Nitrofurantoin rechallenge and recurrent toxicity

Abstract

There are a limited number of pathological responses to noxious stimuli, including drugs, and drug-induced (iatrogenic) disease may be difficult to distinguish from other causes. We describe the case of a woman who had two different serious reactions in association with two courses of the antibiotic nitrofurantoin given 16 On specific questioning about whether she might be taking any medications, particularly for prevention of cystitis, she recalled that she had been prescribed by her general practitioner a urinary, 'antiseptic' tablet which she had taken at night for more than a year but she had not considered it to be a drug. It was subsequently identified as nitrofurantoin 50 mg. A working diagnosis of nitrofurantoininduced interstitial pulmonary fibrosis was made, the drug was stopped and she improved gradually such that eight weeks later her tCO had risen to 16.93 and her chest X-ray is shown in the figure (B)

Paresthesias Developing in an Elderly Patient after Chronic Usage of Nitrofurantoin and Vitamin B6

“…Several studies have reported known serious adverse events after short‐term or prolonged use of nitrofurantoin with or without renal impairment leading to neuropathy, pulmonary disorders, and blood dyscrasias 1–6 . The neuropathy occurs more frequently in women and in the elderly.…”