nitrofurantoin macrocrystals 50 mg Capsule, 100-count — NDC 68382-0559-01 package photo

nitrofurantoin macrocrystals 50 mg Capsule, 100-count

by Zydus Pharmaceuticals (USA) Inc. · 100 CAPSULE in 1 BOTTLE (68382-559-01)
NDC 68382-0559-01
🏷️ FDA NDC (as labeled) 68382-559-01 billing pads the product segment with a zero
This package
Contains100-count Cost per ea$0.1587 NADAC Per package$15.87 / 100 capsules Pack sizes3 compare ↓
Also priced by: Medicaid pays $0.4694/unit · Part D plans $0.3581/unit — full pricing hub ↓
Rx only Generic On market Non-controlled
🗂️ Data synced Jul 24, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →

🆔 Identity & classification

FDA NDC (as labeled) 68382-559-01
Product NDC 68382-559
11-digit billing NDC 68382055901
NCPDP billing unit EA — each (per item)
RxCUI 311995, 1648759
UNII 927AH8112L
Application # ANDA205005
SPL Set ID 2862e49a-66e9-4418-9343-4404036775fc
Established class (EPC) Nitrofuran Antibacterial
Chemical class Nitrofurans
DEA schedule Non-controlled
Marketing category ANDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2018-02-15
Route ORAL
Dosage form CAPSULE
Substance NITROFURANTOIN
GPI-14 16800050100115
GPI class Nitrofurantoin Macrocrystal
GCN Seq No 009430
GCN 41822
HICL code 004087
Ingredient (HICL) Nitrofurantoin Macrocrystal
HIC1 code W
Therapeutic class — broad (HIC1) Anti-Infecting Agents
HIC2 code W2
Therapeutic class — intermediate (HIC2) Antibacterials
HIC3 code W2F
Therapeutic class — specific (HIC3) Nitrofuran Derivatives Antibacterial Agents
AHFS code 08:36.00.00
AHFS class Urinary Anti-Infectives
FDB label name NITROFURANTOIN MCR 50 MG CAP
FDB brand name Nitrofurantoin
Legend status F — Federal legend — prescription drug or device
TE code (Orange Book) AB · RLD · RS
Why two NDCs? The FDA registers this code as 68382-559-01 — a 5-3-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the product segment → 68382-0559-01. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

🏷️ RxNorm drug class

This medicine belongs to the Nitrofuran Antibacterial class.

Pharmacologic class Nitrofuran Antibacterial
Drug family (ATC) Nitrofuran derivatives
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

🏭 Manufacturer & labeler

LabelerZydus Pharmaceuticals (USA) Inc.
Application holderZYDUS PHARMACEUTICALS USA INC
FDA applicationANDA205005 (ANDA)
Labeler code68382
First marketedFeb 2018
Product typeHuman Prescription Drug
Portfolio173 products on file
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

🩺 Clinical

Label name NITROFURANTOIN MCR 50 MG CAP Ingredient Nitrofurantoin Macrocrystal
📖 What it is MedlinePlus · NLM

Nitrofurantoin is used to treat urinary tract infections. Nitrofurantoin is in a class of medications called antibiotics. It works by killing bacteria that cause infection. Antibiotics such as nitrofurantoin will not work for colds, flu, or other viral infections. Using antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.

Read the full MedlinePlus article ↗
📗 Our plain-language guide HelloPharmacist
  • Nitrofurantoin is an antibiotic specifically for urinary tract infections — think bladder infections, not kidney infections. It works by concentrating in your urine where it kills...
  • What exactly is nitrofurantoin used for?
  • Yes, every time. Taking nitrofurantoin with food isn't just about avoiding an upset stomach — food actually helps your body absorb more of the medication, so it works better. Even...
  • Do I really need to take it with food every single time?
📖 Read our full Nitrofurantoin guide →
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

💊 What it looks like

Color Blue / White
ShapeCapsule
Imprint560
Size18 mm
ScoringNot scored
One label can cover several strengths, so colors may be combined — always confirm a loose pill against the dispensed prescription label or a pharmacist.
Where does this data come from?
Physical description (imprint, shape, color, scoring, coating) from this product’s FDA Structured Product Labeling (SPL), mirrored from DailyMed / openFDA.

