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Nitrofurantoin (Macrobid) is a medication that requires careful consideration due to its potential risks and specific usage precautions. Below is a summary of critical safety information and warnings that should be thoroughly reviewed. For any concerns or further clarification, it is essential to consult with your healthcare provider.

• Lung Damage: Rare instances of lung damage have been reported, especially with usage extending beyond 6 months. Symptoms such as persistent cough or difficulty breathing should prompt immediate consultation with a healthcare provider.

• Liver Damage: Severe liver damage, though very rare, can occur, particularly in individuals with a history of liver issues. Look out for symptoms like unexplained stomach pain, nausea, vomiting, dark urine, pale stools, or yellowing of the skin or eyes, and seek medical advice promptly.

• Nerve Damage (Neuropathy): The medication can occasionally cause nerve damage, which may be permanent. Individuals with kidney problems or other risk factors like anemia, low vitamin B levels, electrolyte imbalances, or diabetes should be vigilant for numbness or tingling sensations and discuss these with their healthcare provider.

• Hemolytic Anemia: There is a risk of red blood cell breakdown in individuals with a deficiency of glucose-6-phosphate dehydrogenase (G6PD). This condition is more common in Black individuals and those of Mediterranean or Middle Eastern descent. Report any unusual weakness, dizziness, or fatigue to your healthcare provider.

• Severe Diarrhea: Nitrofurantoin can disrupt gut bacteria, potentially leading to severe diarrhea. This is sometimes due to Clostridioides difficile (C. diff), a contagious and potentially serious condition. Symptoms such as watery or bloody stools, stomach cramps, or fever require immediate medical attention.

Contraindications: This medication should not be used under the following conditions:

• History of liver damage or jaundice associated with nitrofurantoin.
• Severe kidney problems.
• Inability to urinate or reduced urine output.
• Females who are 38 to 42 weeks pregnant, or during labor and delivery.
• Infants under 1 month of age.

In the event of an overdose or serious adverse reaction, seek emergency medical assistance immediately. Always follow the prescribed dosage and inform your healthcare provider about any existing medical conditions or concurrent medications to ensure safe use of nitrofurantoin (Macrobid).

Common side effects:

• Nausea
• Headache
• Vomiting
• Loss of appetite
• Gas

Less common but important to monitor:

• Diarrhea
• Upset stomach
• Stomach pain
• Dizziness
• Drowsiness
• Itchiness
• Fever
• Chills
• Pins and needles sensation
• Dark urine
• Unrelenting nausea
• Yellowing of the skin or eyes
• Fatigue
• Fast heartbeat
• Oral thrush
• Vaginal yeast infection
• White patches in the mouth
• Changes in vaginal discharge

Serious side effects:

• Severe headaches
• Eye pain
• Vision changes
• Mental/mood changes
• Signs of infection
• Numbness or tingling in hands or feet
• Unusual muscle weakness
• Severe lung problems
• Continuous diarrhea
• Abdominal pain
• Blood/mucus in stool
• Serious allergic reactions
• Rash
• Itching
• Swelling of the face, tongue, or throat
• Severe dizziness
• Trouble breathing

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Cholera Vaccine, Live
• Fluconazole