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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35432
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I was switched from Levaquin to Nitrofurantoin for a

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Good evening,
I was switched from Levaquin to Nitrofurantoin for a UTI/Polyphrenitis. I am a cancer patient (multiple myeloma) with both a low white blood cell and red blood cell count along with neutropenia.
WBC 2.6
RBC 3.10
I went to the ER due to hyponatremia as sodium was 123 and chloride was 90. I was given 1000 NS 0.9% 1000ml.
I noticed that the new medication Nitrofuraintoin is contraindicated in individuals with anemia and electrolyte imbalances. Should I be concered about taking this medication?
Hello Eleanor,

Yes, you should again discuss this change of medication with your doctor. Anemia and electrolyte disturbance are relative contraindications for Nitrofurantoin. So your doctor may get a culture test of urine; if was not performed earlier. The culture test tells about the best antibiotic to eradicate the infection. Your doctor may continue Nitrofurantoin if it has shown to be sensitive for your bacteria causing the infection. In that case a weekly monitoring of your counts, anemia profile and electrolytes would be done.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

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Customer: replied 5 years ago.

I tried contacting the ER doctor that saw me, but she has finished her shift. Should I continue with the old medication for now until I can reach her tomorrow?




What was the reason given for stopping the Levaquin?

Dr. Arun
Customer: replied 5 years ago.

I am not sure. I am thinking maybe it because I was experiencing some diarrhea or perhaps due to by low WBC count. I have purchased some Pedialyte to help with the electrolyte imbalance. Is there anything else I can drink to help bring my sodium and chloride levels up?


You may continue, Levaquin, till you are able to contact the doctor. Following would help in diarrhea and electrolyte imbalance, till than;

1) Gatorade / Pedialyte
2) Plenty of fluids
3) BRAT diet; banana, rice, applesauce, toast. Vegetable broths / vegetable soups, coconut water also can help.
4) Probiotics

It is privilege assisting you.

Dr. Arun
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