Противомикробное средство из группы нитрофуранов, предназначенное, прежде всего, для лечения инфекций мочевыводящих путей. Нитрофурантоин нарушает синтез белков в бактериях и проницаемость клеточной мембраны. В малых дозах обладает бактериостатическим действием, в больших - бактерицидным. Эффективен в отношении грамположительных и грамотрицательных бактерий (Staphylococcus spp., Streptococcus spp., Shigella dysenteria, Shigella flexneri, Shigella hoydii, Shigella sonnei, Escherichia coli., Proteus spp.). Устойчивы к нитрофурантоину: Pseudomonas aeruginosa, Pseudomonas cepacia, Providencia spp., Acinetobacter spp.
Нитрофурантоин не используют при инфекциях мочевыводящих путей, вызванных гонококками, хламидиями, микоплазмами.
Фармакокинетика
Абсорбция из желудочно-кишечного тракта (ЖКТ) - хорошая. Биодоступность - 50 % (пища увеличивает биодоступность). Скорость всасывания зависит от размеров кристаллов.
Связь с белками плазмы крови - 60 %. Метаболизируется в печени и мышечной ткани. Период полувыведения (Т1/2) - 20-25 мин. Проникает через плаценту, гематоэнцефалический барьер (ГЭБ), в грудное молоко. Выводится полностью почками (30-50 % - в неизмененном виде).
Эффективную терапевтическую концентрацию препарат достигает в мочевыводящих путях, а не в крови и тканях. У пациентов с нарушениями функции почек концентрация нитрофурантоина в плазме крови и Т1/2 увеличиваются. Если клиренс креатинина (КК) менее 60 мл/мин, терапевтическая концентрация нитрофурантоина в моче не достигается, возможна кумуляция действующего вещества и повышенный риск токсичности. Нитрофурантоин проявляет большую активность в кислой моче. Если pH мочи выше 8, то препарат теряет бактерицидную активность.
Показания к применению
Бактериальные инфекции мочевыводящих путей, вызванные чувствительными к нитрофурантоину микроорганизмами: острые неосложненные инфекции, тяжелые осложненные рецидивирующие инфекции, профилактика инфекций мочевыводящих путей, в том числе, при неосложненных хронических заболеваниях и при урологических операциях или обследовании (цистоскопия, катетеризация мочевыводящих путей и т.п.).
Противопоказания
Повышенная чувствительность к нитрофурантоину, производным нитрофурана или другим компонентам препарата, хроническая почечная недостаточность (КК < 60 мл/мин), олигурия, анурия, хроническая сердечная недостаточность (ХСН) II - III степени, цирроз печени, хронический гепатит, дефицит глюкозо-6-фосфатдегидрогеназы, острая порфирия, анурия, фиброз легких, беременность, период грудного вскармливания, неврит или полинейропатия, детский возраст до 6 лет.
С осторожностью
При сахарном диабете, анемии, нарушении электролитного баланса, дефиците витаминов группы В, недостаточности функции печени, заболеваниях легких, склонности к развитию периферических нейропатий (зуд рук, ног, онемение).
Применение при беременности и в период грудного вскармливания
Препарат в период беременности противопоказан. При необходимости применения препарата в период лактации грудное вскармливание необходимо прекратить.
Способ применения и дозы
Внутрь, во время еды, запивая большим количеством жидкости.
Взрослым и детям старше 12 лет
При острых неосложненных инфекциях мочевыводящих путей - 100 мг (2 таблетки по 50 мг или 1 таблетка 100 мг) 2 раза в день в течение 7 дней.
Симптомы болезни могут исчезнуть прежде, чем наступит излечение от инфекции, и при прекращении применения лекарственного средства болезнь может обостриться снова.
При тяжелых осложненных рецидивирующих инфекциях - 100 мг (2 таблетки по 50 мг или 1 таблетка 100 мг) 3-4 раза в день в течение 7 дней. При появлении тошноты необходимо снизить дозу или прекратить прием.
Профилактика инфекций мочевыводящих путей, в том числе, при неосложненных хронических заболеваниях и при урологических операциях или обследовании (цистоскопия, катетеризация мочевыводящих путей и т.п.) - 100 мг (2 таблетки по 50 мг или 1 таблетка 100 мг) на ночь.
