Medicines

Nitrofurantoin for urinary tract infections

This leaflet is for parents and carers about how to use this medicine in children. Our information may differ from that provided by the manufacturers, because their information usually relates to adults. Read this leaflet carefully. Keep it somewhere safe so that you can read it again.

If your child has ever had a reaction to any medicine, tell your doctor before giving Nitrofurantoin.

Name of medicine

Nitrofurantoin

Brand names: Aratoin, Furadantin, Genfura, Macrodantin,

Modified-release: Macrobid

Why is it important for my child to take Nitrofurantoin?

A urinary tract infection (UTI) is caused by bacteria in the urine (wee). It is important for your child to take this medicine in the way that your doctor has told you to, so that it kills all the bacteria and gets rid of the infection. If the infection is not treated, there is a risk that it could spread to the kidneys, causing damage.

Nitrofurantoin can also be used to prevent UTIs (prophylaxis) in children with infections that keep coming back, or in children who are at a high risk of such infections. In this case, it prevents the bacteria from growing in your child’s urine.

What is Nitrofurantoin available as?

  • Tablets: 50 mg, 100 mg (contain lactose)
  • Capsules: 50 mg, 100 mg (contain lactose)
  • Modified-release capsules: 100mg (Macrobid capsules contain sugar and lactose)
  • Liquid medicine (suspension): 25 mg in 5 mL; sugar-free liquid medicine may be available on request, ask you doctor or pharmacist.

When should I give Nitrofurantoin

For the treatment of a UTI

  • Nitrofurantoin is usually given four times each day. This is usually first thing in the morning, at about midday, late afternoon and at bedtime. Ideally, these times should be about 4 hours apart (e.g. 8 am, midday, 4 pm, 8 pm).
  • Modified-release capsules (Macrobid) are taken twice each day, once in the morning and once in the evening. Ideally, these times are 10–12 hours apart, for example some time between 7am and 8 am, and 7pm and 8 pm.

For the prevention of UTI

  • Nitrofurantoin is given once a day, usually in the evening.

Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.

How much should I give?

Your doctor will work out the amount of Nitrofurantoin (the dose) that is right for your child. The dose will be shown on the medicine label.

It is important that you follow your doctor’s instructions about how much to give.

How should I give Nitrofurantoin?

Tablets

  • Tablets should be swallowed with a glass of water, squash or juice. Your child should not chew the tablet.

Capsules

  • Capsules should be swallowed with a glass of water, squash or juice. Your child should not chew the capsule.

Liquid medicine

  • Shake the medicine well. Measure out the right amount using an oral syringe or a medicine spoon. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.

When should the medicine start working?

Your child should start to get better after taking the medicine for 2 days. It is important that they take the whole course of medicine that has been prescribed. Do not stop early.

What if my child is sick (vomits)?

  • If your child is sick less than 30 minutes after having a dose of Nitrofurantoin, give them the same dose again.
  • If your child is sick more than 30 minutes after having a dose of Nitrofurantoin, do not give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your family doctor, nurse, pharmacist, or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.

What if I forget to give it?

If you usually give it once a day in the evening: If you remember before bedtime, give the missed dose. You do not need to wake a sleeping child to give a missed dose. You can give the missed dose in the morning, as long as this is at least 12 hours before the evening dose is due.

If you usually give it twice a day: If you remember up to 4 hours after you should have given a dose, give your child the missed dose. For example, if you usually give a dose at about 7am, you can give the missed dose at any time up to 11am. If you remember after that time, do not give the missed dose. Give the next dose as usual.

If you usually give it four times a day: Do not give the missed dose. Just give the next dose as usual.

Never give a double dose of Nitrofurantoin.

What if I give too much?

You are unlikely to cause harm if you give an extra dose of Nitrofurantoin by mistake. If you are concerned that you may have given too much, contact your doctor or local NHS services (details at end of leaflet). Have the medicine or packaging with you if you telephone for advice.

Are there any possible side effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side effects).

Side effects you must do something about

If your child is short of breath or is wheezing, or their face, lips or tongue start to swell, or they develop a rash, they may be allergic to Nitrofurantoin. Take your child to hospital or phone for an ambulance straight away.

