drug is not free of adverse effects and complications, such as hypersensitivity reactions, pulmonary and hepatic disorders.
Objectives: to analyze the long-term adverse reactions and contraindications of nitrofurantoin in patients with urinary tract infection.
Methods: a literature review was carried out, which consisted of reading and analyzing different citations in the PubMed database, Google Scholar, and Cochrane library. Search strategies were used by combining terms to structure search strategies.
Results: a total of 5 articles were used to understand the long-term adverse effects of nitrofurantoin. The analysis of the evidence shows that being female, elderly, and recurrent urinary tract infections are the main risk factors for suffering these adverse effects.
Conclusions: nitrofurantoin is a widely used antimicrobial for the treatment of urinary tract infection. In elderly patients, mainly female, suffering from recurrent UTI, prolonged use may develop adverse effects, either mild (bacterial resistance or gastrointestinal symptoms) or severe (pulmonary, hepatic symptoms and in some cases neuropathies)
References
Maredia NN, Fanning MJ, Christie AL, Prokesch BC, Zimmern PE. Adverse effects of chronic nitrofurantoin therapy in women with recurrent urinary tract infections in an outpatient setting. World J Urol. julho de 2021;39(7):2597–603.
Sargın G, Elbek O, Balantekin C, Meteoglu I, Culhacı N. Acute respiratory distress syndrome and hepatotoxicity associated with single dose nitrofurantoin use. Case Rep Pulmonol. 2012;2012:465389.
Carvalho de Matos A, Pais Macedo C, Afonso Mendes P, Cipriano MA, Paiva A, Simão A. Concomitant Nitrofurantoin- Induced Autoimmune Hepatitis and Interstitial Lung Disease. GE Port J Gastroenterol. julho de 2022;29(4):273– 9.
Goldberg O, Moretti M, Levy A, Koren G. Exposure to nitrofurantoin during early pregnancy and congenital malformations: a systematic review and meta-analysis. J Obstet Gynaecol Can. fevereiro de 2015;37(2):150–6.
Schaeffer EM. Re: Nitrofurantoin- induced lung disease and prophylaxis of urinary tract infections. J Urol. outubro de 2013;190(4):1252.
Velema MS, Voerman HJ. DRESS syndrome caused by nitrofurantoin. Neth J Med. abril de 2009;67(4):147–9.
López-López L, Rivera-Rodríguez N, Vilá LM. Nitrofurantoin-induced microangiopathic haemolytic anaemia and thrombocytopaenia in a patient with systemic lupus erythematosus. BMJ Case Rep. 12 de setembro de 2012;2012:bcr-2012-006507.
Geerts AFJ, Eppenga WL, Heerdink R, Derijks HJ, Wensing MJP, Egberts TCG, et al. Ineffectiveness and adverse events of nitrofurantoin in women with urinary tract infection and renal impairment in primary care. Eur J Clin Pharmacol. setembro de 2013;69(9):1701–7.
O’Bryen J, Hannay G, Gleeson S. Nitrofurantoin-induced pulmonary fibrosis. Aust J Gen Pract. março de 2022;51(3):149–51.
Prieto de Paula JM, Martín-Luquero Ibáñez M, Franco Hidalgo S. Nitrofurantoin and non-autoimmune hepatitis. Med Clin (Barc). 21 de abril de 2017;148(8):382–3.
Leão RN, Barreto P, Leão RR, Ribeiro JV. Nitrofurantoin: cause of DRESS syndrome. BMJ Case Rep. 8 de maio de 2013;2013:bcr2013008991.
Claussen K, Stocks E, Bhat D, Fish J, Rubin CD. How Common Are Pulmonary and Hepatic Adverse Effects in Older Adults Prescribed Nitrofurantoin? J Am Geriatr Soc. junho de 2017;65(6):1316–20.
Mikkelsen LF, Rubak S. Reversible lung fibrosis in a 6-year-old girl after long term nitrofurantoin treatment. BMC Pulm Med. 26 de novembro de 2020;20(1):313.
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Copyright (c) 2025 Luciano Queiroz Marcelino, Marcelo Adrian Estrin (Author)
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