Bempedoic Acid
Severe
Database
Clinical effect not specified
Source: DDInter
Drug reference
Nalidixic Acid
First-generation quinolone antibacterial · Antibiotic
Also known as NegGram, Wintomylon
START
1 g PO four times daily × 7 days
TYPICAL MAX
4 g/day
STOP IF
Seizure, severe rash/photosensitivity, or haemolysis
WATCH
Renal function, CNS effects, G6PD status, sun exposure
CDSCO approvedSchedule HATC J01MB02
KDIGO 2024 + manufacturer label
- ONSET
- 1h · urinary kill
- PEAK
- 1.5h · Tmax
- t½
- 2h · t½
- DURATION
- 6h · QID interval
EXCRETION
Renal — high urinary concentration
route + CYP
INTERACTIONS
12 major
SEVERE in our sources
PREGNANCY
Avoid, especially at term (haemolysis risk in neonate); use alternatives.
FDA category + note
Top interactionssee all 12 →
- Bempedoic AcidSevereDatabaseDDInter
- BetamethasoneSevereDatabaseDDInter
- BupropionSevereDatabaseDDInter
- BusulfanSevereDatabaseDDInter
Available in India
6 branded formulations. Look up specific brands in the Drugs workspace.
Mechanism
Inhibits bacterial DNA gyrase (topoisomerase II), blocking DNA replication; bactericidal against Gram-negative uropathogens with urinary-tract-limited activity.
Indications
Uncomplicated lower urinary tract infections (Gram-negative)Bacillary dysentery (historical/limited)
Dosing
- Adult
- 1 g PO four times daily for 7 days (acute); reduce to 500 mg QID for prolonged therapy.
- Pediatric
- >3 months: 50 mg/kg/day in 4 divided doses (acute); halve for maintenance.
- Renal adjustment
- Avoid in moderate–severe impairment (inadequate urinary levels + toxicity).
- Hepatic adjustment
- Caution in hepatic impairment (partly hepatically metabolised).
- Geriatric
- Reduce dose; CNS and photosensitivity risk.
- Max dose
- 4 g/day
Pharmacokinetics
Onset
Within hours (urinary bactericidal levels)
Peak effect
1–2 h (Tmax)
Duration
~6 h (QID dosing)
Half-life
1.1–2.5 h (active metabolite longer)
Bioavailability
Well absorbed orally
Protein binding
~90%
Metabolism
Hepatic (active hydroxynalidixic acid)
Excretion
Renal — high urinary concentration
Contraindications
- History of quinolone hypersensitivity
- History of seizures/epilepsy
- G6PD deficiency (haemolysis risk)
- Infants <3 months
- Severe renal impairment
Side effects
Common
NauseaVomitingRashPhotosensitivityHeadacheVisual disturbance
Serious
- Seizures
- Raised intracranial pressure (children)
- Haemolytic anaemia (G6PD)
- Photosensitive bullous reactions
- Tendon disorders (class effect)
Pregnancy & lactation
Pregnancy
Avoid, especially at term (haemolysis risk in neonate); use alternatives.
Lactation
Avoid in G6PD-deficient infants; small amounts in milk.
Drug interactions
Betamethasone
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Bupropion
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Busulfan
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Carmustine
Severe
Database
Drug interaction classified as: synergy
Source: DDInter
Chlorambucil
Severe
Database
Clinical effect not specified
Source: DDInter
Chlorpropamide
Severe
Database
Drug interaction classified as: antagonism
Source: DDInter
Clozapine
Severe
Database
Drug interaction classified as: metabolism
Source: DDInter
Cyclophosphamide
Severe
Database
Clinical effect not specified
Source: DDInter
Dacarbazine
Severe
Database
Clinical effect not specified
Source: DDInter
Deflazacort
Severe
Database
Clinical effect not specified
Source: DDInter
Dexamethasone
Severe
Database
Clinical effect not specified
Source: DDInter
Related guidelines
Urinary tract infection
EAU · Urology · 2024
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IDSA · Infectious Diseases · 2010
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ADA_DENTAL · Dentistry · 2019
Infective endocarditis prevention
ADA_DENTAL · Dentistry · 2015
Preoperative cardiac evaluation for non-cardiac surgery
AHA · Cardiology · 2025
Ask House about Nalidixic Acid
Continue into a citation-backed clinical answer with the drug context already attached.
Sources: KD Tripathi 7e, Goodman & Gilman 14e, Katzung, BNF·Verified: 2026-05-20 · House clinical team·Cockpit curated: 2026-05-20