Nintoin 500 mg/100 ml Suspension

Nintoin 500 mg/100 ml suspension by Incepta Pharmaceuticals Ltd. is a medicine that contains Nitrofurantoin. In Bangladesh, it is mainly used for treatment of uncomplicated lower urinary tract infection (cystitis) caused by susceptible bacteria.

Nitrofurantoin works by being concentrated in the urine and damaging bacterial enzymes and genetic material, which helps stop bacterial growth. A key caution is that it is not suitable for kidney infection (pyelonephritis) or severe systemic infection, and kidney function must be considered before use.

• Treatment of acute uncomplicated lower urinary tract infection (acute cystitis) caused by susceptible bacteria.
• Prevention or suppression of recurrent urinary tract infection when a doctor considers it appropriate.
• It is not indicated for pyelonephritis, perinephric abscess, prostatitis, or infections outside the urinary tract.

Adult dosing depends on the formulation, kidney function, severity of infection, and whether it is being used for treatment or prevention. For uncomplicated cystitis, nitrofurantoin is usually taken by mouth for a short course; for prevention, a lower once-daily dose may be prescribed. Take exactly as prescribed, preferably with food or milk to improve absorption and reduce stomach upset. Do not stop early unless advised by the doctor, even if symptoms improve.

• Common: nausea, vomiting, loss of appetite, abdominal discomfort, diarrhoea, headache, dizziness, and dark yellow or brown urine discoloration.
• Allergic reactions: rash, itching, swelling, wheezing, or severe skin reactions; seek urgent help if these occur.
• Lung reactions: sudden cough, chest pain, fever, or shortness of breath; long-term use can rarely cause chronic lung disease.
• Liver injury: yellowing of the skin or eyes, dark urine, severe fatigue, or upper abdominal pain.
• Nerve problems: numbness, tingling, or weakness, especially in people with kidney disease, diabetes, anaemia, or vitamin B deficiency.
• Blood problems, including haemolytic anaemia, can occur rarely, especially in people with G6PD deficiency.

Use Nitrofurantoin only for infections where it is appropriate; it does not treat viral illness or upper urinary tract/kidney infection. Extra caution is needed in people with reduced kidney function, lung disease, liver disease, anaemia, diabetes, electrolyte imbalance, vitamin B deficiency, G6PD deficiency, or a history of neuropathy. Long-term use requires medical monitoring for lung, liver, nerve, and blood-related adverse effects. Use under the guidance of a registered doctor or pharmacist.

• Magnesium trisilicate-containing antacids may reduce absorption and effectiveness; avoid taking them together unless advised.
• Probenecid and sulfinpyrazone can reduce urinary excretion of nitrofurantoin, which may lower urinary antibacterial effect and increase toxicity risk.
• Other medicines that can affect the kidneys or nerves may increase the risk of adverse effects; inform the doctor about all medicines and supplements.
• Antibiotics may reduce the effectiveness of live oral typhoid vaccine; vaccination timing should be discussed with a healthcare professional.
• Food or milk may increase absorption and reduce stomach upset, so it is commonly taken with meals.

• Known hypersensitivity to nitrofurantoin or other nitrofuran medicines.
• Significant renal impairment, commonly avoided when estimated GFR or creatinine clearance is below 30 mL/minute.
• Previous nitrofurantoin-associated cholestatic jaundice or liver dysfunction.
• Pregnancy at term (around 38 to 42 weeks), during labour or delivery, due to risk of haemolytic anaemia in the newborn.
• Neonates under 1 month of age.
• Suspected or confirmed pyelonephritis, perinephric abscess, or systemic bacterial infection where adequate tissue levels are required.

Nitrofurantoin may be used in pregnancy when clearly needed and prescribed for an appropriate urinary infection, but it should be avoided at term, during labour, and in people with known or suspected G6PD deficiency. During breastfeeding, it is generally avoided if the infant is under 1 month old, premature, jaundiced, or has G6PD deficiency; otherwise a doctor may consider it with monitoring for diarrhoea, rash, or unusual symptoms in the baby.

Store at room temperature, away from excess heat, moisture, and direct light. Keep the container tightly closed and out of reach of children. For suspension, follow the label or pharmacist’s instructions on shaking, storage, and expiry after opening; do not use after the expiry date.