What are the side effects of nitrofurantoin and ciprofloxacin?

Nitrofurantoin

Common side effects of nitrofurantoin include:

The macrocrystalline form (Macrodantin) appears to cause less stomach upset. Stomach upset also can be minimized by using a lower dose or by taking nitrofurantoin with food or milk.

Possible serious side effects include:

Nitrofurantoin can cause serious lung injury. The reaction can occur within hours of the start of treatment if the patient has previously received nitrofurantoin, or within a few days of starting nitrofurantoin for the first time. Symptoms include:

In other persons, lung injury may occur after approximately a month of treatment. Symptoms include:

  • Difficulty breathing
  • Rapid breathing
  • Cough

Fortunately, the symptoms usually resolve within a week if the medication is stopped. In other individuals, lung injury may not develop until after several months or years of therapy. Unless it is recognized and treated, this delayed lung injury can result in permanent lung damage that remains even after the drug is stopped.

Nitrofurantoin can also cause damage to the sensory nerves of the arms and legs (peripheral neuropathy), which can cause tingling in the extremities. The condition can become severe and is more likely to occur in people with diabetes, vitamin B deficiency, or general debilitation.

Reduced red blood cell count (anemia) by breaking red blood cells (hemolytic anemia) can occur from nitrofurantoin. This reaction occurs most frequently in persons with a deficiency of an enzyme called glucose-6-phosphate dehydrogenase that is very important to the survival of red blood cells.

Nitrofurantoin also can cause liver damage leading to jaundice or a form of hepatitis that can be fatal. Elevated liver enzymes indicate liver damage and are a reason to stop the drug.

Treatment with nitrofurantoin can cause urine to change color to a dark yellow or brown.

Ciprofloxacin

The most common side effects of Cipro, Cipro XR are:

Anaphylaxis, or shock, is a rare allergic reaction to this drug. This allergic reaction is a medical emergency and if you are experiencing these symptoms seek medical care immediately.

Symptoms of shock include:

Possible serious side effects of Cipro, Cipro XR include:

  • Peripheral neuropathy
  • Central nervous system (CNS) effects, for example —
  • Hyperglycemia
  • Clostridium difficile-associated diarrhea (CDAD)
  • Abnormal heartbeats
  • Liver dysfunction
  • Stroke
  • Convulsions
  • Toxic epidermal necrolysis
  • Stevens-Johnson syndrome
  • Vasculitis
  • Allergic pneumonitis
  • Interstitial nephritis
  • Acute kidney failure
  • Hepatitis
  • Jaundice
  • Liver failure
  • Anemia
  • Leukopenia

Other serious side effects and adverse events of Cipro, Cipro XR include:

  • Cipro, Cipro XR should be used with caution in patients with central nervous system diseases such as seizures, because rare seizures have been reported in patients receiving Cipro, Cipro XR.
  • Cipro, Cipro XR should be avoided in children and adolescents less than 18 years of age, as safe use in these patients has not been established.
  • Many antibiotics, including Cipro, Cipro XR, can alter the normal bacteria in the colon and encourage overgrowth of a bacterium responsible for the development of inflammation of the colon (C. difficile or pseudomembranous colitis). Patients who develop signs of pseudomembranous colitis after starting Cipro, Cipro XR (diarrhea, fever, abdominal pain, and possibly shock) should contact their doctor immediately.
  • Cardiac arrest
  • Respiratory failure