Nalidixic acid
Mechanism :
It is an antibacterial agent with good gram-negative action. It is used in the treatment of urinary tract infections, diarrhea and dysentery.
Indication :
- Lower urinary tract infections due to gram negative organisms such as E. Coli, Klebsiella, Proteus.
Contraindications :
Hypersensitivity, Infants <3 years old, Treatment of febrile patients in whom renal involvement is likely, Porphyria.
Dosing :
55 mg/kg/day in 3-4 divided doses PO.
Adverse Effect :
Drowsiness, weakness, headache and vertigo, double vision, skin rash, blood dyscrasias, convulsions, raised intracranial tension and photosensitivity.
Interaction :
CYP 1A2 inhibitor: Antacids; Sucralfate; Iron; Multivitamins containing zinc; Didanosine; NSAIDS;
Theophylline: Nalidixic acid decreases theophylline.
Melphalan: Increases incidence of severe hemorrhagic colitis.
Warfarin: Increases anticoagulant effect.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
20-50 | Dose as in normal renal function |
10-20 | Dose as in normal renal function |
<10 | Avoid. |
Dose in Patients undergoing Renal Replacement Therapies
CAPD | Unlikely to be dialysed. Dose as in GFR<10 mL/min |
HD | Unlikely to be dialysed. Dose as in GFR<10 mL/min |
HDF/High flux | Unlikely to be dialysed. Dose as in GFR<10 mL/min |
CAV/VVHD | Unknown dialysability. Dose as in normal renal function |
Hepatic Dose :
Use with caution. Hepatic dysfunction is reported.