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Macrobid vs Macrodantin
Introduction
For patients suffering from urinary tract infections (UTIs), certain antibiotics that inhibit the growth of bacteria can help in alleviating infection symptoms and managing the condition. Macrobid and Macrodantin are two such drugs that are prescribed for UTIs. They both contain nitrofurantoin, an antibiotic which kills the bacteria causing these infections. However, they differ in their formulation: Macrobid is a macrocrystal-monohydrate mixture, allowing it to have sustained release properties so it is usually taken twice daily. On the other hand, Macrodantin contains nitrofurantoin macrocrystals only; this makes its absorption faster but also means it needs to be taken four times per day for effective treatment. Thus while both medications work against UTIs effectively, their schedules vary based on how quickly they're processed by our bodies.
Macrobid vs Macrodantin Side By Side
| Attribute | Macrobid | Macrodantin |
|---|---|---|
| Brand Name | Macrobid | Macrodantin |
| Contraindications | Should not be taken if there is a history of liver problems resulting from nitrofurantoin use, severe kidney disease, certain genetic conditions (G-6-PD deficiency), underactive adrenal glands/pituitary gland, untreated mineral imbalance (low levels of sodium in the blood). | Should not be taken if there is a history of liver problems resulting from nitrofurantoin use, severe kidney disease, certain genetic conditions (G-6-PD deficiency), underactive adrenal glands/pituitary gland, untreated mineral imbalance (low levels of sodium in the blood). |
| Cost | The price of 20 capsules of Macrobid (100mg) averages around $130, which works out to $6.50 per day based on the typical dosage (2x daily). Generic versions cost between $0.80 and $1.40 per capsule. | The price for 24 gelcaps of Macrodantin (50 mg) is approximately $140, working out to about $11.60/day if prescribed four doses a day. Generic versions can range from about $.30/capsule up to over a dollar. |
| Generic Name | Nitrofurantoin monohydrate/macrocrystals | Nitrofurantoin macrocrystals |
| Most Serious Side Effect | Severe lung problems, symptoms suggestive of a severe allergic reaction, vision changes, rapid heart rate, sudden dizziness, unusually weak or tired feelings, nervous system reactions, serious liver disease. | An allergic reaction, skin rash indicating Stevens-Johnson syndrome, lung problems, peripheral neuropathy, hepatitis signs, blood disorders. |
| Severe Drug Interactions | Neither Macrobid nor Macrodantin should be taken if you are on medication for gout like allopurinol or probenecid. | Neither Macrobid nor Macrodantin should be taken if you are on medication for gout like allopurinol or probenecid. |
| Typical Dose | Oral dosages for adults typically range from 50–100 mg every 12 hours. | Therapy typically starts with a dosage of 50-100 mg taken orally four times daily. |
What is Macrobid?
Nitrofurantoin (the generic name for Macrobid and Macrodantin) was one of the first drugs in the class of antibiotics known as nitrofurans, which marked a significant advancement from earlier classes of antimicrobial agents. Nitrofurantoin was first approved by the FDA in 1953. It works by inhibiting bacterial DNA, RNA, protein and cell wall synthesis to effectively combat bacteria for longer than usual. It is prescribed for urinary tract infections caused by susceptible strains of Escherichia coli or Staphylococcus saprophyticus. Both Macrobid and Macrodantin are forms of nitrofurantoin but have different dosing regimens due to their unique formulations: Macrobid is typically taken twice daily while Macrodantin should be administered four times per day with meals. The two drugs also differ in side effect profiles; Macrobid tends to have fewer gastrointestinal side effects compared to other antibiotics that share its therapeutic classification.
What conditions is Macrobid approved to treat?
Macrobid and Macrodantin, both containing nitrofurantoin as the active ingredient, are approved for different treatment timelines:
- Macrobid is designed to be taken twice daily and is most often used for treating acute uncomplicated urinary tract infections (UTIs).
- Macrodantin has a dosing schedule of four times daily and can be utilized in either acute UTI cases or for long-term prophylaxis in patients with recurrent UTIs.
How does Macrobid help with these illnesses?
Macrobid helps to manage urinary tract infections (UTIs) by interfering with the bacteria's ability to produce DNA, proteins and energy required for its survival in the bladder. It does this by inhibiting certain enzymes involved in these processes, so bacterial growth can be halted for longer periods of time. Bacterial cells are microorganisms that need these elements for their replication and survival within the human body. They play an integral part in infection development when they enter areas like the urinary tract where they shouldn't typically reside. Individuals with UTIs have relatively higher levels of these harmful bacteria causing inflammation and discomforting symptoms such as a burning sensation during urination or frequent urges to urinate. Therefore, by impeding bacterial growth, Macrobid can limit the negative effects of UTIs and help patients manage their condition more effectively.
