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nitrofurantoin

nitrofurantoin

Drug Name	Form	Strength	Non-Formulary	Restricted	TX Sub	Notes
Macrobid	CAPSULE, ORAL	macrocrystals-monohydrate 100 mg
Macrodantin	CAPSULE, ORAL	macrocrystals 50 mg

Display Urinary Anti-infectives Class : 083600

Medication comments:

Per policy, these drugs are subject to renal dosing adjustments by pharmacy.
Generic + Route (Brand) • Indications	Usual Adult Dose Comments	Renal Dosage Adjustments
nitrofurantoin PO (Macrodantin/Furadantin^©)	50-100 mg q6h	CrCl ≥ 30: No adjustment necessary CrCl < 30: *Contraindicated*
nitrofurantoin PO (MacroBid^©)	100 mg BID	CrCl ≥ 30: No adjustment necessary CrCl < 30: *Contraindicated*

2023 American Geriatrics Society Beers Criteria^® for potentially inappropriate medication use in older adults.
Medication:	nitrofurantoin (Furadantin, Macrobid, Macrodantin)
Criteria 1: Potentially inappropriate medication use in older adults. (Table 2)
Drug(s)	nitrofurantoin
Rationale	Potential for pulmonary toxicity, hepatoxicity, and peripheral neuropathy, especially with long-term use; safer alternatives available.
Recommendation	Avoid in individuals with CrCl <30 mL/min or for long-term suppression.
Quality of evidence: Low, Strength of Recommendation: Strong

Criteria 5: medications that should be avoided or have their dosage reduced with varying levels of kidney function in older adults. (Table 6)
CrCl (mL/min) at which action is required	<30
Rationale	Potential for pulmonary toxicity, hepatoxicity, and peripheral neuropathy, especially with long-term use. (See also Table 2).
Recommendation	Avoid if CrCl <30 mL/min
Quality of evidence: Low, Strength of Recommendation: Strong

Pediatric Pharmacy Association 2025 KIDs List of Key Potentially Inappropriate Drugs in Pediatrics
Medication:	nitrofurantoin (Furadantin, Macrobid, Macrodantin)
Key Potentially Inappropriate Drugs in Pediatrics (KIDs) List: Second Edition (Table 1)
Drug	nitrofurantoin
Risk/Rationale	Hemolytic anemia
Recommendation	Avoid in younger than 1 mo
Quality of evidence: Very low, Strength of Recommendation: Weak

Last updated: Sep. 25, 2025

Renal Adjustment Policy nitrofurantoin subject to adjustments by pharmacy.

UpToDate Lexidrug

Pharmacy Contact Info:

Main Inpatient Pharmacy: ext 4599, 3503
Fax: 704-878-7283

Director of Pharmacy - Randi Raynor, PharmD: ext 4501
Clinical Coordinator - Laura Rollings, PharmD: ext 4597
Pharmacy Informaticist - Stephen Pringle, PharmD: ext 7645
Pharmacy Technician Supervisor - Amy Wingler, CPhT: ext 7385
Pharmacy Automation Coordinator (Omnicell) - Melissa Fulford, CPhT: ext 3556

This site is intended for the staff of Iredell Health System. While others may view accessible pages, Iredell Health System makes no warranty, express or implied, as to the use of this information outside of Iredell Health System. The content of this policy and procedure document serves as guidance to the delivery of quality patient care. Care providers are expected to exercise critical thinking and situational awareness skills, and in specific situations to take such action as is necessary for the delivery of quality patient care.