🧪 Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.

  • UNII H3R47K3TBD
    FD&C Blue No. 1 is a synthetic blue dye approved for use in foods and medicines. It serves as a colorant to give the medication its distinctive appearance and help with product identification.
  • UNII PN2ZH5LOQY
    A synthetic red dye approved by the FDA for use in foods, medicines, and cosmetics. It serves as a colorant to make tablets, capsules, and liquids visually distinctive for product identification.
  • UNII 2G86QN327L
    Gelatin is a protein derived from animal collagen, commonly used in medicines as a gelling agent and capsule material. It helps create soft or hard capsule shells that hold and release medication, and can also thicken liquid formulations.
  • UNII EWQ57Q8I5X
    Lactose monohydrate is a natural sugar derived from milk. It serves as a filler and binder in tablets and capsules, helping create the proper size, texture, and consistency of the medicine.
  • UNII 70097M6I30
    Magnesium stearate is a salt made from magnesium and stearic acid, a fatty substance. It's used in tablets and capsules as a lubricant and glidant to help ingredients flow smoothly during manufacturing and prevent sticking.
  • UNII 368GB5141J
    A detergent and foaming agent derived from coconut or palm oil. In medications, it helps break down and mix oil and water-based ingredients, aids in tablet disintegration, and improves how the drug dissolves and spreads in the mouth or digestive system.
  • UNII O8232NY3SJ
    A plant-based carbohydrate derived from corn kernels. It acts as a filler to add bulk, a binder to hold ingredients together, and a disintegrant to help the tablet break apart in your stomach for absorption.
  • UNII 7SEV7J4R1U
    A powder made from a naturally occurring mineral. In medicines, talc works as a glidant and anti-caking agent, helping tablets and capsules flow smoothly during manufacturing and preventing clumping.
  • UNII 15FIX9V2JP
    Titanium dioxide is a bright white mineral powder commonly used as a colorant and opacifying agent. It makes pills and tablets white or lighter in color and helps make coatings non-transparent.

9 inactive ingredients listed in the exact product block matched to this NDC.

Where does this data come from?
Data sourced from official FDA Structured Product Labeling (SPL) via DailyMedingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

💲 Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer eaPer package
Retail pharmacies payNADAC · weekly $0.159 $15.87 / 100 capsules
Medicaid paysCMS SDUD · 12 mo $0.4694 $46.94 / 100 capsules
Medicare drug plans payPart D · Q2 2026 $0.3581 $35.81 / 100 capsules
NADAC price history (per ea) — tap or hover for the price & month
Dec 2021 Jul 2022 Dec 2025 Aug 2026 $0.425 $0.140
▼ Down 60% over the last 24 months.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

