Nirofurtants are the second class of antibacterial preparation after sulfonamides recommended for a wide medical use. They are less effective against the majority of antibiotics and are used in the treatment of acute uncomplicated form of urinary tract infections (Nitrofurantoin), intestinal infections (Nifuroxazide) and several protozoal infections - trichomoniasis and lambliosis (Nifuratel,Furazolidone).

Members of this drug class include:

  • Furazolidone, antibacterial
  • Furylfuramide
  • Furazidin
  • Nitrofurantoin, antibacterial
  • Nitrofurazone, antibacterial
  • Nifuratel
  • Nifurquinazol, antibacterial
  • Nifurtoinol, antibacterial
  • Nifuroxazide, antibiotic
  • Nifurtimox, antiparasitic
  • Nifurzide, anti-infective

Action mechanism
Being acceptors of oxygen, nitrofurans inhibit the process of cellular respiration and biosynthesis of nucleic acids. Depending on blood concentration nitrofurans exert bacteriostatic or bactericidal effect. The resistance of microorganisms to nitrofurans develops slowly.s

Spectrum of activity

Nitrofurans are characterized by a rather broad spectrum of antibacterial activity. In high doses nitrofurans are active against many gram-negative (E.coli, K.pneumoniae, etc.) and gram-positive bacteria, some anaerobes, Candida albicans.
P.aeruginosa, most strains of Proteus, acinetobacter are resistant to nitrofurans. In addition, furazolidone and nifuratel are active against some protozoa (Giardia, Trichomonas).

Most commonly nitrofurans are indicated for the treatment of the following conditions:

  • Urogenital infections: acute cystitis, suppressive therapy of chronic infections (Nitrofurantoin) Prophylaxis of infection during surgical interventions, cystoscopy, catheterization of the bladder (Nitrofurantoin, furazidin)
  • Intestinal infections: acute infectious diarrhea, enterocolitis (Nifuroxazide, Nifuratel)
  • Giardiasis (Furazolidone, Nifuratel)
  • Trichomoniasis (Nifuratel, Furazolidone)
  • Infectious wounds (Furazidin)

Side effects
The most common side effects typical for all nitrofurans include:

  • Digestive system: nausea, vomiting, diarrhea
  • Liver: increased levels of transaminases, hepatitis, cholestasis
  • Allergic reactions: skin rash, fever, arthralgia, myalgia, eosinophilia, lupus-like syndrome
  • Respiratory system: pneumonia (nitrofurantoin), bronchospasm, cough, chest pain
  • Nervous system: dizziness, headache, general weakness, drowsiness, peripheral polyneuropathy
  • Hematological reactions: leukopenia, megaloblastic and hemolytic anemia

Nitrofurans should not be used in the following conditions:

  • Reactions of hypersensitivity or allergic reactions to nitrofurantoins
  • Renal failure (furazidin, nitrofurantoin)
  • Hepatic failure (furazolidone)
  • Deficiency of G6PD
  • Pregnancy
  • Breastfeeding
  • Infants


Allergic reactions are crossed resistant to all nitrofurans
Pregnancy. Nitrofurans must not be used during pregnancy because of negative effects for the fetus
Breastfeeding. Nitrofurans can pass through breast milk and may cause hemolytic anemia in newborns
Pediatric use. Nitrofurans should not be used in children because of insufficient development of liver enzymes
Geriatric use. Nitrofurans should be used with caution with elderly patients because of increased risk of kidney damage.
Kidney failure. Nitrofurantoin and furazidine are contraindicated for use in renal failure. These medicines may increase the risk of nephrotoxicity.
Hepatic failure. Nitrofurans may cause hepatotoxic action in patients with liver diseases.
Other concomitant diseases. Risk of peripheral polyneuropathy is increased in anemia, diabetes, disorders of water-electrolyte balance, hypovitaminosis B.

Drugs interactions.

  • Quinolones decrease the effectiveness of nitrofurantoin and furazidine
  • Chloramphenicol increases the risk of hematopoiesis suppression
  • Alcohol and Furazolidone may cause significant side effects

Furazolidone when used in combination with MAO inhibitors, sympathomimetics, tricyclic antidepressants, foods containing thyramine may increase the risk of hypertonic crisis © 2020