FURACIN
Clinical safety rating: caution
Comprehensive clinical and safety monograph for FURACIN (FURACIN).
Nitrofurazone is a nitrofuran derivative that acts as a bactericidal agent by inhibiting bacterial enzymes involved in carbohydrate metabolism. It undergoes reduction by bacterial nitroreductases to reactive intermediates that damage DNA and other macromolecules.
| Metabolism | Primarily metabolized via reduction of the nitro group by bacterial nitroreductases; small fraction undergoes hepatic microsomal metabolism; elimination via renal excretion (unchanged and metabolites). |
| Excretion | Primarily renal (approximately 40-60% unchanged drug), with minor biliary and fecal elimination (~5-10%). |
| Half-life | Terminal elimination half-life is 3-7 hours in adults with normal renal function; may be prolonged in renal impairment. |
| Protein binding | Binds primarily to serum albumin; approximately 40-60% protein bound. |
| Volume of Distribution | Vd is approximately 0.3-0.5 L/kg, indicating distribution mainly into extracellular fluid. |
| Bioavailability | Topical: negligible systemic absorption (<1%). Oral: not administered due to poor systemic absorption and toxicity. |
| Onset of Action | Topical: 30-60 minutes for bacteriostatic effect. Oral: not used systemically. Intravenous: not applicable. |
| Duration of Action | Topical: 6-12 hours depending on formulation and infection severity. Systemic use not recommended. |
| Action Class | Nitrofuran & its derivatives |
| Brand Substitutes | Furapar Cream, Furasept Cream, Decacin Cream |
Topical: Apply to affected area 2-3 times daily. For urinary tract infection (oral, not available in US): 50-100 mg orally 4 times daily.
| Dosage form | OINTMENT |
| Renal impairment | Nitrofurazone is contraindicated in renal impairment (CrCl <30 mL/min); avoid use. For mild impairment (CrCl 30-50 mL/min): no adjustment needed for topical use. |
| Liver impairment | No specific guidelines; use with caution in severe hepatic impairment (Child-Pugh C) due to potential for increased toxicity. |
| Pediatric use | Topical: same as adults. Oral (if used): 1.5-2 mg/kg/day divided every 6 hours; not recommended for infants <1 month. |
| Geriatric use | No specific dose adjustment; monitor for renal function due to age-related decline; topical use preferred. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for FURACIN (FURACIN).
| Breastfeeding | Compatible with breastfeeding; M/P ratio not established. Avoid in nursing mothers of infants with G6PD deficiency or hyperbilirubinemia. |
| Teratogenic Risk | First trimester: Limited human data, but animal studies suggest no major teratogenic risk. Second/Third trimester: No evidence of fetal harm, but avoid near term due to risk of kernicterus in newborns (theoretical, based on sulfonamide component). |
| Fetal Monitoring |
■ FDA Black Box Warning
None
| Serious Effects |
Hypersensitivity to nitrofurazone or any nitrofuran compounds; renal impairment (for systemic use, topical use caution); neonates (especially premature) due to risk of methemoglobinemia; pregnancy and lactation (topical use only if clearly needed).
| Precautions | Potential for skin sensitization and allergic contact dermatitis; overgrowth of nonsusceptible organisms (including fungi); use only on intact or debrided wounds; avoid prolonged use; not for use in eyes, otic, or mucous membranes; may cause methemoglobinemia in neonates with large surface area application. |
Loading safety data…
| No specific monitoring required beyond standard obstetric care. Monitor for signs of hemolysis in mother with G6PD deficiency. |
| Fertility Effects | No known adverse effects on fertility in humans or animal studies. |