🔁 Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Nitrofurantoin macrocrystals 50 mg 43386-0641-01 Lupin 100 capsules $0.153 AB Availability likely save 4%
Nitrofurantoin Macrocrystals 50 mg 00115-1643-01 Amneal 100 capsules $0.159 AB Availability likely
nitrofurantoin macrocrystals 50 mg 00904-7026-61 Major 100 capsules $0.159 AB Availability likely
Nitrofurantoin Macrocrystals 50 mg 50268-0623-15 AvPAK 50 capsules $0.159 AB Availability likely
nitrofurantoin (macrocrystals) 50 mg 59651-0753-01 Aurobindo 100 capsules $0.159 AB Availability likely
Nitrofurantoin Macrocrystals 50 mg 60687-0839-01 American 100 capsules $0.159 AB Availability likely
Nitrofurantoin 50 mg 62332-0390-31 Alembic 100 capsules $0.159 AB Availability likely
nitrofurantoin macrocrystals 50 mg 68001-0604-00 BluePoint 100 capsules $0.159 AB Availability likely
nitrofurantoin macrocrystals 50 mgthis 68382-0559-01 Zydus 100 capsules $0.159 AB Availability likely
nitrofurantoin macrocrystals 50 mg 70756-0411-11 Lifestar 100 capsules $0.159 AB Availability likely
nitrofurantoin macrocrystals 50 mg 72603-0183-01 NorthStar 100 capsules $0.159 AB Availability likely
nitrofurantoin macrocrystals 50 mg 47781-0307-01 Alvogen 100 capsules $0.310 AB Discontinued +95%
Nitrofurantion 50 mg 68001-0385-00 BluePoint 100 capsules $0.310 FDA listed +95%
Nitrofurantoin 50 mg 46708-0390-31 Alembic 100 capsules AB FDA listed
Macrodantin 50 mg 52427-0287-01 Almatica 100 capsules AB Discontinued
Nitrofurantion 50 mg 57664-0232-18 Sun 1000 capsules FDA listed
nitrofurantoin macrocrystals 50 mg 70771-1170-00 Zydus 1000 capsules AB FDA listed
Nitrofurantion Macrocrystals 50 mg 71205-0023-10 Proficient 10 capsules AB FDA listed
nitrofurantoin macrocrystals 50 mg 71335-2254-01 Bryant 28 capsules AB FDA listed
About this product: this is a generic version of the medicine. FDA equivalence ratings are shown when available, and other versions are listed above, least expensive first.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

Availability & generic status

🏛️
2018
On the market since
Feb 2018
📍
2026
Currently FDA-listed
8 years listed
🔓
·
Generic on the market
this product is a generic
This is a generic drug

This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.

Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

🗺️ Medicaid utilization & spend

📍 This exact package only: Medicaid data is reported per full 11-digit NDC — labeler, product and pack size — so every number here is for 68382-0559-01, not the drug overall. Other pack sizes report separately.
💊 Pharmacy benefit only: These are Medicaid outpatient pharmacy claims, billed by NDC. They exclude the medical benefit — clinic- or hospital-administered drugs billed under HCPCS J-codes — so drugs used mostly that way (e.g. Avastin, Lucentis, Keytruda) can look low or missing here. That’s expected, not an error.
📅 Q1 2025 – Q1 2026 · 5 quarters of data
ⓘ The newest quarter is usually incomplete when first published; states restate recent quarters in later CMS releases, so the latest figures typically revise upward. State coverage-policy changes can also shift quarter-to-quarter totals.
Prescriptions last 4 qtrs
6.6K
Units reimbursed last 4 qtrs
200.8K
Gross reimbursed last 4 qtrs
$94.2K
Avg / prescription
$14.19
Avg / unit
$0.4694
Latest quarter Q1 2026
1.5KRx
Medicaid pays / ea
$0.4694
gross reimbursed
vs
NADAC / ea
$0.1587
acquisition cost
=
Spread
+$0.3107
+196% vs cost
What Medicaid paid per ea (before rebates; includes the pharmacy’s dispensing fee) compared with NADAC — the average price pharmacies pay to buy the drug. A positive spread means Medicaid reimbursed more than the purchase price, before manufacturer rebates.
Fee-for-service vs managed care
33% FFS 67% MCO
Fee-for-service · 2,159 Rx Managed care · 4,483 Rx
State Medicaid map
Alaska: no data reported AK Maine: no data reported ME Washington: 2,921 units · 37.4 per 100k residents WA Idaho: 1,964 units · 100 per 100k residents ID Montana: no data reported MT North Dakota: no data reported ND Minnesota: 2,901 units · 50.6 per 100k residents MN Wisconsin: 8,117 units · 137 per 100k residents WI Michigan: 13,499 units · 134 per 100k residents MI New York: 13,831 units · 70.7 per 100k residents NY Vermont: 980 units · 151 per 100k residents VT New Hampshire: 266 units · 19.0 per 100k residents NH Oregon: 5,947 units · 140 per 100k residents OR Nevada: 1,220 units · 38.2 per 100k residents NV Wyoming: no data reported WY South Dakota: no data reported SD Iowa: 3,072 units · 95.8 per 100k residents IA Illinois: 4,077 units · 32.5 per 100k residents IL Indiana: 8,893 units · 130 per 100k residents IN Ohio: 8,341 units · 70.8 per 100k residents OH Pennsylvania: 8,730 units · 67.4 per 100k residents PA New Jersey: 2,428 units · 26.1 per 100k residents NJ Massachusetts: 357 units · 5.1 per 100k residents MA California: 8,937 units · 22.9 per 100k residents CA Utah: 1,961 units · 57.4 per 100k residents UT Colorado: 4,439 units · 75.5 per 100k residents CO Nebraska: 2,836 units · 143 per 100k residents NE Missouri: 5,500 units · 88.8 per 100k residents MO Kentucky: 5,093 units · 113 per 100k residents KY West Virginia: 3,762 units · 213 per 100k residents WV Virginia: 9,787 units · 112 per 100k residents VA Maryland: 1,912 units · 30.9 per 100k residents MD Connecticut: 1,876 units · 51.9 per 100k residents CT Rhode Island: no data reported RI Arizona: 5,937 units · 79.9 per 100k residents AZ New Mexico: 3,906 units · 185 per 100k residents NM Kansas: 698 units · 23.7 per 100k residents KS Arkansas: 2,076 units · 67.7 per 100k residents AR Tennessee: 4,707 units · 66.1 per 100k residents TN North Carolina: 7,117 units · 65.7 per 100k residents NC South Carolina: 2,600 units · 48.4 per 100k residents SC Delaware: no data reported DE Oklahoma: 6,375 units · 157 per 100k residents OK Louisiana: 5,860 units · 128 per 100k residents LA Mississippi: 2,641 units · 89.8 per 100k residents MS Alabama: 5,345 units · 105 per 100k residents AL Georgia: 5,423 units · 49.2 per 100k residents GA D.C.: no data reported DC Hawaii: no data reported HI Texas: 9,098 units · 29.8 per 100k residents TX Florida: 5,332 units · 23.6 per 100k residents FL
Units reimbursed · per 100k residents
5.1213
gray = no data reported
Colors are per 100,000 residents, so big states don’t automatically dominate. Tap or hover a state for its actual totals.
Tap or hover a state
…for its Medicaid breakdown
🏆 Top states by units · per 100k residents
1 West Virginia 213 /100k
2 New Mexico 185 /100k
3 Oklahoma 157 /100k
4 Vermont 151 /100k
5 Nebraska 143 /100k
6 Oregon 140 /100k
7 Wisconsin 137 /100k
8 Michigan 134 /100k
National units — by quarter
💵 About the dollar figures: “reimbursed” is what Medicaid paid pharmacies before confidential manufacturer rebates, so the program’s real net cost is lower than these numbers. Fee-for-service and managed-care claims are combined unless split above. Source: CMS State Drug Utilization Data; per-100k rates use 2023 Census population estimates.

💊 Medicaid utilization by pack size

Medicaid (SDUD) totals over the four most recent reported quarters for every package size of this drug — handy when a specific package (e.g. a starter/titration pack) carries little or no Medicaid volume on its own.
1000 capsules68382-0559-10 No Medicaid data
100 capsules68382-0559-30 No Medicaid data
Drug total (last 4 qtrs): 6,642 Rx · 200,762 units · $94,238 gross reimbursed
Tap a pack size to open its page. Source: CMS State Drug Utilization Data, last 4 quarters.

