Composition
Susp: Per 5 ml: Nalidixic acid 250 mg. Tab 500 mg: Nalidixic acid 500 mg. Caplet 1 gm: Nalidixic acid 1 gm.
Indications & Dosage
Urinary tract infections: Adults: Acute infections; 1 gm four times daily for min 7 day. Chronic infections; 500 mg four times daily. Children 3 months-12 yrs: 12.5 mg/kg 4 times daily for 7 days, reduced to 7.5 mg/kg 4 times daily in prolonged therapy or 15 mg/kg twice daily for prophylaxis; 12-18 yrs: 900 mg 4 times daily for 7 days, reduced in chronic infections to 600 mg 4 times daily. Gastro-intestinal infections due to gram-negative organisms: Adult: 500 mg-1 gm four times daily.
Contraindications
Acute porphyrias, avoid in risk factor for QT interval prolongation such as; acute myocardial infarction, bradycardia, congenital long QT syndrome, electrolyte disturbances, heart failure with reduced left ventricular ejection fraction and history of symptomatic arrhythmias,
Precautions
Caution in liver disease. Use with caution in renal impairment; avoid if eGFR less than 20 ml/minute/1.73m2,anaemia, diabetes mellitus, electrolyte imbalance, pulmonary disease; on long-term therapy, monitor liver function and monitor for pulmonary symptoms, especially in the elderly
Interactions
Anticoagulants, probenecid, antibacterials, caution if concomitant use with other drugs known to prolong the QT interval.
Pregnancy
No evidence of risk in humans
Lactation
Avoid. Risk to infant very small
Side Effects
Cranial nerve palsy, increased intracranial pressure, metabolic acidosis, peripheral neuropathy, toxic psychosis, GI, CNS and visual disturbances, rash-es, blood dyscrasias, convulsions, photosensitivity.