Детям 6-12 лет (масса тела более 25 кг)
При острых неосложненных инфекциях мочевыводящих путей - 3 мг/кг/день, разделенные на 3-4 приема. Курс лечения 7 дней.
Детям с массой тела менее 25 кг применение препарата не рекомендуется из-за большой дозы действующего вещества в одной таблетке.
Побочное действие
Частота возникновения нежелательных реакций, отмеченных при приеме нитрофурантоина, приведена в следующей градации: очень часто (?1/10), часто (?1/100, < 1/10), нечасто (?1/1000, < 1/100), редко (?1/10 000, < 1/1000), очень редко (< 1/10 000) и частота неизвестна (невозможно оценить на основании имеющихся данных).
Инфекционные и паразитарные заболевания: частота неизвестна - псевдомембранозный колит, суперинфекция мочеполового тракта, чаще вызываемая Pseudomonas aeruginosa или Candida spp.
Нарушения со стороны крови и лимфатической системы: редко - мегалобластическая анемия, лейкопения, гранулоцитопения или агранулоцитоз, тромбоцитопения, гемолитическая анемия у пациентов с дефицитом глюкозо-6-фосфатдегидрогеназы. Нарушения со стороны иммунной системы: очень редко - волчаночноподобный синдром (сыпь, эозинофилия, лихорадка, артралгия), при этом в сыворотке крови наблюдается увеличение двух и более параметров -антинуклеарные антитела, антитела к гладкой мускулатуре или к базальной мембране клубочков и реакция Кумбса. В отдельных случаях - ангионевротический отек, анафилаксия, аутоиммунные реакции, связанные с хроническими изменениями в легких или печени. Нарушения со стороны нервной системы: часто - головная боль; редко - повышение внутричерепного давления; частота неизвестна - головокружение, астения, нистагм, сонливость; периферическая полинейропатия (включая неврит зрительного нерва), первые симптомы которой - чувство онемения и жжения в ногах, мышечная слабость.
Нарушения со стороны дыхательной системы, органов грудной клетки и средостения: очень редко - острые и хронические реакции повышенной чувствительности легких, характеризующиеся лихорадкой, эозинофилией, кашлем, болью в грудной клетке, одышкой («нитрофурантоиновая пневмония»), интерстициальные изменения в легких, бронхообструктивный синдром, плеврит. Легочный инфильтрат или уплотнение и плевральный выпот могут появиться в течение нескольких часов или дней от начала терапии; после прекращения приема препарата они обычно рассасываются. Подострые или острые легочные симптомы, в том числе фиброз легких, могут незаметно развиться у пациентов при продолжительной терапии; фиброз может быть необратимым, особенно если терапия продолжалась после появления симптомов (см. раздел «Противопоказания»),
Нарушения со стороны желудочно-кишечного тракта: часто - тошнота, рвота, отсутствие аппетита; редко - диарея, боль в животе, панкреатит, воспаление слюнных желез.
Нарушения со стороны печени и/или желчевыводящих путей: редко - гепатит, холестатическая желтуха (дозонезависимы и проходят после отмены препарата).
Нарушения со стороны кожи и подкожных тканей: часто - аллергические реакции (кожные высыпания, крапивница, зуд); очень редко - эксфолиативный дерматит, полиморфная эритема.
Нарушения со стороны половых органов и молочной железы: очень редко - проходящее нарушение сперматогенеза.
Прочие: редко - боль в суставах, обратимое выпадение волос.
Лечение: прием большого количества жидкости приводит к повышению выведения препарата с мочой. Эффективен диализ.
Взаимодействие с другими лекарственными средствами
Антациды и адсорбенты снижают всасывание нитрофурантоина.
Одновременное применение нитрофурантоина и препаратов группы хинолона (налидиксовая кислота, фторхинолоны) приводит к уменьшению антибактериального действия последних. Средства, способствующие выведению мочевой кислоты (пробенецид и сульфинпиразон), могут блокировать секрецию почечными канальцами, при этом снижается концентрация нитрофурантоина в моче (уменьшается антибактериальный эффект) и повышается концентрация в крови (увеличивается токсичность).