📦 Packaging — all sizes for this product

Package NDCDescription Per unit Per pack Marketing startStatus
68382-0559-01 You're viewing this 100 CAPSULE in 1 BOTTLE (68382-559-01) $0.1587 / ea $15.87 2018-02-15 Active
68382-0559-10 1000 CAPSULE in 1 BOTTLE (68382-559-10) 2018-02-15 Active
68382-0559-30 10 BLISTER PACK in 1 CARTON (68382-559-30) / 10 CAPSULE in 1 BLISTER PACK 2018-02-15 Active

In Medicaid, this is the most-dispensed pack of this product — about 100% of fills over the last four reported quarters. See all packs ↓

Pack size FAQ

What quantity is in NDC 68382-0559-01?
NDC 68382-0559-01 is a 100-count package — 100 capsule in 1 bottle.
What is the difference between NDC 68382-0559-01 and NDC 68382-0559-30?
Both are nitrofurantoin macrocrystals 50 mg Capsule — the drug itself is identical. NDC 68382-0559-01 is the 100-count package, while NDC 68382-0559-30 is the 100 capsules package.
What NDC number is used to bill for this package of nitrofurantoin macrocrystals 50 mg Capsule?
Bill NDC 68382-0559-01 — the 11-digit billing format is 68382055901. Pharmacy and medical claims use the 11-digit form; the FDA label may print a shorter form of the same code.

Prices are the latest CMS NADAC pharmacy acquisition cost per NDC; per-pack figures are per-unit × pack quantity, shown only when the pack is denominated in the same measure NADAC prices.

📄 Full prescribing information FDA SPL

The complete FDA label for this product — the official prescribing information, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🎯 Indications and Usage ~1 min read

INDICATIONS AND USAGE: Nitrofurantoin macrocrystals capsules are specifically indicated for the treatment of urinary tract infections when due to susceptible strains of Escherichia coli , enterococci, Staphylococcus aureus , and certain susceptible strains of Klebsiella and Enterobacter species. Nitrofurantoin is not indicated for the treatment of pyelonephritis or perinephric abscesses. To reduce the development of drug-resistant bacteria and maintain the effectiveness of nitrofurantoin macrocrystals capsules and other antibacterial drugs, nitrofurantoin macrocrystals capsules should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria.

When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy. Nitrofurantoins lack the broader tissue distribution of other therapeutic agents approved for urinary tract infections.

Consequently, many patients who are treated with nitrofurantoin macrocrystals capsules are predisposed to persistence or reappearance of bacteriuria. Urine specimens for culture and susceptibility testing should be obtained before and after completion of therapy. If persistence or reappearance of bacteriuria occurs after treatment with nitrofurantoin macrocrystals capsules, other therapeutic agents with broader tissue distribution should be selected.

In considering the use of nitrofurantoin macrocrystals capsules, lower eradication rates should be balanced against the increased potential for systemic toxicity and for the development of antimicrobial resistance when agents with broader tissue distribution are utilized.

⏱️ Dosage and Administration 149 words

DOSAGE AND ADMINISTRATION: Nitrofurantoin macrocrystals capsules should be given with food to improve drug absorption and, in some patients, tolerance. Adults: 50 to 100 mg four times a day -- the lower dosage level is recommended for uncomplicated urinary tract infections. Pediatric Patients: 5 to 7 mg/kg of body weight per 24 hours, given in four divided doses (contraindicated under one month of age).

Therapy should be continued for one week or for at least 3 days after sterility of the urine is obtained. Continued infection indicates the need for reevaluation. For long-term suppressive therapy in adults, a reduction of dosage to 50 to 100 mg at bedtime may be adequate.

For long-term suppressive therapy in pediatric patients, doses as low as 1 mg/kg per 24 hours, given in a single dose or in two divided doses, may be adequate. SEE WARNINGS SECTION REGARDING RISKS ASSOCIATED WITH LONG-TERM THERAPY.

Contraindications 131 words

CONTRAINDICATIONS: Anuria, oliguria, or significant impairment of renal function (creatinine clearance under 60 mL per minute or clinically significant elevated serum creatinine) are contraindications. Treatment of this type of patient carries an increased risk of toxicity because of impaired excretion of the drug. Because of the possibility of hemolytic anemia due to immature erythrocyte enzyme systems (glutathione instability), the drug is contraindicated in pregnant patients at term (38 to 42 weeks' gestation), during labor and delivery, or when the onset of labor is imminent.

