Drug Information

Acetohydroxamic acid

Acetohydroxamic acid
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(For additional information see “Acetohydroxamic acid: Patient drug information”)

Brand Names: U.S.

  • Lithostat®
Brand Names: Canada

  • Lithostat®
Pharmacologic Category

  • Urinary Tract Product
Dosing: AdultSusceptible infections: Oral: 250 mg 3-4 times/day for a total daily dose of 10-15 mg/kg/day

Dosing: PediatricSusceptible infections: Oral: Initial: 10 mg/kg/day

Dosing: GeriatricRefer to adult dosing.

Dosing: Renal ImpairmentNot recommended for use in significant renal impairment (Srcr >2.5 mg/dL).

Dosage Forms: U.S.Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, oral:

Lithostat®: 250 mg

Generic Equivalent Available: U.S.No

AdministrationShould be administered on an empty stomach, 1 hour before or 2 hours after meals.

UseAdjunctive therapy in chronic urea-splitting urinary infection

Medication Safety Issues

Sound-alike/look-alike issues:

Lithostat® may be confused with Lithobid®

Adverse Reactions SignificantFrequency not defined.

Cardiovascular: Deep vein thrombosis (rare), embolism, palpitation, phlebitis

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Central nervous system: Anorexia, anxiety, depression, headache, malaise, nervousness, tremor

Dermatologic: Flushing (with ethanol consumption), rash (nonpruritic, macular)

Gastrointestinal: Nausea, vomiting

Hematologic: Hemolytic anemia (15% with laboratory evidence; ~3% severe requiring discontinuation; may be accompanied by GI symptoms or systemic complaints of malaise and/or fatigue); hyperbilirubinemia

Respiratory: Pulmonary embolism (rare)

ContraindicationsHypersensitivity to acetohydroxamic acid or any component of the formulation; pregnancy

Warnings/Precautions Concerns related to adverse effects:

• Bone marrow suppression: May suppress bone marrow function; use with caution in patients with prior bone marrow depression. Close monitoring of hematologic function is recommended.

• Hemolytic anemia: Has been associated with hemolytic anemia (Coombs’ negative), which may be associated with gastrointestinal distress and systemic symptoms; use with caution in patients with anemia. Monitor hematologic parameters during extended therapy.

• Hepatotoxicity: May cause hepatic injury; close monitoring of hepatic function is recommended.

Disease-related concerns:

• Psychiatric disorders: Use with caution in patients with pre-existing psychiatric disorders; may be associated with nervousness, anxiety, and/or depression.

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Drug Interactions

(For additional information: Launch Lexi-Interact™ Drug Interactions Program )

There are no known significant interactions.

Ethanol/Nutrition/Herb InteractionsEthanol: Avoid ethanol (may increase incidence of rash and/or flushing).

Food: May decrease absorption of acetohydroxamic acid.

Pregnancy Risk FactorX (show table)

LactationExcretion in breast milk unknown/not recommended

Dietary ConsiderationsShould be taken on an empty stomach, 1 hour before or 2 hours after meals.

Pricing: U.S. (www.drugstore.com)Tablets (Lithostat)

250 mg (100): $169.98

Monitoring ParametersIn patients receiving therapy >2 weeks, monitor CBC with reticulocytes at 3-month intervals during the duration of treatment.

International Brand Names

  • Uronefrex (BE, ES, FR, LU)
Mechanism of ActionAcetohydroxamic acid inhibits bacterial urease enzymes, decreasing the formation of ammonia in the urine by urea-splitting organisms. A reduction in urinary ammonia may increase the antibacterial activity of some antibiotic agents.