Антибактериальное действие нитрофурантоина снижается в щелочной среде, поэтому не рекомендуют сочетать нитрофурантоин с препаратами, повышающими pH мочи (натрия гидрогенкарбонат).
Особые указания
Частота побочных эффектов со стороны желудочно-кишечного тракта уменьшается при приеме препарата с пищей и большим количеством жидкости.
Осторожность следует соблюдать при анемии, сахарном диабете, нарушении электролитного баланса, дефиците витаминов группы В и фолиевой кислоты, заболеваниях легких, недостаточности функции печени, а так же при склонности к развитию периферических нейропатий (зуд рук или ног, онемение).
Прием препарата должен быть прекращен при наличии первых признаков периферической нейропатии (возникновение парестезий), так как развитие данного осложнения может быть опасным для жизни.
При появлении первых реакций повышенной чувствительности легких, развитии гепатита, нарушениях со стороны крови прием препарата следует прекратить и принять соответствующие меры.
При продолжительном лечении следует контролировать функции легких, особенно пожилым пациентам, у которых возможно ухудшение функции легких (см. раздел «Побочное действие»). При продолжительном лечении следует контролировать функции печени (см. разделы «Противопоказания» и «Побочное действие»).
Если КК < 60 мл/мин, терапевтическая концентрация нитрофурантоина в моче не достигается, возможна кумуляция действующего вещества и повышенный риск токсичности (см. раздел «Противопоказания»).
Прием препарата должен быть прекращен при проявлении признаков гемолиза у пациентов с подозрением на недостаточность глюкозо-6-фосфатдегидрогеназы. Нитрофурантоин может окрашивать мочу в темно-желтый или коричневый цвет. Нитрофурантоин не следует применять для лечения заболеваний коркового вещества почек, гнойного паранефрита, простатита. Не следует принимать препарат для лечения пиелонефрита, который сопровождается воспалением паренхиматозной ткани или периренальным воспалением. Нитрофурантоин не следует применять в комбинации с препаратами, вызывающими нарушения функции почек.
Лечение нитрофурантоином может привести к появлению устойчивых микроорганизмов. У пациентов, получающих нитрофурантоин, могут наблюдаться ложноположительные реакции при определении глюкозы в моче.
Во время лечения нельзя употреблять алкогольные напитки.
Влияние на способность управлять транспортными средствами, механизмами
В период лечения необходимо соблюдать осторожность при управлении транспортными средствами и занятии другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций, в связи с побочными эффектами со стороны нервной системы.
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Нитрофурантоин нарушает синтез белков в бактериях и проницаемость клеточной мембраны. В малых дозах обладает бактериостатическим действием, в больших - бактерицидным. Эффективен в отношении грамположительных и грамотрицательных бактерий (Staphylococcus spp., Streptococcus spp., Shigella dysenteria, Shigella flexneri, Shigella hoydii, Shigella sonnei, Escherichia coli., Proteus spp.). Устойчивы к нитрофурантоину: Pseudomonas aeruginosa, Pseudomonas cepacia, Providencia spp., Acinetobacter spp."}},{"type":"paragraph","data":{"text":"Нитрофурантоин не используют при инфекциях мочевыводящих путей, вызванных гонококками, хламидиями, микоплазмами."}},{"type":"paragraph","data":{"text":"Фармакокинетика"}},{"type":"paragraph","data":{"text":"Абсорбция из желудочно-кишечного тракта (ЖКТ) - хорошая. Биодоступность - 50 % (пища увеличивает биодоступность). Скорость всасывания зависит от размеров кристаллов."}},{"type":"paragraph","data":{"text":"Связь с белками плазмы крови - 60 %. Метаболизируется в печени и мышечной ткани. Период полувыведения (Т1/2) - 20-25 мин. Проникает через плаценту, гематоэнцефалический барьер (ГЭБ), в грудное молоко. Выводится полностью почками (30-50 % - в неизмененном виде)."