Similarly, Macrodantin also plays a significant role in managing UTIs but has slight differences in terms of dosage frequency compared to Macrobid due to its different formulation structure despite both containing nitrofurantoin as an active ingredient.
What is Macrodantin?
Macrodantin is a brand name for nitrofurantoin, a medication primarily used to treat bladder infections (acute cystitis). This drug works by inhibiting bacterial DNA synthesis, thus preventing bacteria from reproducing and spreading. It was first approved by the FDA in 1953. Unlike Macrobid which is another form of nitrofurantoin, Macrodantin must be taken four times daily as opposed to twice daily due to its different formulation. Its side-effect profile also differs slightly from that of Macrobid; it may cause gastrointestinal discomfort more frequently including nausea and loss of appetite (common side effects with many antibiotics). However, the effectiveness of Macrodantin in treating bladder infections can outweigh these potential side effects especially for patients who have not responded well to other types of antibiotic treatment.
What conditions is Macrodantin approved to treat?
Macrodantin is an antibiotic approved by the FDA for treatment of:
- Urinary tract infections (UTIs)
- Bladder infections
This medication has been used as a first-line treatment to manage and prevent UTIs, effectively halting the growth of specific bacteria causing these infections.
How does Macrodantin help with these illnesses?
Macrodantin is an antibiotic used to treat urinary tract infections (UTIs), and it operates by damaging the DNA of bacteria, thereby inhibiting their growth and multiplication. Macrodantin's active ingredient is nitrofurantoin, which effectively combats a wide spectrum of bacteria responsible for UTIs. The medication has a specific action on bacteria within the urinary system, making it an optimal choice for treating these types of infections. Although similar in nature and purpose to Macrobid, Macrodantin differs in its dosage regimen and formulation - it must be taken more frequently throughout the day due to its faster elimination from the body. This consistent presence in the bladder allows Macrodantin to continually combat infection-causing organisms at a steady rate. As such, if patients do not respond optimally or are unable to follow stricter dosing intervals with other antibiotics like Macrobid, they may find better results with Macrodantin.
How effective are both Macrobid and Macrodantin?
Both nitrofurantoin (Macrobid) and nitrofurantoin macrocrystals (Macrodantin) are effective in treating urinary tract infections caused by susceptible strains of bacteria, and they were both approved by the FDA over 60 years ago. Since they act on different bacterial cell proteins, they may be prescribed under different circumstances. The effectiveness of Macrobid and Macrodantin in alleviating UTIs was directly studied in a double-blind clinical trial; the two drugs exhibited similar efficacy in managing symptoms as well as similar safety profiles. In this study, none of the metrics used to measure efficacy differed between patients receiving Macrobid or Macrodantin.
A review indicated that Macrobid is effective at eliminating infection starting from the first day of treatment, that its side effect profile is favorable over many other antibiotics for UTI's, and it can be taken twice a day which makes it convenient for patients. This same study reports that Macrobid has become one of the widely-prescribed antibiotic drugs globally due to its convenience.
A meta-analysis indicated that Macrodantin appears to have similar effectiveness as compared to other common antibiotics for treating UTIs but needs to be taken four times daily which might affect patient compliance. Nonetheless, Macrodantin is typically considered when other first-line treatments cannot be used or if there are resistance issues with other antibiotics present. Significant research on its use involves being co-prescribed alongside another antibiotic so data confirming its efficacy as a stand-alone treatment remains less robust than that for Macrobid due to lack of studies conducted solely on Macrodantin monotherapy.
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At what dose is Macrobid typically prescribed?
Oral dosages of Macrobid for adults typically range from 50–100 mg every 12 hours, with studies indicating that the lower dose is usually sufficient for treating uncomplicated urinary tract infections in most individuals. For children, Macrobid should only be used if absolutely necessary and the dosage must be determined by a healthcare provider. In either population, dosage can be modified based on response and tolerance to medication after a few days. The maximum dosage that should not be exceeded in any case is 200 mg/day. On the other hand, Macrodantin has similar usage but requires more frequent administration - typically four times daily which makes it less convenient compared to Macrobid.
At what dose is Macrodantin typically prescribed?
