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Nalidixic Acid: Brands, Price & Uses in Bangladesh
Nalidixic Acid is a first-generation quinolone antibacterial indicated for the treatment of urinary tract infections (UTIs) caused by susceptible strains of gram-negative organisms.
About Nalidixic Acid
Indications of Nalidixic Acid
Nalidixic Acid is a first-generation quinolone antibacterial indicated for the treatment of urinary tract infections (UTIs) caused by susceptible strains of gram-negative organisms.
Established/Approved Use
- Uncomplicated urinary tract infections (cystitis, pyelonephritis) caused by susceptible gram-negative bacteria including Escherichia coli, Proteus species, Klebsiella species, and Enterobacter species.
Notes on Use
Nalidixic Acid is an older, narrow-spectrum quinolone that has largely been superseded by newer fluoroquinolones in many countries due to a higher rate of resistance development and a narrower spectrum of activity. It is not effective against Pseudomonas aeruginosa or most gram-positive organisms and should not be used for systemic infections outside the urinary tract. Use should be guided by local susceptibility patterns and, where possible, urine culture and sensitivity testing.
Dosage & Administration of Nalidixic Acid
Dosage by Indication
| Population | Indication | Dose |
|---|---|---|
| Adults | Acute uncomplicated UTI | 1 g orally four times daily (every 6 hours) for 1–2 weeks |
| Adults | Prolonged/chronic therapy | May be reduced to 500 mg four times daily (approximately 2 g/day) if treatment beyond 2 weeks is required |
| Children over 3 months | UTI | Approximately 13.75 mg/kg every 6 hours (about 55 mg/kg/day) in divided doses for 1–2 weeks; may be reduced to about half this dose for maintenance therapy of prolonged treatment |
| Infants under 3 months | — | Not recommended (see Contraindications) |
Administration
- May be taken with or without food; taking with food may reduce gastrointestinal upset.
- Antacids and products containing aluminum, magnesium, calcium, iron, or zinc should be separated from Nalidixic Acid dosing by at least 2 hours, as they reduce absorption.
- A full course should be completed even if symptoms improve early.
Take exactly as prescribed by your physician; do not stop, extend, skip doses, or share this medicine with others without medical advice.
Side Effects of Nalidixic Acid
Common
- Gastrointestinal upset (nausea, vomiting, diarrhea, abdominal discomfort)
- Headache, dizziness, drowsiness, weakness
- Photosensitivity (skin reaction to sunlight/UV light)
Less Common
- Visual disturbances (blurred vision, altered color perception, diplopia)
- Allergic/hypersensitivity skin reactions (rash, pruritus)
- Arthralgia, myalgia
Rare but Serious
- Seizures/convulsions, especially in patients with predisposing CNS conditions (see Contraindications)
- Hemolytic anemia in patients with G6PD deficiency (see Contraindications)
- Hepatotoxicity (jaundice, elevated liver enzymes)
- Increased intracranial pressure (pseudotumor cerebri), particularly in children
- Severe hypersensitivity reactions including anaphylaxis
- Clostridioides difficile-associated diarrhea/colitis
Patients should seek prompt medical attention for severe rash, difficulty breathing, seizures, severe diarrhea, or signs of liver problems (yellowing of skin/eyes, dark urine).
Contraindications of Nalidixic Acid
Nalidixic Acid is contraindicated in:
- Patients with known hypersensitivity to Nalidixic Acid or other quinolone antibacterials.
- Patients with a history of seizure disorders/epilepsy (established CNS-lowering-seizure-threshold contraindication).
- Infants under 3 months of age.
- Patients with known glucose-6-phosphate dehydrogenase (G6PD) deficiency, due to risk of hemolysis.
Frequently Asked Questions about Nalidixic Acid
What is Nalidixic Acid used for?
Nalidixic Acid is used to treat urinary tract infections (UTIs) caused by susceptible gram-negative bacteria such as E. coli, Proteus, Klebsiella, and Enterobacter species. It is an older, narrow-spectrum quinolone antibiotic and is not used for infections outside the urinary tract.
How should I take Nalidixic Acid?
Take Nalidixic Acid exactly as prescribed by your physician, usually every 6 hours, with or without food. Complete the full course even if you feel better early. Do not stop, extend, skip doses, or share this medicine with others without medical advice. Avoid taking antacids or mineral supplements within 2 hours of your dose, as they can reduce absorption.
Can Nalidixic Acid be taken during pregnancy or while breastfeeding?
Nalidixic Acid should generally be avoided during pregnancy because quinolone antibacterials have shown effects on developing cartilage in animal studies; it should only be used if clearly needed and the potential benefit justifies the potential risk to the fetus, under medical advice. Nalidixic Acid is excreted in breast milk and has been linked to hemolytic anemia in nursing infants, so breastfeeding is generally not recommended during treatment; consult your physician.
Who should not take Nalidixic Acid?
Nalidixic Acid should not be taken by people with a known allergy to Nalidixic Acid or other quinolone antibiotics, people with a history of seizure disorders (epilepsy), infants under 3 months of age, or people with G6PD deficiency, due to risk of hemolysis.
What are the common side effects of Nalidixic Acid?
Common side effects of Nalidixic Acid include nausea, vomiting, diarrhea, headache, dizziness, drowsiness, and photosensitivity (increased sensitivity to sunlight). Less common but serious effects include visual disturbances, seizures (especially in predisposed individuals), hemolytic anemia in G6PD-deficient patients, and liver problems. Seek medical attention promptly for severe reactions.
What should I do if I miss a dose or take too much Nalidixic Acid?
If you miss a dose of Nalidixic Acid, take it as soon as you remember unless it is almost time for the next dose; do not double up. If you or someone else has taken too much Nalidixic Acid and shows symptoms such as severe drowsiness, confusion, or seizures, seek immediate medical attention or contact a poison control center right away.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.