For the same reason, the drug is contraindicated in neonates under one month of age. Nitrofurantoin macrocrystals capsules are contraindicated in patients with a previous history of cholestatic jaundice/hepatic dysfunction associated with nitrofurantoin. Nitrofurantoin macrocrystals capsules are also contraindicated in those patients with known hypersensitivity to nitrofurantoin.

⚠️ Warnings ~2 min read

WARNINGS: Pulmonary reactions: ACUTE , SUBACUTE , OR CHRONIC PULMONARY REACTIONS HAVE BEEN OBSERVED IN PATIENTS TREATED WITH NITROFURANTOIN. IF THESE REACTIONS OCCUR , NITROFURANTOIN MACROCRYSTALS SHOULD BE DISCONTINUED AND APPROPRIATE MEASURES TAKEN. REPORTS HAVE CITED PULMONARY REACTIONS AS A CONTRIBUTING CAUSE OF DEATH.

CHRONIC PULMONARY REACTIONS (DIFFUSE INTERSTITIAL PNEUMONITIS OR PULMONARY FIBROSIS , OR BOTH) CAN DEVELOP INSIDIOUSLY. THESE REACTIONS OCCUR RARELY AND GENERALLY IN PATIENTS RECEIVING THERAPY FOR SIX MONTHS OR LONGER. CLOSE MONITORING OF THE PULMONARY CONDITION OF PATIENTS RECEIVING LONG-TERM THERAPY IS WARRANTED AND REQUIRES THAT THE BENEFITS OF THERAPY BE WEIGHED AGAINST POTENTIAL RISKS (SEE RESPIRATORY REACTIONS).

Hepatotoxicity: Hepatic reactions, including hepatitis, cholestatic jaundice, chronic active hepatitis, and hepatic necrosis, occur rarely. Fatalities have been reported. The onset of chronic active hepatitis may be insidious, and patients should be monitored periodically for changes in biochemical tests that would indicate liver injury.

If hepatitis occurs, the drug should be withdrawn immediately and appropriate measures should be taken. Neuropathy: Peripheral neuropathy, which may become severe or irreversible, has occurred. Fatalities have been reported.

Conditions such as renal impairment (creatinine clearance under 60 mL per minute or clinically significant elevated serum creatinine), anemia, diabetes mellitus, electrolyte imbalance, vitamin B deficiency, and debilitating disease may enhance the occurrence of peripheral neuropathy. Patients receiving long-term therapy should be monitored periodically for changes in renal function. Optic neuritis has been reported rarely in postmarketing experience with nitrofurantoin formulations.

Hemolytic anemia: Cases of hemolytic anemia of the primaquine-sensitivity type have been induced by nitrofurantoin. Hemolysis appears to be linked to a glucose-6-phosphate dehydrogenase deficiency in the red blood cells of the affected patients. This deficiency is found in 10 percent of Blacks and a small percentage of ethnic groups of Mediterranean and Near-Eastern origin.

Hemolysis is an indication for discontinuing nitrofurantoin macrocrystals; hemolysis ceases when the drug is withdrawn. Clostridium difficile-associated diarrhea: Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including nitrofurantoin, and may range in severity from mild diarrhea to fatal colitis. Treatment with antibacterial agents alters the normal flora of the colon leading to overgrowth of C. difficile .

C. difficile produces toxins A and B which contribute to the development of CDAD. Hypertoxin producing strains of C. difficile cause increased morbidity and mortality, as these infections can be refractory to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea following antibiotic use.

Careful medical history is necessary since CDAD has been reported to occur over two months after the administration of antibacterial agents. If CDAD is suspected or confirmed, ongoing antibiotic use not directed against C. difficile may need to be discontinued. Appropriate fluid and electrolyte management, protein supplementation, antibiotic treatment of C. difficile , and surgical evaluation should be instituted as clinically indicated.

