Two medicines, side by side
Levofloxacin vs nitrofurantoin
Levofloxacin and nitrofurantoin are both labeled for bacterial infections and urinary tract infections. Drugs@FDA records approvals of levofloxacin since 1996 and of nitrofurantoin since 1953. Pharmacies paid $0.259 per levofloxacin 750 mg tablet and $0.165 per nitrofurantoin mcr 50 mg capsule (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, levofloxacin is a fluoroquinolone antibacterial and nitrofurantoin a nitrofuran antibacterial.
Check it at the source: the levofloxacin FDA label on DailyMed (effective July 10, 2024); the nitrofurantoin FDA label on DailyMed (effective June 24, 2026).
Highlights of the levofloxacin record
Levofloxacin (Levaquin) · label of July 10, 2024
SERIOUS ADVERSE REACTIONS INCLUDING TENDINITIS, TENDON RUPTURE, PERIPHERAL NEUROPATHY, CENTRAL NERVOUS SYSTEM EFFECTS AND EXACERBATION OF MYASTHENIA GRAVIS See full prescribing information for complete boxed warning.
Used for
From the label: indicationsLevofloxacin is a fluoroquinolone antibacterial indicated in adults (18 years of age and older) with infections caused by designated, susceptible bacteria and in pediatric patients where indicated ( 1 , 12.4 ). […]
On the market
- Earliest approval on file
- December 20, 1996
- Generic labelers
- 44 labelers
- Pharmacy cost
- $0.259 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 13
Highlights of the nitrofurantoin record
Nitrofurantoin (Macrobid) · label of June 24, 2026
Used for
From the label: indicationsNitrofurantoin capsules (monohydrate/macrocrystals) are indicated only for the treatment of acute uncomplicated urinary tract infections (acute cystitis) caused by susceptible strains of Escherichia coli or Staphylococcus saprophyticus. Nitrofurantoin is not indicated for the treatment of pyelonephritis or perinephric abscesses. […]
On the market
- Earliest approval on file
- February 6, 1953
- Generic labelers
- 47 labelers
- Pharmacy cost
- $0.165 per capsule
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 13
Source: FDA drug labels via openFDA (Levofloxacin label of July 10, 2024, Nitrofurantoin label of June 24, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do levofloxacin and nitrofurantoin differ on the record?
In FDA's classes, levofloxacin is a fluoroquinolone antibacterial and nitrofurantoin a nitrofuran antibacterial.
How each works, in its label's words: Levofloxacin, “Levofloxacin is a member of the fluoroquinolone class of antibacterial agents [see Microbiology ( 12.4 )].”; Nitrofurantoin, “Mechanism of Action The mechanism of the antimicrobial action of nitrofurantoin is unusual among antibacterials.”
Only the levofloxacin label carries a boxed warning.
Generics: levofloxacin since 2010; nitrofurantoin since 1970 (Drugs@FDA).
| Levofloxacin | Nitrofurantoin | |
|---|---|---|
| Labeled for | Bacterial infections, Urinary tract infections | Urinary tract infections, Bacterial infections |
| Pharmacologic class | Fluoroquinolone Antibacterial | Nitrofuran Antibacterial |
| How it works (label) | Levofloxacin is a member of the fluoroquinolone class of antibacterial agents [see Microbiology ( 12.4 )]. | Mechanism of Action The mechanism of the antimicrobial action of nitrofurantoin is unusual among antibacterials. |
| Half-life (label) | The mean terminal plasma elimination half-life of levofloxacin ranges from approximately 6 to 8 hours following single or multiple doses of levofloxacin given orally or intravenously. | n/a |
| Earliest approval on file (Drugs@FDA) | December 20, 1996 | February 6, 1953 |
| First generic approved | December 20, 2010 | September 30, 1970 |
| Generic labelers (NDC) | 44 labelers | 47 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.259 per tablet (Levofloxacin 750 mg tablet) | $0.165 per capsule (Nitrofurantoin mcr 50 mg capsule) |
| 12-month price change | -11% | -12% |
| Boxed warning | Yes | No |
| Shortage now | No current entry | A presentation being discontinued |
| Recalls recorded | 13 | 13 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 59,954 | 22,755 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What next?
- Alternatives to levofloxacin
- every medicine labeled for the same conditions