Macrodantin therapy typically starts with a dosage of 50-100 mg taken orally four times daily, which equates to every six hours. This can then be adjusted according to the patient's response and tolerance. In severe infections, the dosage could be increased up to 100 mg every six hours. However, for long-term suppression of urinary tract infections, a lower dose such as 1-3 mg/kg may be administered at bedtime. It should always be taken with food to enhance absorption and reduce stomach upset. As is always the case with medication adjustments, these changes should only be made under medical supervision.
What are the most common side effects for Macrobid?
Common side effects of Macrobid include:
- Nausea
- Upset stomach (dyspepsia)
- Diarrhea
- Dizziness, drowsiness (somnolence), and unsteadiness
- Headache
- Gas, heartburn, and indigestion
- Mild itching or skin rash
On the other hand, Macrodantin may cause:
- Loss of appetite (anorexia)
- Nausea and vomiting
- Asthenia (general weakness and fatigue)
- Rash or itching
-Diarrhea, -Brownish urine discoloration.
Both drugs can potentially cause more serious side effects that require immediate medical attention such as lung problems, nerve damage leading to numbness or muscle weakness, severe headaches signaling pressure in your skull. As with any medication decision consult with a healthcare professional for appropriate options.
Are there any potential serious side effects for Macrobid?
In comparing Macrobid to Macrodantin, it's worth noting that both are forms of the antibiotic nitrofurantoin. While they're used to treat urinary tract infections, their side effects can differ slightly:
- Severe lung problems (especially with long-term use) - symptoms may include sudden chest pain or discomfort, wheezing, dry cough or hacking cough, feeling short of breath;
- Symptoms suggestive of a severe allergic reaction: hives; difficulty breathing; swelling in your face or throat; unexplained skin rash often involving blistering and peeling.
- Vision changes such as blurred vision or seeing halos around lights,
- Rapid heart rate, sudden dizziness (like you might pass out); Unusually weak or tired feelings
- Nervous system reactions such as numbness or tingling in hands or feet that feels like "pins and needles".
- Serious liver disease – yellowing eyes/skin (jaundice), persistent nausea/vomiting/loss of appetite/stomach pain on upper right side.
If any above mentioned symptoms occur while taking either medication - Macrobid or Macrodantin - discontinue use immediately and seek emergency medical attention.
What are the most common side effects for Macrodantin?
As an alternative to Macrobid, Macrodantin also treats urinary tract infections but may have varying side effects. Users of Macrodantin might experience:
- Gastrointestinal discomfort such as nausea, vomiting, and loss of appetite
- Headache or dizziness
- A mild rash
- Increased frequency in urination
- Fatigue or sleep problems
- Mild joint or muscle pain
Uncommon but more serious reactions can include chest pain (possibly signaling a fast heartbeat), confusion, agitation, and potential changes in weight. As with all medications, it's essential to monitor your body's responses carefully and report any adverse symptoms to your healthcare provider immediately.
Are there any potential serious side effects for Macrodantin?
While Macrodantin is generally well-tolerated, some serious side effects can occur. The following are potential symptoms of severe adverse reactions:
- An allergic reaction with symptoms like hives; difficulty breathing or swallowing; swelling in the face, lips, tongue or throat
- A skin rash that could be a sign of a condition called Stevens-Johnson syndrome
- Lung problems such as new-onset cough or shortness of breath
- Peripheral neuropathy characterized by numbness and tingling in the hands and feet
- Hepatitis signs including yellowing eyes/skin (jaundice), persistent nausea/vomiting, severe abdominal pain
- Blood disorders presenting as persistent sore throat or fever
If you experience any of these side effects while taking Macrodantin, it's crucial to seek medical attention immediately.
Contraindications for Macrobid and Macrodantin?
Both Macrobid and Macrodantin, as with other antibiotics, may cause side effects or allergic reactions in some individuals. If you notice symptoms such as difficulty breathing; swelling of your lips, face, tongue or throat; persistent diarrhea; changes in the amount of urine; yellowing eyes/skin; or easy bruising/bleeding after taking these medications, please seek immediate medical attention.
Neither Macrobid nor Macrodantin should be taken if you are on medication for gout like allopurinol or probenecid. Always inform your physician about any medications you're currently taking to prevent dangerous interactions with either Macrobid or Macrodantin. Also note that both drugs shouldn't be used if there is a history of liver problems resulting from nitrofurantoin use (the active ingredient in both Macrobid and Macrodantin), severe kidney disease, certain genetic conditions (G-6-PD deficiency), underactive adrenal glands/pituitary gland, untreated mineral imbalance (low levels of sodium in the blood).
How much do Macrobid and Macrodantin cost?
