Nalid
Generic Name
Nalidixic Acid 300 mg/5 ml Suspension
Manufacturer
Generic Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| nalid 300 mg suspension | ৳ 41.75 | N/A |
Description
Overview of the medicine
Nalidixic acid is an older-generation quinolone antibiotic used to treat urinary tract infections (UTIs) caused by susceptible Gram-negative bacteria. It is particularly effective for infections localized in the urinary system.
Uses & Indications
Dosage
Adults
Adults: Usually 1 g (approx. 16.7 ml of 300 mg/5 ml suspension) four times daily for 7-14 days. This suspension strength is often preferred for pediatric use.
Elderly
Elderly: Dosage adjustment may be required based on renal function. Caution advised due to increased susceptibility to adverse effects.
Renal_impairment
Renal impairment: Dose reduction is necessary in patients with mild to moderate renal impairment. Contraindicated in severe renal impairment (creatinine clearance <20 ml/min).
How to Take
Administer orally with or without food. Taking with food may help reduce gastrointestinal upset. Ensure the suspension is well shaken before use. Use a measuring spoon or cup for accurate dosing.
Mechanism of Action
Nalidixic acid inhibits bacterial DNA gyrase and topoisomerase IV enzymes, which are crucial for bacterial DNA replication, transcription, repair, and recombination. By blocking these enzymes, it prevents bacterial growth and leads to bacterial cell death.
Pharmacokinetics
Onset
Clinical effects are typically observed within 1-2 hours of administration.
Excretion
Primarily excreted in the urine (approximately 80% within 24 hours), with a small amount excreted in feces.
Half life
Plasma half-life of the parent drug is 1-2.5 hours; the active hydroxymetabolite has a half-life of about 6-7 hours.
Absorption
Rapidly and well absorbed from the gastrointestinal tract (about 96%). Peak plasma concentrations are reached within 1-2 hours.
Metabolism
Extensively metabolized in the liver to an active hydroxymetabolite and inactive glucuronide conjugates.
Side Effects
Contraindications
- Hypersensitivity to nalidixic acid or any quinolone antibiotic.
- History of convulsive disorders or epilepsy.
- Severe renal or hepatic impairment.
- Infants less than 3 months of age.
- Patients with G6PD deficiency (risk of hemolytic anemia).
Drug Interactions
Probenecid
May decrease the renal excretion of nalidixic acid, leading to increased plasma levels and potential toxicity.
Nitrofurantoin
May antagonize the antibacterial effect of nalidixic acid, concomitant use is not recommended.
Anticoagulants (e.g., Warfarin)
May enhance the anticoagulant effect, requiring close monitoring of INR and dose adjustment.
Antacids (containing magnesium/aluminum), Iron, Zinc
These agents can chelate nalidixic acid, reducing its absorption. Administer at least 2 hours apart.
Storage
Store below 30°C in a dry place. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, abdominal pain, and CNS effects such as headache, dizziness, confusion, and convulsions. Management involves gastric lavage, supportive care, and ensuring adequate fluid intake. Diazepam may be used for convulsions.
Pregnancy & Lactation
Pregnancy Category C. Nalidixic acid should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in breast milk; therefore, use in lactating mothers should be avoided or breast-feeding discontinued.
Side Effects
Contraindications
- Hypersensitivity to nalidixic acid or any quinolone antibiotic.
- History of convulsive disorders or epilepsy.
- Severe renal or hepatic impairment.
- Infants less than 3 months of age.
- Patients with G6PD deficiency (risk of hemolytic anemia).
Drug Interactions
Probenecid
May decrease the renal excretion of nalidixic acid, leading to increased plasma levels and potential toxicity.
Nitrofurantoin
May antagonize the antibacterial effect of nalidixic acid, concomitant use is not recommended.
Anticoagulants (e.g., Warfarin)
May enhance the anticoagulant effect, requiring close monitoring of INR and dose adjustment.
Antacids (containing magnesium/aluminum), Iron, Zinc
These agents can chelate nalidixic acid, reducing its absorption. Administer at least 2 hours apart.
Storage
Store below 30°C in a dry place. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include nausea, vomiting, abdominal pain, and CNS effects such as headache, dizziness, confusion, and convulsions. Management involves gastric lavage, supportive care, and ensuring adequate fluid intake. Diazepam may be used for convulsions.
Pregnancy & Lactation
Pregnancy Category C. Nalidixic acid should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in breast milk; therefore, use in lactating mothers should be avoided or breast-feeding discontinued.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from the date of manufacture. Refer to the product label for specific expiry date.
Availability
Pharmacies
Approval Status
Approved (internationally since 1964, widely available)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Most clinical data for nalidixic acid is historical, established through trials conducted in the 1960s and subsequent decades, confirming its efficacy and safety profile for UTIs.
Lab Monitoring
- Renal function tests (e.g., serum creatinine, BUN) for patients with renal impairment or prolonged therapy.
- Liver function tests for patients with hepatic impairment or prolonged therapy.
- Complete blood count (CBC) for prolonged therapy, especially in G6PD deficient patients.
Doctor Notes
- Emphasize the importance of completing the full course of therapy to prevent resistance and relapse.
- Counsel patients on potential photosensitivity and advise protective measures.
- Monitor patients for CNS effects, especially those with a history of seizures or predisposing factors.
- Consider renal function adjustments in elderly patients or those with impaired kidney function.
Patient Guidelines
- Complete the entire course of medication, even if symptoms improve, to prevent recurrence and resistance.
- Do not share this medication with others, even if they have similar symptoms.
- Report any unusual or severe side effects to your doctor immediately.
- Avoid excessive exposure to sunlight or artificial UV light, as this medication can increase photosensitivity.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
Driving Precautions
Nalidixic acid may cause dizziness, drowsiness, or visual disturbances. Patients should exercise caution when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain good hydration by drinking plenty of fluids.
- Practice good personal hygiene to prevent UTIs.
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