Can You Crush Nitrofurantoin?

Written by

Jessica Guht

Jessica is a medical writer with an unquenched thirst to discover something new. She believes that medical content should be accessible to everyone and strives to write content that every single person can understand. When Jessica isn’t writing, she can usually be found reading a book with a dog cuddled in her lap. Jessica has a Masters of Engineering degree in Biomedical Engineering.

Medically reviewed by

Amy Dougherty, FNP-BC, AGAC

Amy is a Board Certified Family Health Nurse Practitioner (FNP) with over 15 years of experience working in Hospital Medicine, Urgent Care and Primary Care practices. Amy graduated Thomas Jefferson University with high distinction earning a Bachelor of Science in Nursing in 2008, a Master of Science in Nursing in 2010 and a Post Master's Certificate in Adult Gerontology Acute Care (AGAC) in 2014. She was recognized by the Elite American Nurses Association in 2013 for her dedication, achievements and leadership in the field Nursing. She served as a clinical preceptor for a number of Nurse Practitioner students and enjoys teaching the bright minds of future NPs.

We’ve all been prescribed pills before and wondered how we’re possibly going to be able to swallow them. Whether because of the size of your pill or any conditions you have that make swallowing difficult, it can interfere with your ability to take medication. 

In this situation, it may seem logical to crush up the medication and sprinkle it on your food or drink, but this isn’t always a good option. Sometimes, doing this can influence how effective your medication is, such as with nitrofurantoin. 

You should not crush nitrofurantoin, as it can impact its absorption and effectiveness. Continue reading to learn more about why this is and what other options are available.

Key Takeaways:

• You should not crush, chew, or open nitrofurantoin capsules or tablets.
• Nitrofurantoin has an enteric coating to protect it from stomach acid; crushing it removes these protections.
• The enteric coating is essential for ensuring that nitrofurantoin reaches the bladder effectively. 
• Crushing the medication can result in its destruction by stomach acid before it reaches its target area.
• Crushing nitrofurantoin may also cause some irritation to your stomach, producing unpleasant symptoms. 
• If you are having trouble taking nitrofurantoin in its pill form, consult with your doctor for alternative options.

Table of Contents

• About Crushing Oral Medication
• Can You Crush Nitrofurantoin?
• When to See a Doctor?
• In Conclusion

About Crushing Oral Medication

Some medications come in rather large pills that can seem difficult to swallow, and in these cases, it seems like it would be a smart idea to crush the pill. All you’re doing is breaking it up so you can still take it; it’s the same otherwise, right? Unfortunately, that isn’t always the case. 

Medications that come as a pill or tablet are designed this way for a specific reason. There’s a lot of engineering put into a medication’s formulation because its design affects its absorption into your body. By crushing a pill, you interfere with this carefully calculated design.

For instance, some medications have a coating that controls the release of the drug, slowing it down so that it is not destroyed by the acid in your stomach so quickly. By crushing the pill, you remove the protection of this coating, which can result in a suboptimal therapeutic effect. 

Similarly, some medications are designed in such a way that slows down their release, such as the case with extended-release tablets. By crushing these pills, you significantly increase the amount of the medication in your body at one time, which can cause serious side effects and unpleasant symptoms. 

Beyond these more serious results, crushing a pill may also make it harder to take because you remove the coating that hides the unpleasant take of the medication. While it is generally safe to crush these pills with a sugar or film coating to mask the flavor, you may not want to. 

That being said, it can be hard to tell, especially by looking, what type of coating a pill has, whether it’s only a sugar coating to hide the taste or an enteric coating to protect it from the stomach’s acidic environment. Because of this, you can’t just look at a drug to determine if you can crush it; you need to look into the guidelines for each medication. 

Can You Crush Nitrofurantoin?

Nitrofurantoin is an antibiotic prescribed to treat urinary tract infections and goes by the brand name Macrobid. It is available as a tablet, capsule, or liquid—for the former two options, they should be taken whole and should not be crushed or broken beforehand. 

Nitrofurantoin contains an enteric coating that protects the contents, or the antibiotic itself, from stomach acid. If you crush the pill, this coating will no longer be in place, and the medication will no longer have this protection. 

The appeal of nitrofurantoin for treating UTIs is that it collects in the bladder, but if it is crushed, it will be destroyed by stomach acid before it has a chance to reach the bladder. 

Furthermore, if nitrofurantoin is crushed, it may cause some irritation to your stomach, producing unpleasant symptoms. 

When to See a Doctor?

If you cannot take nitrofurantoin in its pill form, ask your doctor if an alternative option is available. For example, nitrofurantoin also comes as a liquid so that you do not have to worry about swallowing a pill. 

Additionally, if you’re ever unsure if it is okay to crush medication, ask your doctor. 

In Conclusion

Nitrofurantoin is an antibiotic prescribed for UTIs that contains an enteric coating to protect the medication from stomach acid. Because of this coating, nitrofurantoin should not be crushed, and doing so will cause the medication to be less effective. In some cases, it may even irritate your stomach. 

If you struggle to swallow your nitrofurantoin, it is available as a liquid; reach out to your doctor to enquire about this option. Furthermore, if you are ever unsure about if it is safe to crush your medication, ask your doctor or pharmacist. 

Key Takeaways:

• You should not crush, chew, or open Nitrofurantoin capsules or tablets.
• Nitrofurantoin has an enteric coating to protect it from stomach acid; crushing it removes these protections.
• The enteric coating is essential for ensuring that nitrofurantoin reaches the bladder effectively. 
• Crushing the medication can result in its destruction by stomach acid before it reaches its target area.
• Crushing nitrofurantoin may also cause some irritation to your stomach, producing unpleasant symptoms. 
• If you are having trouble taking nitrofurantoin in its pill form, consult with your doctor for alternative options.

Sources:

• Squadrito FJ, del Portal D. Nitrofurantoin. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470526/ 
• McGarry, M. R., Wagner, M. W., & Wall, B. M. (2021). Systemic Inflammatory Response Syndrome Secondary to Nitrofurantoin. Journal of investigative medicine high impact case reports, 9, 2324709620984610. https://doi.org/10.1177/2324709620984610 
• Malik, R. D., Wu, Y. R., Christie, A. L., Alhalabi, F., & Zimmern, P. E. (2018). Impact of Allergy and Resistance on Antibiotic Selection for Recurrent Urinary Tract Infections in Older Women. Urology, 113, 26–33. https://doi.org/10.1016/j.urology.2017.08.070 
• Salawi A. (2022). Pharmaceutical Coating and Its Different Approaches, a Review. Polymers, 14(16), 3318. https://doi.org/10.3390/polym14163318 
• Felton, L. A., & Porter, S. C. (2013). An update on pharmaceutical film coating for drug delivery. Expert opinion on drug delivery, 10(4), 421–435. https://doi.org/10.1517/17425247.2013.763792