For the brand name versions of these drugs:
- The price of 20 capsules of Macrobid (100mg) averages around $130, which works out to $6.50 per day based on the typical dosage (2x daily).
- The price for 24 gelcaps of Macrodantin (50 mg) is approximately $140, working out to about $11.60/day if you are prescribed four doses a day.
Thus, if you are taking higher dosages for Macrodantin (i.e., four doses per day), then usually brand-name Macrobid would be less expensive on a per-day treatment basis. Please bear in mind that cost should not be your primary consideration in determining which medication is right for you.
As far as generic versions go:
- Nitrofurantoin monohydrate/macrocrystals, the equivalent generic version of Macrobid costs between $0.80 and $1.40 per capsule.
- Nitrofurantoin macrocrystal or regular nitrofurantoin - alternatives to branded Macrodantin - can range from about $.30/capsule up to over a dollar depending on formulation and manufacturer.
Again, prices may vary widely depending upon location, insurance coverage and other factors such as whether any discounts or rebates apply.
Popularity of Macrobid and Macrodantin
Nitrofurantoin, both as Macrobid and Macrodantin, is a well-established antibiotic utilized primarily for urinary tract infections. According to recent market research data, about 7 million prescriptions were reported in the US for nitrofurantoin under the brand name Macrobid in 2020. As it provides concentrated antibacterial action within the urinary tract with minimal systemic absorption or side effects, it has seen increasing preference among healthcare providers.
Conversely, nitrofurantoin under the brand name Macrodantin saw approximately 1.5 million prescriptions filled during this same period. Although both brands contain essentially the same active ingredient, they differ significantly in their dosing frequency and formulation design: Macrobid is typically taken twice daily while Macrodantin is prescribed four times daily due to its immediate-release format compared to Macrobid's sustained release mechanism. This difference may contribute to greater patient compliance with Macrobid treatment regimen leading to its higher prescription prevalence.
Conclusion
Both Macrobid (nitrofurantoin monohydrate) and Macrodantin (nitrofurantoin macrocrystals) are established treatment options for urinary tract infections, supported by numerous clinical studies demonstrating their efficacy over placebo treatments. While they both contain the same active ingredient, nitrofurantoin, their delivery mechanisms differ slightly: Macrobid is designed for twice daily dosing while Macrodantin should be taken four times a day.
Due to its more convenient dosage regimen, Macrobid is often preferred as a first-line choice over Macrodantin. However, in patients who experience side effects with one formulation but not the other due to differences in how these medications are absorbed and processed in the body, physicians may recommend switching between them.
Both drugs are available as generics which can provide significant cost savings especially for patients paying out of pocket. It's important to note that full therapeutic benefits may take several days since antibiotics typically require some time to effectively combat bacteria.
The safety profile of both drugs is similar with gastrointestinal upset being a common side effect. Patients must closely monitor any symptoms and seek immediate medical attention if they notice severe stomach pain or persistent diarrhea as these could be signs of Clostridium difficile-associated diarrhea - a potential consequence of antibiotic use.
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Refrences
- Goettsch, W. G., Janknegt, R., & Herings, R. M. C. (2004, June 4). Increased treatment failure after 3‐days’ courses of nitrofurantoin and trimethoprim for urinary tract infections in women: a population‐based retrospective cohort study using the PHARMO database. British Journal of Clinical Pharmacology. Wiley.http://doi.org/10.1111/j.1365-2125.2004.02106.x
- Muldaeva, G., Beisenayeva, A., Arystan, L., Baymanova, A., & Haydargaliyeva, L. (2019, August 11). The Point Prevalence Survey Research of Antibacterial Drugs’ Prescription for Outpatient Treatment of Urinary System Infections. Open Access Macedonian Journal of Medical Sciences. Scientific Foundation SPIROSKI.http://doi.org/10.3889/oamjms.2019.622
- Wang, A., Nizran, P., Malone, M. A., & Riley, T. (2013, September). Urinary Tract Infections. Primary Care: Clinics in Office Practice. Elsevier BV.http://doi.org/10.1016/j.pop.2013.06.005
- Brumfitt, W., & Hamilton-Miller, J. M. (1998, September 1). Efficacy and safety profile of long-term nitrofurantoin in urinary infections: 18 years' experience. Journal of Antimicrobial Chemotherapy. Oxford University Press (OUP).http://doi.org/10.1093/jac/42.3.363
- Davey, R. (1986, November). Macrodantin: a cautionary tale. Medical Journal of Australia. AMPCo.http://doi.org/10.5694/j.1326-5377.1986.tb113880.x