}},{"type":"paragraph","data":{"text":"Эффективную терапевтическую концентрацию препарат достигает в мочевыводящих путях, а не в крови и тканях. У пациентов с нарушениями функции почек концентрация нитрофурантоина в плазме крови и Т1/2 увеличиваются. Если клиренс креатинина (КК) менее 60 мл/мин, терапевтическая концентрация нитрофурантоина в моче не достигается, возможна кумуляция действующего вещества и повышенный риск токсичности. Нитрофурантоин проявляет большую активность в кислой моче. Если pH мочи выше 8, то препарат теряет бактерицидную активность."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Бактериальные инфекции мочевыводящих путей, вызванные чувствительными к нитрофурантоину микроорганизмами: острые неосложненные инфекции, тяжелые осложненные рецидивирующие инфекции, профилактика инфекций мочевыводящих путей, в том числе, при неосложненных хронических заболеваниях и при урологических операциях или обследовании (цистоскопия, катетеризация мочевыводящих путей и т.п.)."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к нитрофурантоину, производным нитрофурана или другим компонентам препарата, хроническая почечная недостаточность (КК < 60 мл/мин), олигурия, анурия, хроническая сердечная недостаточность (ХСН) II - III степени, цирроз печени, хронический гепатит, дефицит глюкозо-6-фосфатдегидрогеназы, острая порфирия, анурия, фиброз легких, беременность, период грудного вскармливания, неврит или полинейропатия, детский возраст до 6 лет."}},{"type":"paragraph","data":{"text":"С осторожностью"}},{"type":"paragraph","data":{"text":"При сахарном диабете, анемии, нарушении электролитного баланса, дефиците витаминов группы В, недостаточности функции печени, заболеваниях легких, склонности к развитию периферических нейропатий (зуд рук, ног, онемение)."}},{"type":"paragraph","data":{"text":"Применение при беременности и в период грудного вскармливания"}},{"type":"paragraph","data":{"text":"Препарат в период беременности противопоказан. При необходимости применения препарата в период лактации грудное вскармливание необходимо прекратить."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь, во время еды, запивая большим количеством жидкости."}},{"type":"paragraph","data":{"text":"Взрослым и детям старше 12 лет"}},{"type":"paragraph","data":{"text":"При острых неосложненных инфекциях мочевыводящих путей - 100 мг (2 таблетки по 50 мг или 1 таблетка 100 мг) 2 раза в день в течение 7 дней."}},{"type":"paragraph","data":{"text":"Симптомы болезни могут исчезнуть прежде, чем наступит излечение от инфекции, и при прекращении применения лекарственного средства болезнь может обостриться снова."}},{"type":"paragraph","data":{"text":"При тяжелых осложненных рецидивирующих инфекциях - 100 мг (2 таблетки по 50 мг или 1 таблетка 100 мг) 3-4 раза в день в течение 7 дней. При появлении тошноты необходимо снизить дозу или прекратить прием."}},{"type":"paragraph","data":{"text":"Профилактика инфекций мочевыводящих путей, в том числе, при неосложненных хронических заболеваниях и при урологических операциях или обследовании (цистоскопия, катетеризация мочевыводящих путей и т.п.) - 100 мг (2 таблетки по 50 мг или 1 таблетка 100 мг) на ночь."}},{"type":"paragraph","data":{"text":"Детям 6-12 лет (масса тела более 25 кг)"}},{"type":"paragraph","data":{"text":"При острых неосложненных инфекциях мочевыводящих путей - 3 мг/кг/день, разделенные на 3-4 приема. Курс лечения 7 дней."}},{"type":"paragraph","data":{"text":"Детям с массой тела менее 25 кг применение препарата не рекомендуется из-за большой дозы действующего вещества в одной таблетке."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Частота возникновения нежелательных реакций, отмеченных при приеме нитрофурантоина, приведена в следующей градации: очень часто (?1/10), часто (?1/100, < 1/10), нечасто (?1/1000, < 1/100), редко (?1/10 000, < 1/1000), очень редко (< 1/10 000) и частота неизвестна (невозможно оценить на основании имеющихся данных)."}},{"type":"paragraph","data":{"text":"Инфекционные и паразитарные заболевания: частота неизвестна - псевдомембранозный колит, суперинфекция мочеполового тракта, чаще вызываемая Pseudomonas aeruginosa или Candida spp."