Selecting here opens the current stored cards. The pinned link below records their fingerprints. Do not enter patient information in links or searches.
Share or print this source review
1 local source card selected. Local card fingerprints checked where supplied. This is not an original-document hash, source-currency guarantee or clinical approval. Record-level cautions below are the current library's cautions, not a frozen prior version.
Copy is optional; the link can be selected and copied manually. No patient data or dose decision is collected.
Clinical context remains essential
Independent clinical review is pending. Confirm indication, exact formulation/route, population, renal measure and units, kidney-function stability, dialysis prescription, interacting drugs, monitoring and source revision. An RX mirror and its original label are not independent corroboration. Missing disagreement notes do not certify agreement.
The historical renal cutoff is preserved. Current product labeling and professional recommendations may use different thresholds; do not silently reconcile them.
U.K. MHRA safety advice for nitrofurantoin; jurisdiction-specific comparison, not a replacement U.S. label.
Renal method
Indexed eGFR, mL/min/1.73 m2; not interchangeable with U.S. label CrCl.
Source revision
Article: September 2014; GOV.UK publication 2015-02-12. Selected advice rechecked 2026-09-08; not presented as a new 2026 guideline.
Retrieved
2026-09-08
Local review status
Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.
Documented differences and cautions on this drug
All record notes are retained here, including notes about sources not selected in this review.
MACROBID label and older-adult criteria use different renal thresholds
The label retains a CrCl-below-60 contraindication; the AGS 2023 older-adult criterion uses below 30. This difference does not establish safety for every patient between those values.
What to reconcile: Confirm population, lower-tract indication, duration and local policy. Document any departure from labeling; neither a source count nor this comparison selects a prescription.
Nitrofurantoin: U.K. indexed-eGFR advice is not the U.S. CrCl label
The added historical MHRA advice differs in renal measure, cutoff and limited lower-UTI exception from the retained U.S. label and geriatric/institutional sources. It is not a new 2026 U.S. rule.
What to reconcile: Keep jurisdiction, infection site, source date and renal estimator attached to each recommendation. Do not substitute one numerical cutoff for another without clinical adjudication.
Nitrofurantoin: label, UCSF and UK guidance remain distinct
The label restriction, UCSF limited-data position and UK short-course exception differ in renal measure, setting and qualifications. UCSF is not an endorsement down to CrCl 30.
What to reconcile: Document jurisdiction and infection scope; preserve the UK multidrug-resistant lower-UTI and benefit-risk qualifications. Do not convert eGFR thresholds into CrCl cutoffs.
U.K. Medicines and Healthcare products Regulatory Agency (MHRA) · U.K. MHRA safety advice for nitrofurantoin; jurisdiction-specific comparison, not a replacement U.S. label.
Renal method: Indexed eGFR, mL/min/1.73 m2; not interchangeable with U.S. label CrCl. Source date: Article: September 2014; GOV.UK publication 2015-02-12. Selected advice rechecked 2026-09-08; not presented as a new 2026 guideline. Retrieved: 2026-09-08
Regulatory safety communication. This is a safety restriction, not a dose-adjustment strategy or evidence that a reduced dose is safe.
Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.
Renal dosing, restrictions and evidence limits
The MHRA advice generally contraindicates use below eGFR 45. A cautious 3 to 7 day course at eGFR 30 to 44 is reserved for lower UTI with suspected or proven multidrug-resistant pathogens when benefits outweigh risks. Do not use this exception for upper UTI or urinary-source sepsis. Monitor pulmonary, hepatic, neurological, hematological and gastrointestinal adverse effects.
RDM44-professional-nitrofurantoin-192ec1ebb9-C1 · Source locator: Advice for healthcare professionals, lines 74-80.
Source-specific limits
Retain U.S. label, geriatric and institutional recommendations separately. Different measures, settings and source dates are not numerical votes.
This reference does not select a regimen. Complete the indication, measured/estimated renal function and trend, dialysis setting, source rationale, monitoring and reassessment plan in your institution's approved documentation system. Confirm the complete current source before adopting its regimen.
GlobalRPh v6.6 | RDM66-DIRECT-PHP-20260911 | Local library date 2026-09-11. Selected-card identity does not imply clinical verification.