🤒 Adverse Reactions ~2 min read

ADVERSE REACTIONS: Respiratory: CHRONIC, SUBACUTE, OR ACUTE PULMONARY HYPERSENSITIVITY REACTIONS MAY OCCUR. CHRONIC PULMONARY REACTIONS OCCUR GENERALLY IN PATIENTS WHO HAVE RECEIVED CONTINUOUS TREATMENT FOR SIX MONTHS OR LONGER. MALAISE, DYSPNEA ON EXERTION, COUGH, AND ALTERED PULMONARY FUNCTION ARE COMMON MANIFESTATIONS WHICH CAN OCCUR INSIDIOUSLY.

RADIOLOGIC AND HISTOLOGIC FINDINGS OF DIFFUSE INTERSTITIAL PNEUMONITIS OR FIBROSIS, OR BOTH, ARE ALSO COMMON MANIFESTATIONS OF THE CHRONIC PULMONARY REACTION. FEVER IS RARELY PROMINENT. THE SEVERITY OF CHRONIC PULMONARY REACTIONS AND THEIR DEGREE OF RESOLUTION APPEAR TO BE RELATED TO THE DURATION OF THERAPY AFTER THE FIRST CLINICAL SIGNS APPEAR.

PULMONARY FUNCTION MAY BE IMPAIRED PERMANENTLY, EVEN AFTER CESSATION OF THERAPY. THE RISK IS GREATER WHEN CHRONIC PULMONARY REACTIONS ARE NOT RECOGNIZED EARLY. In subacute pulmonary reactions, fever and eosinophilia occur less often than in the acute form.

Upon cessation of therapy, recovery may require several months. If the symptoms are not recognized as being drug-related and nitrofurantoin therapy is not stopped, the symptoms may become more severe. Acute pulmonary reactions are commonly manifested by fever, chills, cough, chest pain, dyspnea, pulmonary infiltration with consolidation or pleural effusion on x-ray, and eosinophilia.

Acute reactions usually occur within the first week of treatment and are reversible with cessation of therapy. Resolution often is dramatic (see WARNINGS ). Changes in EKG (e.g., non-specific ST/T wave changes, bundle branch block) have been reported in association with pulmonary reactions.

Cyanosis has been reported rarely. Hepatic: Hepatic reactions, including hepatitis, cholestatic jaundice, chronic active hepatitis, and hepatic necrosis, occur rarely (see WARNINGS ). Neurologic: Peripheral neuropathy, which may become severe or irreversible, has occurred.

Fatalities have been reported. Conditions such as renal impairment (creatinine clearance under 60 mL per minute or clinically significant elevated serum creatinine), anemia, diabetes mellitus, electrolyte imbalance, vitamin B deficiency, and debilitating diseases may increase the possibility of peripheral neuropathy (see WARNINGS ). Asthenia, vertigo, nystagmus, dizziness, headache, and drowsiness also have been reported with the use of nitrofurantoin.

Benign intracranial hypertension (pseudotumor cerebri), confusion, depression, optic neuritis, and psychotic reactions have been reported rarely. Bulging fontanels, as a sign of benign intracranial hypertension in infants, have been reported rarely. Dermatologic: Exfoliative dermatitis and erythema multiforme (including Stevens-Johnson syndrome) have been reported rarely.

Transient alopecia also has been reported. Allergic: A lupus-like syndrome associated with pulmonary reactions to nitrofurantoin has been reported. Also, angioedema; maculopapular, erythematous, or eczematous eruptions; pruritus; urticaria; anaphylaxis; arthralgia; myalgia; drug fever; chills; and vasculitis (sometimes associated with pulmonary reactions) have been reported.

Hypersensitivity reactions represent the most frequent spontaneously-reported adverse events in worldwide postmarketing experience with nitrofurantoin formulations. Gastrointestinal: Nausea, emesis, and anorexia occur most often. Abdominal pain and diarrhea are less common gastrointestinal reactions.

These dose-related reactions can be minimized by reduction of dosage. Sialadenitis and pancreatitis have been reported. There have been sporadic reports of pseudomembranous colitis with the use of nitrofurantoin.

