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Nitrofurantoin safety alert — GPhC CRA MCQ

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HardAdverse Drug Reactions and Drug SafetyNitrofurantoin safety alertGPhC CRA

A patient on long-term nitrofurantoin prophylaxis reports yellowing of the eyes and dark urine. They also have new shortness of breath. What is the most appropriate action?

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Correct answer: E — Stop and refer urgently for possible hepatic or pulmonary toxicity assessment

Nitrofurantoin can cause serious hepatic and pulmonary adverse reactions, especially with long-term use. Jaundice, dark urine and breathlessness require urgent medical assessment and review of the medicine. Reassurance or dose escalation would be unsafe. The reaction should also be reported if suspected.

Reference: MHRA Drug Safety Update; BNF