Comparative Pharmacology
Head-to-head clinical analysis: NITROFURANTOIN versus SYNERCID.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NITROFURANTOIN versus SYNERCID.
NITROFURANTOIN vs SYNERCID
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Nitrofurantoin is reduced by bacterial flavoproteins to reactive intermediates that inactivate or inhibit bacterial ribosomal proteins, DNA, RNA, and metabolic enzymes, leading to bacterial cell death.
Synercid is a combination of two streptogramin antibiotics, quinupristin and dalfopristin, which bind to the 50S bacterial ribosome and inhibit protein synthesis. Quinupristin binds to the 23S rRNA near the peptidyl transferase center, while dalfopristin binds to a nearby site and enhances quinupristin's binding. The synergistic effect results in irreversible inhibition of bacterial protein synthesis.
100 mg orally twice daily for 5-7 days (uncomplicated UTI); 50-100 mg orally four times daily for 7 days (symptomatic uncomplicated UTI). Extended-release: 100 mg orally twice daily for 7 days.
7.5 mg/kg IV every 8 hours, administered as a 60-minute infusion.
None Documented
None Documented
Clinical Note
moderateNitrofurantoin + Norfloxacin
"The therapeutic efficacy of Norfloxacin can be decreased when used in combination with Nitrofurantoin."
Clinical Note
moderateNitrofurantoin + Teriflunomide
"The serum concentration of Teriflunomide can be increased when it is combined with Nitrofurantoin."
Clinical Note
moderateNitrofurantoin + Probenecid
"The serum concentration of Probenecid can be increased when it is combined with Nitrofurantoin."
Clinical Note
moderateNitrofurantoin + Rolapitant
Normal renal function: 20-60 minutes; impaired function: prolonged up to 1-2 hours, clinically significant due to urinary concentration requirement
The terminal elimination half-life is approximately 0.85 hours for dalfopristin and 1.3 hours for quinupristin; however, the active metabolite of quinupristin has a half-life of about 3.5 hours, supporting twice-daily dosing.
Renal: ~40% unchanged via glomerular filtration and tubular secretion, biliary/fecal: <1%
Primarily hepatic metabolism with biliary excretion; approximately 15% of the dalfopristin dose and 32% of the quinupristin dose are excreted unchanged in feces; renal excretion is minor (<5% for both components).
Category D/X
Category C
Antibiotic
Antibiotic
"The serum concentration of Rolapitant can be increased when it is combined with Nitrofurantoin."