}},{"type":"paragraph","data":{"text":"Нарушения со стороны крови и лимфатической системы: редко - мегалобластическая анемия, лейкопения, гранулоцитопения или агранулоцитоз, тромбоцитопения, гемолитическая анемия у пациентов с дефицитом глюкозо-6-фосфатдегидрогеназы. Нарушения со стороны иммунной системы: очень редко - волчаночноподобный синдром (сыпь, эозинофилия, лихорадка, артралгия), при этом в сыворотке крови наблюдается увеличение двух и более параметров -антинуклеарные антитела, антитела к гладкой мускулатуре или к базальной мембране клубочков и реакция Кумбса. В отдельных случаях - ангионевротический отек, анафилаксия, аутоиммунные реакции, связанные с хроническими изменениями в легких или печени. Нарушения со стороны нервной системы: часто - головная боль; редко - повышение внутричерепного давления; частота неизвестна - головокружение, астения, нистагм, сонливость; периферическая полинейропатия (включая неврит зрительного нерва), первые симптомы которой - чувство онемения и жжения в ногах, мышечная слабость."}},{"type":"paragraph","data":{"text":"Нарушения со стороны дыхательной системы, органов грудной клетки и средостения: очень редко - острые и хронические реакции повышенной чувствительности легких, характеризующиеся лихорадкой, эозинофилией, кашлем, болью в грудной клетке, одышкой («нитрофурантоиновая пневмония»), интерстициальные изменения в легких, бронхообструктивный синдром, плеврит. Легочный инфильтрат или уплотнение и плевральный выпот могут появиться в течение нескольких часов или дней от начала терапии; после прекращения приема препарата они обычно рассасываются. Подострые или острые легочные симптомы, в том числе фиброз легких, могут незаметно развиться у пациентов при продолжительной терапии; фиброз может быть необратимым, особенно если терапия продолжалась после появления симптомов (см. раздел «Противопоказания»),"}},{"type":"paragraph","data":{"text":"Нарушения со стороны желудочно-кишечного тракта: часто - тошнота, рвота, отсутствие аппетита; редко - диарея, боль в животе, панкреатит, воспаление слюнных желез."}},{"type":"paragraph","data":{"text":"Нарушения со стороны печени и/или желчевыводящих путей: редко - гепатит, холестатическая желтуха (дозонезависимы и проходят после отмены препарата)."}},{"type":"paragraph","data":{"text":"Нарушения со стороны кожи и подкожных тканей: часто - аллергические реакции (кожные высыпания, крапивница, зуд); очень редко - эксфолиативный дерматит, полиморфная эритема."}},{"type":"paragraph","data":{"text":"Нарушения со стороны половых органов и молочной железы: очень редко - проходящее нарушение сперматогенеза."}},{"type":"paragraph","data":{"text":"Прочие: редко - боль в суставах, обратимое выпадение волос."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптом: рвота, тошнота, головная боль, головокружение."}},{"type":"paragraph","data":{"text":"Лечение: прием большого количества жидкости приводит к повышению выведения препарата с мочой. Эффективен диализ."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Антациды и адсорбенты снижают всасывание нитрофурантоина."}},{"type":"paragraph","data":{"text":"Одновременное применение нитрофурантоина и препаратов группы хинолона (налидиксовая кислота, фторхинолоны) приводит к уменьшению антибактериального действия последних. Средства, способствующие выведению мочевой кислоты (пробенецид и сульфинпиразон), могут блокировать секрецию почечными канальцами, при этом снижается концентрация нитрофурантоина в моче (уменьшается антибактериальный эффект) и повышается концентрация в крови (увеличивается токсичность)."}},{"type":"paragraph","data":{"text":"Антибактериальное действие нитрофурантоина снижается в щелочной среде, поэтому не рекомендуют сочетать нитрофурантоин с препаратами, повышающими pH мочи (натрия гидрогенкарбонат)."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Частота побочных эффектов со стороны желудочно-кишечного тракта уменьшается при приеме препарата с пищей и большим количеством жидкости."}},{"type":"paragraph","data":{"text":"Осторожность следует соблюдать при анемии, сахарном диабете, нарушении электролитного баланса, дефиците витаминов группы В и фолиевой кислоты, заболеваниях легких, недостаточности функции печени, а так же при склонности к развитию периферических нейропатий (зуд рук или ног, онемение)."