Drug Index

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)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Avoid.

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnlikely to be dialysed. Dose as in GFR<10 mL/min
HDUnlikely to be dialysed. Dose as in GFR<10 mL/min
HDF/High fluxUnlikely to be dialysed. Dose as in GFR<10 mL/min
CAV/VVHDUnknown dialysability. Dose as in normal renal function

Hepatic Dose :

Use with caution. Hepatic dysfunction is reported.
07/10/2024 04:30:24 Nalidixic acid
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