Nitrofurantoin and PN

[Marjorie-Kravitz]

    
      Re: Nitrofurantoin and PN
    


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Posted by CCF Neurology MD on September 13, 1997 at 01:27:16:

In Reply to: Nitrofurantoin and PN posted by Marjorie Kravitz on September 05, 1997 at 08:38:47:

: I have had  peripheral neuropathy for about 6 years. Now, after a series of urinary tract infections the urologist has prescribed Nitrofurantoin (50 mg/day) as a preventive measure. The book "Worst Pills, Best Pills" (Dr. Sidney Wolfe) for older people (I am 60) lists this medication as a risk for neuropathy. A book from Consumer Reports with info from U.S. Pharmacopiea mentions that people with nerve damage may have increased side effects. Have you ever seen or heard of nerve damage from this medication? My urologist has not and the nurse said it affects less than 1% in this way. Any input would be appreciated.
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Dear Marjorie:
You are right about nitrofurantoin causing peripheral neuropathy. This, however, was mostly observed in patients with renal insufficiency (who tend to retain the drug), and was most reported in the sixties and seventies, when higher doses of the drug were used. Nevertheless, some studies did indicate that even normal volunteers taking a short course of the drug developed some slight subclinical deterioration of their electrical nerve conductions. In contrast, most experts on the treatment of recurrent urinary infection, I believe, find it an extremely safe and efficacious drug in the doses you mention.
In your case, we are comparing minor risks. Since nitrofurantoin does indeed have the low but definite potential of contributing to deterioration of your neuropathy, I think it is reasonable to ask your doctors about other possible alternatives.
In case you live near the Cleveland area, you are welcome to seek a second opinion from neurologists as well as urologists at the Cleveland Clinic. The number to call for appointments is [phone], or [phone] toll free.
This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options of your specific medical condition.