The onset of pseudomembranous colitis symptoms may occur during or after antimicrobial treatment (see WARNINGS ). Hematologic: Cyanosis secondary to methemoglobinemia has been reported rarely. Miscellaneous: As with other antimicrobial agents, superinfections caused by resistant organisms, e.g., Pseudomonas species or Candida species, can occur.

Laboratory Advers…

🆘 Overdosage 47 words

OVERDOSAGE: Occasional incidents of acute overdosage of nitrofurantoin macrocrystals have not resulted in any specific symptoms other than vomiting. Induction of emesis is recommended. There is no specific antidote, but a high fluid intake should be maintained to promote urinary excretion of the drug. It is dialyzable.

🧬 Clinical Pharmacology 105 words

CLINICAL PHARMACOLOGY: Nitrofurantoin macrocrystals is a larger crystal form of nitrofurantoin. The absorption of nitrofurantoin macrocrystals is slower and its excretion somewhat less when compared to nitrofurantoin. Blood concentrations at therapeutic dosage are usually low.

It is highly soluble in urine, to which it may impart a brown color. Following a dose regimen of 100 mg q.i.d. for 7 days, average urinary drug recoveries (0 to 24 hours) on day 1 and day 7 were 37.9% and 35%. Unlike many drugs, the presence of food or agents delaying gastric emptying can increase the bioavailability of nitrofurantoin macrocrystals, presumably by allowing better dissolution in gastric juices.

📦 How Supplied / Storage and Handling 186 words

HOW SUPPLIED: Nitrofurantoin Capsules, USP (Macrocrystals) 50 mg are light yellow to yellow powder filled in size "3" empty hard gelatin capsules with blue opaque colored cap and white opaque colored body imprinted with '559' in black ink and are supplied as follows: NDC 68382-559-01 in bottles of 100 capsules NDC 68382-559-10 in bottles of 1000 capsules NDC 68382-559-30 in unit-dose blister cartons of 100 (10 x 10) unit-dose capsules Nitrofurantoin Capsules, USP (Macrocrystals) 100 mg are light yellow to yellow powder filled in size "2" empty hard gelatin capsules with blue opaque colored cap and blue opaque colored body imprinted with '560' in black ink and are supplied as follows: NDC 68382-560-01 in bottles of 100 capsules NDC 68382-560-10 in bottles of 1000 capsules NDC 68382-560-30 in unit-dose blister cartons of 100 (10 x 10) unit-dose capsules Storage Store at 20° to 25°C (68° to 77°F) [See USP Controlled Room Temperature] .

Dispense in a tight, light-resistant container as defined in the USP using a child-resistant closure. Manufactured by: Zydus Lifesciences Ltd., Ahmedabad, India Distributed by: Zydus Pharmaceuticals (USA) Inc. Pennington, NJ 08534 Rev.: 10/22

📋 Description 152 words

DESCRIPTION: Nitrofurantoin capsules, USP (macrocrystals) is a synthetic chemical of controlled crystal size. It is a stable, lemon-yellow, crystalline compound. Nitrofurantoin capsules, USP (macrocrystals) is an antibacterial agent for specific urinary tract infections.

It is available in 50 mg and 100 mg capsules for oral administration. 1-[[(5-nitro-2-furanyl)methylene] amino]-2,4-imidazolidinedione Nitrofurantoin macrocrystals is a lemon-yellow crystalline compound. It is soluble in dimethylformamide, very slightly soluble in water and in alcohol.

Each nitrofurantoin capsules, USP (macrocrystals) intended for oral administration contains 50 mg and 100 mg of nitrofurantoin macrocrystals. In addition, each capsule contains the following inactive ingredients: gelatin, lactose monohydrate, magnesium stearate, pregelatinized starch, talc and titanium dioxide. Additionally each 50 mg and 100 mg capsule shell contains FD & C Blue # 1, FD & C Red # 3 and sodium lauryl sulphate.

The capsule is printed with black pharmaceutical ink which contains black iron oxide, potassium hydroxide, propylene glycol and shellac. figure

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗
For educational and professional reference only — not medical advice. Pricing reflects published NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.