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UTI Treatment

This treatment plan reviews the risks and benefits of the treatment we are recommending. Please make sure to read it and the manufacturer's pamphlet that comes with the medicine. The manufacturer's pamphlet contains the full information on interactions, side effects, and other important information you should know about the medicine before you start.

Instructions

You have stated that you wish to take a medication for your symptoms of Urinary Tract Infection (bladder infection, UTI). The medication you have been prescribed is Nitrofurantoin, which you are to take 1 Tablet (100mg) 2 times each day (morning and evening) for 7 days. This medication is used to kill the infection of bacteria growing in your urinary bladder. >90% of these infections are caused by E. coli and are due to the proximity of the female urethra (urine tube) to the end of the gastrointestinal (GI) tract.

Signs of this infection include burning with urination, foul-smelling urine without itching or vaginal discharge. You may experience fullness or tenderness of the lower abdomen, more frequent need to use the restroom, or a sensation of being unable to fully empty your bladder. A slight pink or red tinge to the urine can be common, but bleeding is not and should be addressed immediately with an in-person physician.

Refills

You may request a refill by logging into your Account (Subscriptions > Next Refill). If you placed a one-time order, please order as normal.

If your symptoms aren't getting better after you start taking the medicine or if you develop new or worsening symptoms such as fever, chills, nausea, vomiting, or pain, in the mid to upper back, you should see a doctor in-person immediately. More than 3 UTIs in a year should also be managed in person with testing and a referral to Urology to identify potential underlying causes.

Active Ingredients

This medicine contains the following active ingredients. If you are allergic to any of these components, similar components, or any of the others components listed in the manufacturer's pamphlet do not take it and call or message us immediately:

• Nitrofurantoin
  
  

Conditions

We have evaluated your health history and the specific health information you provided us, however if anything changes and you develop or discover that one of these conditions applies to you please stop taking this medicine and call or message us immediately:

• Pregnancy
• Breastfeeding
• Central nervous system problems
• Liver problems
• Kidney problems
• Low urine output
• Anemia
• Diabetes
• G6PD deficiency
• Fever greater than 100.4 F
  
  

Pregnancy and Breastfeeding

Oral nitrofurantoin can potentially cause birth defects if taken in the first trimester of pregnancy. It is not recommended for use during early breastfeeding due to the potential for side effects in the infant. All pregnant women with UTIs are considered high risk and should be seen in person for management.

Emergency Side Effects

This medicine can cause dangerous and potentially life threatening side effects. If any of the emergency side effects listed in the manufacturer's pamphlet or those below happen to you please stop taking the medicine and call 911 or seek immediate medical help in-person:

• Easy bruising or bleeding
• Difficulty swallowing or throat swelling
• Jaundice or yellow skin
• Difficulty breathing
• Liver and kidney disease
• Severe skin rash or changes
• Severe weakness or fatigue
• Heart palpitations or chest pain
• Vision problems
• Problems with balance
• Bloody diarrhea
• Abdominal pain
• Psychosis
  
  

Other Side Effects

This medicine can also cause other side effects. If any of the other side effects listed in the manufacturer's pamphlet or those below happen to you please stop taking the medicine and call or message us or see your doctor in-person:

• Flatulence
• Loss of appetite
• Depression
• Lightheadedness or passing out
• Nausea or vomiting
• Fever
• Hair loss
• Itching
• Muscle aches
• Headaches

NOTE: This medication does not cause vaginal yeast infections

Medicines, Supplements, and Foods

We have evaluated your health history and the specific health information you provided us, however, if anything changes and you start or discover that you are taking any of the medicines, foods, or supplements listed below call or message us before you take the medicine. Some of these can cause dangerous interactions with the medicine we are prescribing you and we will help you evaluate that risk and decide on an appropriate treatment plan:

• HIV medications
• Birth control (all hormonal)
• Narcotic pain medications
• Anesthetics
• Immunosuppressants
• Nitrates
  
  

Accurate Information

We have evaluated the specific health information you provided and are making our recommendations based on it. If you forgot to provide or incorrectly provided that information we may misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. If you need to clarify or update any information about your health you can message or call us anytime.

Treatment Failure

This treatment is not 100% effective. It may not work or may only partially resolve the condition for which you are seeking treatment. If the treatment is not working, or if you are experiencing new or worsening symptoms, give us a call or message us anytime. If it is an emergency call 911 or seek immediate medical help in-person. You may need to seek alternative treatment such as those listed below or in the follow-up plan.

Misdiagnosis or Delayed Diagnosis

There is also a risk that we will misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. This risk exists with a doctor in-person as well but they may have additional signs and symptoms to aid their evaluation. We use the evidence-based practice and guidelines as well as clinical decision support to try to minimize these risks. Here are some other diagnoses that we attempt to rule out:

• Sexually Transmitted Infections (STIs)
• Yeast infection
• Bacterial Vaginosis (BV)
• Kidney infection/pyelonephritis
  
  

Accepting or Declining Our Recommendation

We are recommending this treatment for you because the potential benefits of treatment outweigh the risks. You should evaluate this information as well as the manufacturer's pamphlet, and any input from your in-person healthcare team or other relevant information to decide if this treatment plan is appropriate for you. You are free to decline our treatment recommendations although, doing so may prolong symptoms and can be associated with other risks or negative outcomes.

Alternative Treatment

We have based our recommendation on your specific case and medical guidelines, but there may be alternative treatments or strategies that may be helpful to you. Some may be more or less effective than what we provide. Some treatments may require an in-person exam or procedure which we can't provide. Message us or talk to your doctor in person to discuss alternative treatments. Here are some other treatments or strategies that you might consider:

• In-person exam with urine sample testing
  
  

Share with Your In-Person Healthcare Team

You can access your records anytime. We strongly recommend that you update your in-person doctor, pharmacist, and the rest of your healthcare team to let them know about any new medicines you are taking or other changes in your health.

You can also ask us questions anytime and we are happy to help you share any information about your health with your in-person healthcare team.