I Am Afraid To Take My Medicine (Macrobid)

[Christine]

Help me--I'm a certified NUT!! My doctor just prescribed Macrobid for a *possible* UTI. I am having some symptoms of a UTI (the urge to go more) but no burning, fever, etc. Urine dipstick showed positive for blood in the urine; however, that's not unusual for me. Urine has been cultured and won't be back until Monday. In the meantime, I'm sitting here looking at this stuff and I just read the Rx Monograph. I am so SCARED of an allergic reaction. Probably irrationally so. I had one just a few months ago to a blood pressure medicine, believe it or not.

Now I'm terrified to take this. Then for some reason they put a "controlled substance" sticker on the bottle and a "may cause drowsiness, do not drive" sticker. Yikes.

Anyone taken this?

 

[Disney-Kim]

My DS has taken Macrobid for years with no problems. Works very well for UTI's. She has not had ANY problems.
good luck !!

 

[Rajah]

I take Macrodantin (or the generic) regularly for UTIs with no problem. Never had Macrobid that I know of.

Are you alone, or do you have someone there with you to watch you in case of a reaction?

 

[ChrisnSteph]

I've taken Macrobid for a UTI before. I don't remember having any side effects. Just take it - your infection will only get worse if you don't, and your UTI may not be painful now but give it time...trust me, take the medicine!

 

[Christine]

I take Macrodantin (or the generic) regularly for UTIs with no problem. Never had Macrobid that I know of.

Are you alone, or do you have someone there with you to watch you in case of a reaction?

No, I'm not alone. It doesn't matter though. My biggest FEAR is having a reaction and having to go to the emergency room. I do not want to go, I do not want a reaction.

This is just ridiculous.

 

[Blondie]

Since when is Macrobid a controlled substance? I think maybe that was an error.

I've taken Macrobid for UTI's several times. As long as I take it with food in my stomach, I have no problems. If taken on an empty stomach, it makes me very nauseated and gives me stomach cramps.

 

[CathrynRose]

No, I'm not alone. It doesn't matter though. My biggest FEAR is having a reaction and having to go to the emergency room. I do not want to go, I do not want a reaction.

This is just ridiculous.

Well, then Im ridiculous too - check out this link:

http://www.askapatient.com/index.asp

I found it looking up Levaquin thinking just like you are!!

 

[minkydog]

Since when is Macrobid a controlled substance? I think maybe that was an error.

It is a controlled substance in that it requires a prescription from a doctor, rather than being over the counter.

 

[Blondie]

I was thinking controlled substance aka narcotic.

Thanks for the clarification.

 

[Dznypal]

macrobid is not a controlled substance (unless maybe for some odd reason it is in your state)

Im a Pharmacy tech. work with this drug ---do yourself a favor and take the med--UTI are no fun to start with and only get worse if left unteated!!!


gee now I sound like a commerical--

hope you get better soon--

dont worry you should do fine on macrobid

 

[Disneyrsh]

Well, then Im ridiculous too - check out this link:

http://www.askapatient.com/index.asp

I found it looking up Levaquin thinking just like you are!!

I'm allergic to levaquin! However, if you think a UTI feels bad, try a full blown kidney infection, which is what a UTI becomes if you don't treat it! Those suckers HURT! I had never had a UTI before so I thought I could 'tough it out'. Yeah, not! Take the meds! Help me before I use another exclamation point...

 

[Christine]

....still scared.

 

[Twinkles6892]

Personally, I say, your doctor said it was fine, take the darned medicine. Stop being such a baby! CARPE DIEM WOMAN!

 

[Christine]

Personally, I say, your doctor said it was fine, take the darned medicine. Stop being such a baby! CARPE DIEM WOMAN!

I hear ya, but my doctor has told me something is "fine" before and it hasn't quite worked out well--hence, my phobia.

 

[Disney-Kim]

did you look up the side effects on the internet? I think you will be fine.
A bad UTI is going to be terrible.
Its only an anti-bacterial drug...kills the bugs...I don't think its narcotic in any way.

 

[Blondie]

I just pulled out my standy by RX for a UTI (Macrobid 100mg) and the only labels on it say "may cause discoloration of the urine" and "take with food."

There are no labels about causing drowsiness or being a controlled substance.

Hope you feel better soon Christine. Can you take Augementin? I think it's also used for UTI's.

 

[Monte Cristo]

My wife is a pharmacist with a major pharmacy chain. She says that the "controlled substance and drowsiness" label was an error. In fact she says incorrect labeling is the most common error.

She says a UTI left untreated could possibly lead to a kidney infection.

MC

 

[Christine]

Thanks everyone. I do feel a bit calmer, but as you can guess, I'm not going to take it...yet. And, my doctor did tell me that I could wait for the culture if I wanted to. She mainly gave me the drugs so that I "wouldn't get into trouble over the weekend."

You see, my symptoms are not very typical for a UTI. I have been having "pressure" at night when I try to sleep. For the past few days, it's only been at night and I have been having insomnia due to anxiety. Last night I didn't sleep at all, kept feeling like I needed to pee, and the feeling stayed with me most of the day.

