Risks of Macrobid in Patients with Small Fiber Neuropathy

Patient Risk Factors

Patients with diabetes mellitus are at an increased risk of nitrofurantoin-induced neuropathy 1
Vitamin B deficiency is a risk factor for nitrofurantoin-induced neuropathy 1

Assessment of small-fiber function, including pinprick and temperature sensation, is essential in patients with small fiber neuropathy taking nitrofurantoin 1
Large-fiber function, including vibration sensation using a 128-Hz tuning fork, should be monitored in patients with small fiber neuropathy taking nitrofurantoin 1
Protective sensation, using 10-g monofilament testing, should be assessed in patients with small fiber neuropathy taking nitrofurantoin 1

Patients with small fiber neuropathy taking nitrofurantoin should be monitored for development or worsening of pain and dysesthesia (unpleasant sensations of burning and tingling) 1
Numbness is a potential symptom of nitrofurantoin-induced neuropathy in patients with small fiber neuropathy 1
Autonomic symptoms, such as orthostatic hypotension and gastrointestinal disturbances, may indicate progression of neuropathy in patients with small fiber neuropathy taking nitrofurantoin 1

Gabapentin may be considered as a first-line option for treating neuropathic pain in patients with small fiber neuropathy 2