Two medicines, side by side
Nitrofurantoin vs azithromycin
Nitrofurantoin and azithromycin are both labeled for bacterial infections. Drugs@FDA records approvals of nitrofurantoin since 1953 and of azithromycin since 1991. Pharmacies paid $0.165 per nitrofurantoin mcr 50 mg capsule and $0.266 per azithromycin 250 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. Azithromycin's other strengths are brand-only: $98.51 per mL (Azasite 1% eye drops). In FDA's classes, nitrofurantoin is a nitrofuran antibacterial and azithromycin a macrolide antimicrobial.
Check it at the source: the nitrofurantoin FDA label on DailyMed (effective June 24, 2026); the azithromycin FDA label on DailyMed (effective December 4, 2025).
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
Highlights of the azithromycin record
Azithromycin (Zithromax) · label of December 4, 2025
Used for
From the label: indicationsAzithromycin tablets are macrolide antibacterial drug indicated for the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms in the specific conditions listed below. […]
On the market
- Earliest approval on file
- November 1, 1991
- Generic labelers
- 55 labelers
- Pharmacy cost
- $0.266 per tablet
Supply and safety
- Shortage
- A presentation being discontinued
- Recalls
- 11
Source: FDA drug labels via openFDA (Nitrofurantoin label of June 24, 2026, Azithromycin label of December 4, 2025); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do nitrofurantoin and azithromycin differ on the record?
In FDA's classes, nitrofurantoin is a nitrofuran antibacterial and azithromycin a macrolide antimicrobial.
How each works, in its label's words: Nitrofurantoin, “Mechanism of Action The mechanism of the antimicrobial action of nitrofurantoin is unusual among antibacterials.”; Azithromycin, “Azithromycin is a macrolide antibacterial drug. [see Microbiology ( 12.4 )]”
Generics: nitrofurantoin since 1970; azithromycin since 2005 (Drugs@FDA).
| Nitrofurantoin | Azithromycin | |
|---|---|---|
| Labeled for | Urinary tract infections, Bacterial infections | Bacterial infections |
| Pharmacologic class | Nitrofuran Antibacterial | Macrolide Antimicrobial |
| How it works (label) | Mechanism of Action The mechanism of the antimicrobial action of nitrofurantoin is unusual among antibacterials. | Azithromycin is a macrolide antibacterial drug. [see Microbiology ( 12.4 )] |
| Half-life (label) | n/a | Elimination Plasma concentrations of azithromycin following single 500 mg oral and IV doses declined in a polyphasic pattern resulting in a mean apparent plasma clearance of 630 mL/min and terminal elimination half-life … |
| Earliest approval on file (Drugs@FDA) | February 6, 1953 | November 1, 1991 |
| First generic approved | September 30, 1970 | November 14, 2005 |
| Generic labelers (NDC) | 47 labelers | 55 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.165 per capsule (Nitrofurantoin mcr 50 mg capsule) | $0.266 per tablet (Azithromycin 250 mg tablet) |
| 12-month price change | -12% | -26% |
| Boxed warning | No | No |
| Shortage now | A presentation being discontinued | A presentation being discontinued |
| Recalls recorded | 13 | 11 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 22,755 | 59,712 |
| 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 nitrofurantoin
- every medicine labeled for the same conditions