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Pharmacology · Drugs and Prescriptions

Nitroxoline

Nitroxolinum

Nitroxoline is a synthetic antibacterial agent, a derivative of 8-hydroxyquinoline. The drug has a pronounced bacteriostatic effect and is predominantly used for the treatment of infectious and inflammatory diseases of the urinary tract.

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Pharmacological group8-Hydroxyquinoline derivatives
Spectrum of activityBroad: gram-positive and gram-negative bacteria, fungi, protozoa
PharmacokineticsExcreted by the kidneys unchanged, creating high concentrations in the urine
Dosage form0.05 g tablets
How to write a prescription
Rp.: Tab. Nitroxolini 0,05
D.t.d. N 50
S. Внутрь по 2 таблетки (0,1 г) 4 раза в сутки во время еды

Other spelling variants: Tabulettas Nitroxolini 0.05; Tab. Nitroxolini 0.05 obductas; Tab. "5-NOK" 0.05

Dosage form
Tab. 0.05 g
Administration
Orally 0.1 g 3–4 times a day (maximum daily dose 0.8 g)
Group
Sulfonamides, quinolone and 8-hydroxyquinoline derivatives
2 min readFor medical studentsUpdated 09/24/2026
Material prepared by WhiteCoat Pro editorial team based on platform study guidesReviewed by medical editor: Aulov A. A., general practitioner · 09/24/2026

Mechanism of action

Nitroxoline exerts a bacteriostatic effect through two main mechanisms. First, it selectively inhibits bacterial DNA synthesis. Second, the drug exhibits properties of a chelator: it forms stable complexes with metal ions, which are cofactors of microbial cell enzymes, thereby blocking their function and disrupting the pathogen's metabolism.

Pharmacological effects

The drug is active against a wide range of pathogens:

  • Gram-positive: Staphylococcus spp., Streptococcus spp. (including enterococci and pneumococci), diphtheria agent.
  • Gram-negative: Escherichia coli, Proteus spp., Klebsiella spp., Salmonella spp., Shigella spp., Enterobacter spp.
  • Others: Mycobacterium tuberculosis, Trichomonas, and Candida fungi.
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Indications

The main indication is urinary tract infections, such as cystitis, urethritis, and pyelonephritis. The drug is also prescribed for the prevention of infectious complications after surgical interventions on the urogenital system.

Side effects

Dyspeptic disorders (nausea, indigestion), allergic reactions, and neurological disorders (ataxia, paresthesias) are possible during therapy. An important feature is the coloration of urine into a saffron-yellow color, which patients must be warned about to avoid anxiety.

Prescription details

The drug is rapidly and completely absorbed from the gastrointestinal tract. It is excreted by the kidneys unchanged, which ensures a therapeutic concentration specifically in the urine. Dosing regimen: orally 0.1 g 3–4 times a day. The maximum daily dose (MDD) is 0.8 g.

Briefly: answers to topical questions

What neurological side effects can nitroxoline cause?

Ataxia and paresthesias may occur with the use of nitroxoline.

How to memorize

5-NOK: 5 (nitro) — O (oxyquinoline/hydroxyquinoline) — K (E. coli / UTI clinic). Yellow urine — the "gold" standard of excretion.

Class and exam questions

Why is nitroxoline effective in cystitis?

The drug is excreted by the kidneys unchanged, which creates high concentrations of the active substance directly in the urine, acting on UTI pathogens.

Is it necessary to warn the patient about changes in urine color?

Yes, this is a specific side effect of the drug (saffron-yellow discoloration), which is not a sign of pathology, but may frighten the patient.

What is the maximum daily dose of nitroxoline?

The maximum daily dose is 0.8 g.

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What else to study on this topic

  • Comparative characteristics of 8-hydroxyquinoline derivatives and fluoroquinolones.
  • Mechanisms of resistance development to nitroxoline.
  • Interaction of nitroxoline with other antibacterial agents.
  • Management tactics for patients with CNS side effects.
  • Features of use in chronic kidney disease.

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