Buy Macrobid Online

Macrobid (nitrofurantoin macrocrystals/nitrofurantoin monohydrate)

THERAPEUTIC CLASS

Imidazolidinedione antibacterial

DEA CLASS

RX

INDICATIONS

Treatment of acute uncomplicated urinary tract infections (acute cystitis) caused by susceptible strains of Escherichia coli or Staphylococcus saprophyticus.

ADULT DOSAGE

Urinary Tract Infections

Caused by susceptible strains of Escherichia coli or Staphylococcus saprophyticus

Acute Uncomplicated (Acute Cystitis): 100mg q12h for 7 days

PEDIATRIC DOSAGE

Urinary Tract Infections

Caused by susceptible strains of Escherichia coli or Staphylococcus saprophyticus

>12 Years:
Acute Uncomplicated (Acute Cystitis): 100mg q12h for 7 days

ADMINISTRATION

Oral route

Take with food

HOW SUPPLIED

Cap: 100mg

CONTRAINDICATIONS

Anuria, oliguria, significant impairment of renal function (CrCl <60mL/min or clinically significant elevated SrCr), pregnancy at term (38-42 weeks' gestation), during labor and delivery or when onset of labor is imminent, and neonates <1 month of age, and previous history of cholestatic jaundice/hepatic dysfunction associated with nitrofurantoin.

WARNINGS/PRECAUTIONS

Not for treatment of pyelonephritis or perinephric abscesses. Many patients who undergo treatment are predisposed to persistence/reappearance of bacteriuria; if this occurs after treatment, select other therapeutic agents with broader tissue distribution. Acute, subacute, or chronic pulmonary reactions (diffuse interstitial pneumonitis, pulmonary fibrosis, or both) reported; d/c and take appropriate measures if these occur. Closely monitor pulmonary condition if on long-term therapy. Hepatic reactions (eg, hepatitis, cholestatic jaundice, chronic active hepatitis, hepatic necrosis) occur rarely. Monitor periodically for changes in biochemical tests that would indicate liver injury; withdraw immediately and take appropriate measures if hepatitis occurs. Peripheral neuropathy, which may become severe or irreversible, reported; risk may be enhanced with renal impairment, anemia, diabetes mellitus (DM), electrolyte imbalance, vitamin B deficiency, and debilitating disease. Monitor periodically for renal function changes with long-term therapy. Optic neuritis reported rarely. May induce hemolytic anemia of the primaquine-sensitivity type; d/c therapy if hemolysis occurs. Clostridium difficile-associated diarrhea (CDAD) reported; d/c therapy is CDAD is suspected/confirmed. Use in the absence of a proven or strongly suspected bacterial infection or prophylactic indication is unlikely to provide benefit and increases the risk of the development of drug-resistant bacteria. Lab test interactions may occur. Caution with impaired renal function and in elderly.

ADVERSE REACTIONS

Nausea, headache.

DRUG INTERACTIONS

Antacids containing magnesium trisilicate reduce both the rate and extent of absorption. Uricosuric drugs (eg, probenecid, sulfinpyrazone) may inhibit renal tubular secretion of nitrofurantoin; resulting increased nitrofurantoin serum levels may increase toxicity, and the decreased urinary levels could lessen its efficacy.

PREGNANCY AND LACTATION

Category B, not for use in nursing.

MECHANISM OF ACTION

Imidazolidinedione/nitrofuran antimicrobial agent; inhibits the vital biochemical processes of protein synthesis, aerobic energy metabolism, and DNA, RNA, and cell-wall synthesis.

PHARMACOKINETICS

Absorption: Cmax=<1mcg/mL. Distribution: Found in breast milk. Elimination: Urine (20-25% unchanged).

ASSESSMENT

Assess for anuria, oliguria, significant renal impairment, history of cholestatic jaundice/hepatic dysfunction associated with nitrofurantoin, G6PD deficiency, DM, anemia, electrolyte imbalance, vitamin B deficiency, debilitating disease, drug hypersensitivity, pregnancy/nursing status, and possible drug interactions. Obtain urine specimens for culture and susceptibility testing prior to therapy.

MONITORING

Monitor for persistence or reappearance of bacteriuria, acute/subacute/chronic pulmonary reactions, hepatic reactions, peripheral neuropathy, optic neuritis, hematologic manifestations, and CDAD. Monitor LFTs periodically. Monitor renal and pulmonary function periodically during long-term therapy. Obtain urine specimens for culture and susceptibility testing after completion of therapy.

PATIENT COUNSELING

Inform of the potential risks and benefits of therapy. Advise to take with food (ideally breakfast and dinner) to further enhance tolerance and improve drug absorption. Instruct to complete the full course of therapy and advise to contact physician if any unusual symptoms occur during therapy. Advise not to take antacids containing magnesium trisilicate while on therapy. Inform that therapy treats bacterial, not viral, infections. Advise to take exactly ud; skipping doses or not completing full course may decrease effectiveness and increase drug resistance. Inform that diarrhea is a common problem that usually ends when antibiotic is discontinued. Inform that watery and bloody stools (with/without stomach cramps and fever) may develop even as late as 2 or more months after having taken the last dose; instruct to contact physician as soon as possible if this occurs.

STORAGE

15-30°C (59-86°F).

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