I have no burning AT ALL and, at times, the pressure feeling does go away. So, I personally think it is a case of "overactive bladder" but I just wanted to see if there was an "BIG" signs of a UTI. I guess they found no white blood cells--just microscopic blood (which I always have).

Now, if my symptoms were much worse, I'd probably be knocking back the meds quickly. But, right now I'm not really suffering and I'm worrying more about the side effects of the meds.

I did look it up on the internet and one of the bigger side effects is drowsiness. This does concern me as I do have to drive my son to school in the a.m. and commute a long way. The sticker on my vial and on the internet is pretty clear about not driving until you know how you react.

 

[Christine]

Hope you feel better soon Christine. Can you take Augementin? I think it's also used for UTI's.

Thanks. Yes, I can take Augmentin but the doc didn't want to give me that for some reason. I guess it is not one of the more effective drugs for this condition.

 

[MouseWorshipin]

You can be allergic to ANY drug. The biggest thing with yours is usually funky-colored urine.

Here you go...
nitrofurantoin

(nye troe fyoor an' toyn)



nitrofurantoin

Apo-Nitrofurantoin (CAN), Furadantin, Novo-Furantoin (CAN)



nitrofurantoin macrocrystals

Macrobid, Macrodantin



Pregnancy Category B



Drug classes

Urinary tract anti-infective

Antibacterial



Therapeutic actions

Bacteriostatic in low concentrations, possibly by interfering with bacterial carbohydrate metabolism; bactericidal in high concentrations, possibly by disrupting bacterial cell wall formation, causing cell death.



Indications

· Treatment of UTIs caused by susceptible strains of Escherichia coli, Staphylococcus aureus, Klebsiella, Enterobacter, Proteus

· Prophylaxis or long-term suppression of UTIs



Contraindications and cautions

· Contraindicated with allergy to nitrofurantoin, renal dysfunction; pregnancy, lactation.

· Use cautiously in patients with G6PD deficiency, anemia, diabetes.



Available forms

Capsules—25, 50, 100 mg; Dual-release capsules—100 mg; oral suspension—25 mg/5 mL



Dosages

ADULTS

50–100 mg PO qid for 10–14 days or 100 mg bid for 7 days (Macrobid). Do not exceed 400 mg/day.

· Long-term suppressive therapy: 50–100 mg PO hs.

PEDIATRIC PATIENTS

5–7 mg/kg/day in four divided doses PO. Not recommended in children < 1 mo.

· Long-term suppressive therapy: As low as 1 mg/kg/day PO in one to two doses.



Pharmacokinetics

Route

Onset

Peak

Oral

Rapid

30 min



Metabolism: Hepatic; T1/2: 20–60 min

Distribution: Crosses placenta; enters breast milk

Excretion: Urine



Adverse effects

· CNS: Peripheral neuropathy, headache, dizziness, nystagmus, drowsiness, vertigo

· Dermatologic: Exfoliative dermatitis, Stevens-Johnson syndrome, alopecia, pruritus, urticartia, angioedema

· GI: Nausea, abdominal cramps, vomiting, diarrhea, anorexia, parotitis, pancreatitis, hepatotoxicity

· Hematologic: Hemolytic anemia in G6PD deficiency; granulocytopenia, agranulocytosis, leukopenia, thrombocytopenia, eosinophilia, megaloblastic anemia

· Respiratory: Pulmonary hypersensitivity

· Other: Superinfections of the GU tract; hypotension; muscular aches; brown-rust urine



Interactions

Drug-drug

· Delayed or decreased absorption with magnesium trisilicate, magaldrate

Drug-lab test

· False elevations of urine glucose, bilirubin, alkaline phosphatase, BUN, urinary creatinine

· False-positive urine glucose when using Benedict's or Fehling's reagent



Nursing considerations

Assessment

· History: Allergy to nitrofurantoin, renal dysfunction, G6PD deficiency, anemia, diabetes, pregnancy, lactation

· Physical: Skin color, lesions; orientation, reflexes; R, adventitious sounds; liver evaluation; CBC; liver and kidney function tests; serum electrolytes; blood, urine glucose, urinalysis



Interventions

· Arrange for culture and sensitivity tests before and during therapy.

· Give with food or milk to prevent GI upset.

· Continue drug for at least 3 days after a sterile urine specimen is obtained.

· Monitor clinical response; if no improvement is seen or a relapse occurs, send urine for repeat culture and sensitivity.

· WARNING: Monitor pulmonary function carefully; reactions can occur within hours or weeks of nitrofurantoin therapy.

· Arrange for periodic CBC and liver function tests during long-term therapy.



Teaching points

· Take drug with food or milk. Complete the full course of drug therapy to ensure a resolution of the infection. Take this drug at regular intervals around the clock; consult your nurse or pharmacist to set up a convenient schedule.

· You may experience these side effects: Nausea, vomiting, abdominal pain (eat frequent small meals); diarrhea; drowsiness, blurring of vision, dizziness (observe caution driving or using dangerous equipment); brown or yellow-rust urine (expected effect).

· Report fever, chills, cough, chest pain, difficulty breathing, rash, numbness or tingling of the fingers or toes.



Adverse effects in Italic are most common; those in Bold are life-threatening.