Diuretics And Nitrofurantoin

[MTbowels]

I went with my dad to his GP a few days ago as he had the classic symptoms of an UTI. The GP has agreed following the analysis of a urine sample my dad provided. He has been prescribed Nitrofurantion 50mg capsules 4 times daily.

This morning, my dad asked a simple enough question that threw me. It was: " won't the diuretics I'm taking every day wash away the antibiotic before it does any good down there?"

He's on 5mg of Bumetanide and 50mg Spironolactone daily.

Thank you.

[Sqad]

What a good question.

Diuretics rid the body of fluid which has passed through the blood stream and the kidneys to get where it is, oedema in the legs and feet.

Antibiotics start to act well before the kidney and diuretic defence as they are absorbed and work in the blood stream.

[Sqad]

Put more simply:

The fluid (oedema) on which diuretics act is produced at the end of a long , long journey in the body. The antibiotics act very early on in that journey.

[Vagus]

Doesn’t nitrofantoin work a bit differently to normal antibiotics though? I’ve had three courses of it lately and it was explained to me that most of it gets filtered out of your blood and into your pee to concentrate the antibiotic where it’s needed.

[Sqad]

Vagus.....maybe, but that wasn't the question.....at least I didn't think it was ;-)

OP's Dad was worried that the diuretics that he is taking for his oedema would "wash away" the antibiotics.
Yes antibiotics are absorbed from the blood stream and concentrated in the pee, but in OP's Dad's case he is worried that they may be passed out in his diuresis before they had time to act.

[MTbowels]

Thank you Sqad.

Vagus, I think that's what concerned my dad too. He's a bit of silver surfer and told me the same this morning! The Internet has a lot to answer for!

[MTbowels]

Sqad, cross posts my apology. Yes, that's exactly what he thought. He is concerned they may be washed away in his pee before they have time to act.

[Vagus]

I know it wasn’t exactly the question but is somewhat related :)
As a total non medical person I think I’d be curious too, to know if it was going to be flushed out too soon if I was taking diuretics. I do like to know how things work, and how to get the best from any meds I take.

[MTbowels]

Sqad, so I take it he shouldn't stop his diuretics whilst he's taking the nitrofurantoin and it will kill the bugs just as effectively?

[Sqad]

Exactly.

[Peter Pedant]

No
I thought might be a good answer

[Peter Pedant]

oh look someone started wondering about medical information on the internet 25 y ago.

1997 Aug 23;315(7106):491. doi: 10.1136/bmj.315.7106.491a.
Internet is useful for information on rare conditions.

and here there is a sqawk on quality ( still crap)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1114339/

and they all say dont believe what you read on the internet

[MTbowels]

Thank you Sqad. You've reassured us both.