}},{"type":"paragraph","data":{"text":"Прием препарата должен быть прекращен при наличии первых признаков периферической нейропатии (возникновение парестезий), так как развитие данного осложнения может быть опасным для жизни."}},{"type":"paragraph","data":{"text":"При появлении первых реакций повышенной чувствительности легких, развитии гепатита, нарушениях со стороны крови прием препарата следует прекратить и принять соответствующие меры."}},{"type":"paragraph","data":{"text":"При продолжительном лечении следует контролировать функции легких, особенно пожилым пациентам, у которых возможно ухудшение функции легких (см. раздел «Побочное действие»). При продолжительном лечении следует контролировать функции печени (см. разделы «Противопоказания» и «Побочное действие»)."}},{"type":"paragraph","data":{"text":"Если КК < 60 мл/мин, терапевтическая концентрация нитрофурантоина в моче не достигается, возможна кумуляция действующего вещества и повышенный риск токсичности (см. раздел «Противопоказания»)."}},{"type":"paragraph","data":{"text":"Прием препарата должен быть прекращен при проявлении признаков гемолиза у пациентов с подозрением на недостаточность глюкозо-6-фосфатдегидрогеназы. Нитрофурантоин может окрашивать мочу в темно-желтый или коричневый цвет. Нитрофурантоин не следует применять для лечения заболеваний коркового вещества почек, гнойного паранефрита, простатита. Не следует принимать препарат для лечения пиелонефрита, который сопровождается воспалением паренхиматозной ткани или периренальным воспалением. Нитрофурантоин не следует применять в комбинации с препаратами, вызывающими нарушения функции почек."}},{"type":"paragraph","data":{"text":"Лечение нитрофурантоином может привести к появлению устойчивых микроорганизмов. У пациентов, получающих нитрофурантоин, могут наблюдаться ложноположительные реакции при определении глюкозы в моче."}},{"type":"paragraph","data":{"text":"Во время лечения нельзя употреблять алкогольные напитки."}},{"type":"paragraph","data":{"text":"Влияние на способность управлять транспортными средствами, механизмами"}},{"type":"paragraph","data":{"text":"В период лечения необходимо соблюдать осторожность при управлении транспортными средствами и занятии другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций, в связи с побочными эффектами со стороны нервной системы."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"от 2℃ до 25℃"}}]}],"source":null},"description_toggle":false,"short_description":"Противомикробное средство из группы нитрофуранов, предназначенное, прежде всего, для лечения инфекций мочевыводящих путей. Нитрофурантоин нарушает синтез белков в бактериях и проницаемость клеточной мембраны. В малых дозах обладает бактериостатическим действием, в больших - бактерицидным. Эффективен в отношении грамположительных и грамотрицательных бактерий (Staphylococcus spp., Streptococcus spp., Shigella dysenteria, Shigella flexneri, Shigella hoydii, Shigella sonnei, Escherichia coli., Proteus spp.). Устойчивы к нитрофурантоину: Pseudomonas aeruginosa, Pseudomonas cepacia, Providencia spp., Acinetobacter spp. Нитрофурантоин не используют при инфекциях мочевыводящих путей, вызванных гонококками, хламидиями, микоплазмами. Фармакокинетика Абсорбция из желудочно-кишечного тракта (ЖКТ) - хорошая. Биодоступность - 50 % (пища увеличивает биодоступность). Скорость всасывания зависит от размеров кристаллов. Связь с белками плазмы крови - 60 %. Метаболизируется в печени и мышечной ткани. Период полувыведения (Т1/2) - 20-25 мин. Проникает через плаценту, гематоэнцефалический барьер (ГЭБ), в грудное молоко. Выводится полностью почками (30-50 % - в неизмененном виде). Эффективную терапевтическую концентрацию препарат достигает в мочевыводящих путях, а не в крови и тканях. У пациентов с нарушениями функции почек концентрация нитрофурантоина в плазме крови и Т1/2 увеличиваются. Если клиренс креатинина (КК) менее 60 мл/мин, терапевтическая концентрация нитрофурантоина в моче не достигается, возможна кумуляция действующего вещества и повышенный риск токсичности. Нитрофурантоин проявляет большую активность в кислой моче. 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