acetohydroxamic acid(a-seet-oh-hye-drox-am-ik a-sid) ,
Pregnancy Category: X
Pharmacologic: urease inhibitors
ClassificationTherapeutic: anti infectives
Pharmacologic: urease inhibitors
Adjunct therapy in chronic urea-splitting urinary tract infection.
Reversibly inhibits the bacterial enzyme urease, which results in decreased hydrolysis of urea and subsequent production of ammonia in urine infected with urea-splitting bacteria.
Decreased urinary ammonia levels and decreased urine pH, which increases the efficacy of anti-infective therapy and cure rates.
Does not directly alter pH or have any direct antibacterial activity.
Absorption: Well absorbed following oral administration.
Distribution: Distributed throughout body water.
Metabolism and Excretion: 36–65% excreted unchanged in urine.
Half-life: 5–10 hr (increased in renal impairment).
Time/action profile (effect on urine)
|PO||4–8 hrs||0.25–1 hr†||6–8 hr|
Contraindicated in: Urinary tract infection with non-urea-splitting organisms; Urinary tract infections that can be controlled by culture-specific oral antibiotics; Serum creatinine >2.5 mg/dL or CCr <20 mL/min; Obstetric: Causes birth defects; women of childbearing potential must use adequate contraception; Lactation: Safety not established.
Use Cautiously in: Renal impairment (increased risk of adverse reactions; dosage reduction recommended); Hepatic impairment; Pre-existing thrombophlebitis or phlebothrombosis (increased risk of adverse reactions).
Adverse Reactions/Side Effects
Central nervous system
- headache (most frequent)
- anxiety (most frequent)
- depression (most frequent)
- malaise (most frequent)
- nervousness (most frequent)
- tremulousness (most frequent)
- superficial phlebitis of the lower extremities
- rash (in association with alcohol)
- anorexia, (most frequent)
- nausea, (most frequent)
- vomiting (most frequent)
- anemia (most frequent)
- hemolytic anemia (most frequent)
Drug-Drug interactionDecreases absorption of iron.Iron decreases the absorption of acetohydroxamic acid.Concurrent ingestion of alcohol increases the incidence of rash.
Oral (Adults) 250 mg 3–4 times daily (total dose 10–15 mg/kg/day)(maximum daily dose = 1500 mg).
Oral (Children) 10 mg/kg/day in divided doses; further titration may be necessary.
Renal ImpairmentOral (Adults) Serum creatinine 1.8–2.5 mg/dL—do not exceed 1000 mg/day (given at 12 hr intervals; further adjustments may be necessary).
Tablets: 250 mg
- Assess patient for signs and symptoms of urinary tract infection (frequency, urgency, fever, pus in urine) throughout therapy.
- Lab Test Considerations: Monitor CBC including reticulocyte count after 2 wk of treatment and every 3 mo during therapy. Reticulocytosis and hemolytic anemia may occur. If reticulocyte count is >6%, reduce dose.
- Monitor renal and hepatic function closely during therapy.
Potential Nursing DiagnosesRisk for infection (Indications)
Impaired urinary elimination (Indications)
- If a patient requires iron for a microcytic anemia, intramuscular iron can be used during the course of treatment with acetohydroxamic acid.
- Oral: Administer on an empty stomach, 1 hr before or 2 hr after meals.
- Instruct patient to take medication exactly as directed.
- Inform patient that mild headache may occur during first 48 hr of treatment. Headaches usually respond to oral salicylates (aspirin) and usually disappear spontaneously.
- Advise patient that taking acetohydroxamic acid concurrently with alcohol may cause a nonpruritic macular skin rash to occur on upper extremities and face. Rash usually appears 30–45 min after ingestion of alcohol and may be associated with a sensation of warmth. It usually spontaneously disappears in 30–60 min.
- Emphasize the importance of periodic lab tests to monitor for side effects.
- Caution patients of childbearing potential to use a reliable form of contraception while taking acetohydroxamic acid.
- Decreased urinary ammonia levels and decreased urine pH which increases the efficacy of anti-infective therapy and cure rates in urinary tract infections.
A trademark for the drug acetohydroxamic acid.