Comparative Pharmacology
Head-to-head clinical analysis: NITROFURANTOIN MONOHYDRATE MACROCRYSTALS versus SEPTRA DS.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NITROFURANTOIN MONOHYDRATE MACROCRYSTALS versus SEPTRA DS.
NITROFURANTOIN (MONOHYDRATE/MACROCRYSTALS) vs SEPTRA DS
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Nitrofurantoin is reduced by bacterial flavoproteins to reactive intermediates that inhibit bacterial cell wall synthesis, protein synthesis, and DNA/RNA synthesis. It is bacteriostatic at low concentrations and bactericidal at higher concentrations.
SEPTRA DS is a combination of trimethoprim and sulfamethoxazole. Trimethoprim inhibits bacterial dihydrofolate reductase, while sulfamethoxazole inhibits dihydropteroate synthase, sequentially blocking folate synthesis and ultimately DNA synthesis in susceptible bacteria.
100 mg orally twice daily for 5-7 days; for uncomplicated urinary tract infection.
One DS tablet (800 mg sulfamethoxazole/160 mg trimethoprim) orally every 12 hours for 10-14 days.
None Documented
None Documented
Terminal elimination half-life: 20-60 minutes (average ~30 min) in patients with normal renal function; prolonged in renal impairment (e.g., CrCl <60 mL/min).
Trimethoprim: 8-10 hours; sulfamethoxazole: 10-12 hours (prolonged in renal impairment, e.g., creatinine clearance <30 mL/min increases half-life to >20 hours).
Renal excretion of unchanged drug accounts for approximately 40% of the dose; tubular reabsorption occurs. Biliary/fecal elimination is minimal (<5%).
Renal excretion of unchanged drugs accounts for 50-70% of trimethoprim and 20-30% of sulfamethoxazole; biliary excretion is minor (<10% total).
Category D/X
Category C
Antibiotic
Antibiotic