NALIGYL 250MG 250MG TABLET

Indications

• Urinary tract infections
• Cystitis
• Pyelonephritis

Dosage

Children: Refer to BNF for Children for specific dosing recommendations for paediatric patients.

Adults: Refer to BNF for specific dosing recommendations. Generally, the dosage for adults may vary based on the infection severity and clinical response.

Mechanism of action

Nalidixic acid's active metabolite, hydroxynalidixic acid, binds reversibly to DNA, disrupting RNA synthesis, which in turn inhibits protein synthesis. This mechanism effectively interferes with bacterial DNA synthesis, leading to its bactericidal effects.

Pharmacodynamics

Nalidixic acid demonstrates significant antibacterial activity against gram-negative bacteria, including Enterobacter species, Escherichia coli, Morganella morganii, Proteus mirabilis, Proteus vulgaris, and Providencia rettgeri. It is generally less effective against Pseudomonas species, which are typically resistant. The drug shows a bactericidal action and is effective across the entire urinary pH range. Resistance can develop in a small percentage of patients during treatment, but this resistance is not transferable via R factor.

Pharmacokinetics

Nalidixic acid is rapidly absorbed from the gastrointestinal tract and reaches peak plasma concentrations within 1 to 2 hours post-administration. Its plasma half-life is approximately 1 to 2 hours. The drug is primarily excreted unchanged in the urine, allowing for high concentrations in the urinary tract, which is beneficial for treating urinary infections.

Adverse effects

• Nausea
• Vomiting
• Diarrhea
• Dizziness
• Headache
• Rash
• Tendon damage

Precautions

• Use with caution in patients with renal impairment
• Monitor for signs of tendon damage
• Caution in patients with a history of seizures

Pregnancy

The safety of nalidixic acid during pregnancy has not been established. It should be used only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

Nalidixic acid is excreted in breast milk. Caution should be exercised when administered to nursing mothers.

Storage

Store in a cool, dry place away from light. Keep out of reach of children.

Formulations

• Tablets
• Oral suspension

Mechanism of action

Evidence exists for Nalidixic acid that its active metabolite, hydroxynalidixic acid, binds strongly, but reversibly, to DNA, interfering with synthesis of RNA and, consequently, with protein synthesis. IT APPEARS TO ACT BY INHIBITING DNA SYNTH.

Pharmacodynamics

Nalidixic acid is a quinolone antibacterial agent for oral administration. Nalidixic acid has marked antibacterial activity against gram-negative bacteria including <i>Enterobacter</i> species, <i>Escherichia coli</i>, <i>Morganella Morganii</i>; <i>Proteus Mirabilis</i>, <i>Proteus vulgaris</i>, and <i>Providencia rettgeri</i>. <i>Pseudomonas</i> species are generally resistant to the drug. Nalidixic acid is bactericidal and is effective over the entire urinary pH range. Conventional chromosomal resistance to nalidixic acid taken in full dosage has been reported to emerge in approximately 2 to 14 percent of patients during treatment; however, bacterial resistance to nalidixic acid has not been shown to be transferable via R factor.