Nitrofurantoin very rarely causes serious side-effects. They are not likely to happen, but you should contact your doctor straight away if your child has any of the following symptoms:

  • their skin starts to turn red and then blisters or peels
  • they experience bad headaches
  • they are more sleepy than normal or have blurry or
    double vision
  • persistent fever, chills or cough that does not settle.

Other side-effects you need to know about

Contact your doctor if you are worried about any of these side-effects:

  • Nitrofurantoin may make your child’s urine go yellow/brown. This is nothing to worry about and will go away when the medicine is stopped.
  • Nitrofurantoin may cause dizziness and drowsiness.
  • Some children get diarrhoea or stomach pains and may feel sick (nausea) or be sick (vomit) when they first start taking nitrofurantoin. Giving the medicine with some food or milk may help. This should get better after a week or so as your child gets used to the medicine.
  • Your child may get tingling or numbness in their hands or feet. Contact your doctor if this happens.
  • Your child’s skin may feel itchy. Using a moisturising cream may help, but it should get better on its own.
  • Your child’s hair may become thinner and some may fall out. It should grow back when the medicine is stopped. Discuss this with your doctor at your next visit.

There may sometimes be other side effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at www.mhra.gov.uk/yellowcard

Can other medicines be given at the same time as Nitrofurantoin?

  • You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
  • Nitrofurantoin should not be taken with some medicines. Tell your doctor or pharmacist about any other medicines your child is taking before giving Nitrofurantoin.
  • Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

Is there anything else I need to know about this medicine?

Your child should not have Nitrofurantoin if they have G6PD deficiency or porphyria.

General advice about medicines

If you think someone else may have taken the medicine by accident, contact your doctor straight away.

General advice about antibiotics

  • It is vital that your child completes the course of antibiotic. This means that they must take the medicine for the number of days that the doctor has told you, or until all the tablets or capsules have been taken.
  • Your child will probably start to feel better soon after starting to take the antibiotic. However, it takes a few days for the antibiotic to kill all the bacteria.
  • If you stop giving the antibiotic too soon, the bacteria that are left will start to multiply again, and may cause another infection.
  • There is also a risk that these bacteria will be ‘resistant’ to the first antibiotic. This means that it might not work next time, and your child might need a different antibiotic, which might not work as well or cause more side effects.
  • Children are sometimes sick (vomit) or get diarrhoea when taking antibiotics. Encourage them to drink water to replace the fluid they have lost. You can also buy oral rehydration fluid from your pharmacist.
  • Do not give your child any medicine to stop the diarrhoea unless your doctor has told you to.
  • Try to give the antibiotic at about the same time(s) each day, to help you remember, and to make sure that there is the right amount of medicine in your child’s body to kill the bacteria.
  • Only give this medicine to your child for their current infection.
  • Never save medicine for future illnesses. Give old or unused antibiotics to your pharmacist to dispose of.
  • Only give the antibiotic to the child it was prescribed for. Never give it to anyone else, even if their condition appears to be the same, as it could do harm.
  • Antibiotics only kill bacteria; they do not kill viruses. This means that they do not work against colds, sore throats, flu or other infections that are caused by viruses. Your doctor will not prescribe antibiotics for these illnesses.

If you think someone else may have taken the medicine by accident, contact your doctor for advice.

Where should I keep this medicine?

  • Keep the medicine in a cupboard, away from heat and direct sunlight.
  • It does not need to be kept in the fridge.
  • Make sure that children cannot see or reach the medicine.
  • Keep the medicine in the container it came in.

Who to contact for more information?

Your child’s doctor, pharmacist or nurse will be able to give you more information about Nitrofurantoin and about other medicines used to treat infections.

England: NHS 111

Tel 111

www.nhs.uk

Scotland: NHS 24

Northern Ireland: NI Direct

Wales: NHS Direct

Tel 111 (free) or 0845 46 47 (2p per minute)

111.wales.nhs.uk/

Copyright disclaimer

Version [2]. © NPPG, RCPCH and WellChild, all rights reserved. Review by March 2022.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.