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Nitrofurantoin pulmonary toxicity — GPhC CRA MCQ

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HardAdverse Drug Reactions and SafetyNitrofurantoin pulmonary toxicityGPhC CRA

A 73-year-old woman started nitrofurantoin prophylaxis 6 months ago and now reports progressive breathlessness and dry cough. Oxygen saturation is 94%, chest examination has fine basal crackles and she has no fever. What is the most appropriate action?

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Correct answer: D — Refer for urgent review of possible nitrofurantoin lung toxicity

Long-term nitrofurantoin can cause pulmonary toxicity, including chronic interstitial lung disease. Progressive breathlessness, dry cough and crackles without infection features are concerning. The medicine should be reviewed urgently and respiratory assessment arranged.

Reference: BNF; MHRA Drug Safety Update