Drugs Q & A

Is Nitrofurantoin Safe In Pregnancy?

Although some medicines are considered safe during pregnancy, the effects of other medicines on your unborn baby are unknown. Certain medicines can be most harmful to a developing baby when taken during the first three months of pregnancy, often before a woman even knows she is pregnant.

It can be hard to know if a medicine is safe for your baby. Most medicines are not studied in pregnant women. That’s because researchers worry about how the medicines might affect the baby. But some medicines have been taken for so long by so many women that doctors have a good idea of how safe they are.

What is Nitrofurantoin?

Nitrofurantoin is a prescription medication that comes as an oral capsule and an oral suspension. Nitrofurantoin oral capsule is available as the brand-name drugs Macrobid and Macrodantin. It’s also available as a generic drug. Generic drugs usually cost less than the brand-name version. In some cases, they may not be available in all strengths or forms as the brand-name drug.

Nitrofurantoin is used in the treatment and prevention of urinary tract infections that are caused by certain types of bacteria. The prevalence of urinary tract infections during pregnancy is very high (56%). All pregnant women are usually screened for UTI with a urine culture. Early diagnosis and treatment of UTI during pregnancy can ensure the safety of the mother and the fetus. It also prevents complications during child delivery.

Nitrofurantoin belongs to a class of drugs called antimicrobials or antibiotics. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions. Nitrofurantoin helps kill the bacteria that cause urinary tract infections. It only works against certain types of bacteria.

Is nitrofurantoin safe in pregnancy?

One common question on the lips of many women is whether they can take nitrofurantoin during pregnancy. Nitrofurantoin is commonly prescribed in pregnancy with no known adverse effects on the developing baby. However, the use of nitrofurantoin in early pregnancy has been a source of concern because recent studies have linked nitrofurantoin to cardiac birth defects when taken in the first trimester of pregnancy. Given this risk profile, the use of nitrofurantoin is best limited to the second trimester. However, nitrofurantoin is also safe and effective for once-daily prophylactic therapy during pregnancy but there is currently, a restriction of this agent limited to the last several weeks of pregnancy.

Nitrofurantoin may pass into breast milk and cause side effects in a child who is breastfed. Talk with your doctor about breastfeeding your child. You may need to decide whether to stop breastfeeding or stop taking this medication.

Nitrofurantoin dose in pregnancy          

The recommended dose of nitrofurantoin in pregnancy is 100 mg taken orally twice daily for 5-7 days. Treatment success depends on the eradication of the bacteria rather than on the duration of therapy. A test-for-cure urine culture should show negative findings 1-2 weeks after completion of therapy. A nonnegative culture result is an indication for a 10- to 14-day course of a different antibiotic.

Nitrofurantoin in pregnancy side effects        

Along with its needed effects, the use of nitrofurantoin in pregnancy may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

•          changes in facial skin color

•          chest pain

•          chills

•          cough

•          fever

•          general feeling of discomfort or illness

•          hives

•          hoarseness

•          itching

•          joint or muscle pain

•          shortness of breath

•          skin rash

•          sudden trouble in swallowing or breathing

•          swelling of the face, mouth, hands, or feet

•          troubled breathing

Less common

•          black, tarry stools

•          blood in the urine or stools

•          burning, numbness, tingling, or painful sensations

•          dizziness

•          drowsiness

•          headache

•          pinpoint red spots on the skin

•          sore throat

•          unsteadiness or awkwardness

•          unusual bleeding or bruising

•          unusual tiredness or weakness

•          weakness in the arms, hands, legs, or feet

Rare

•          abdominal or stomach pain

•          blindness

•          blistering, peeling, or loosening of the skin and mucous membranes

•          blue-yellow color blindness

•          bluish color of the fingernails, lips, skin, palms, or nail beds

•          blurred vision or loss of vision, with or without eye pain

•          bulging soft spot on the head of an infant

•          change in the ability to see colors, especially blue or yellow

•          confusion

•          cracks in the skin

•          darkening of the urine

•          decreased vision

•          diarrhea

•          diarrhea, watery and severe, which may also be bloody

•          eye pain

•          general tiredness and weakness

•          light-colored stools

•          loss of appetite

•          loss of heat from the body

•          mental depression

•          mood or mental changes

•          nausea or vomiting

•          pale skin

•          pale stools

•          red skin lesions, often with a purple center

•          red, irritated eyes

•          red, swollen skin

•          red, thickened, or scaly skin

•          skin rash

•          sores, ulcers, or white spots on the lips or in the mouth

•          swollen or painful glands

•          tenderness of salivary glands

•          unpleasant breath odor

•          upper right abdominal pain

•          visual changes

•          vomiting of blood

•          wheezing or tightness in the chest

•          yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

•          diarrhea

•          gas

Incidence not known

•          Dizziness or lightheadedness

•          feeling of constant movement of self or surroundings

•          lack or loss of strength

•          loss of hair, temporary

•          sensation of spinning

•          uncontrolled eye movements

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

What other drugs will interact with nitrofurantoin?

Other drugs may interact with nitrofurantoin, including prescription and over-the-counter medicines, vitamins, and herbal products.

Do not take the following drugs with nitrofurantoin:

Antacids such as Gaviscon that contain magnesium trisilicate: These drugs can make nitrofurantoin less effective.

Probenecid and sulfinpyrazone: Taking these drugs while you’re taking nitrofurantoin may cause harmful levels of nitrofurantoin to build up in your blood. High levels of this drug in your body raise your risk of side effects, while reduced levels in your urine can make the drug less effective.

Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

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