Nitrofurantoin for multiple sclerosis
Fact-checked by What is nitrofurantoin for MS?
Nitrofurantoin is an oral antibiotic that’s approved in the U.S. to prevent and treat urinary tract infections (UTIs). It is commonly prescribed to manage UTIs in people with multiple sclerosis (MS).
People with MS can have damage to the nerves that control the bladder, leading to bladder symptoms such as urinary retention, where the bladder doesn’t fully empty with urination. Urine that remains in the bladder for too long gives bacteria an ideal environment to grow, which can lead to UTIs.
Nitrofurantoin’s mechanism of action remains poorly understood, but the molecule is thought to enter bacterial cells, where it is converted into reactive intermediates that inhibit proteins the bacteria need to survive.
Nitrofurantoin is advantageous relative to other antibiotics because once in the body, it quickly concentrates in the urine within the lower urinary tract — the bladder and urethra — where most UTIs occur.
In the U.S., nitrofurantoin is sold under several brand names, including Macrobid, Macrodantin, and Furadantin, with generics also available.
Therapy snapshot
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| Treatment name | Nitrofurantoin |
| Usage | Used to treat UTIs in people with MS |
| Administration | Oral capsules or suspension |
Who can take nitrofurantoin?
Nitrofurantoin is approved in the U.S. to treat UTIs caused by certain strains of bacteria. It should only be used to treat infections that are proven or strongly suspected to be caused by bacteria.
It is specifically used to treat infections of the lower urinary tract. It is not indicated for treating pyelonephritis, a type of UTI in which the infection has spread upward to the kidneys.
The medication is contraindicated, or should not be used, by:
- people who have little to no urine output or significant kidney impairments
- women who are in the late stages of pregnancy (38 to 42 weeks), are close to going into labor, or who are in labor or delivery
- people with a history of serious immune reactions (hypersensitivity) or liver problems related to nitrofurantoin
How is nitrofurantoin administered?
Nitrofurantoin comes as oral capsules or an oral liquid suspension, and is taken every day with food to improve absorption and drug tolerance.
When used to treat an active UTI, the medication is taken two to four times per day for about a week, or until there’s evidence the infection has been cleared. When used as a preventive treatment in people who experience recurrent UTIs, it is taken once or twice daily at a lower dosage.
Potential side effects of nitrofurantoin
Common side effects of nitrofurantoin include:
- nausea or vomiting
- appetite loss
- diarrhea
- dizziness and sleepiness
- headache
Nitrofurantoin’s prescribing information also includes warnings that it may cause serious adverse events, including:
- hypersensitivity reactions
- lung reactions, some of which can be long-lasting
- liver toxicity
- nerve damage
- red blood cell destruction and anemia
- severe diarrhea associated with bacterial overgrowth
Nitrofurantoin may interact with some other medications, including certain over-the-counter antacids. Patients should talk with their healthcare team about all other medications they are using.
Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
