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Can You Take Nitrofurantoin While Pregnant?

Nitrofurantoin is a commonly prescribed antibiotic used to treat urinary tract infections. But the question that often arises is, can you take Nitrofurantoin whilst pregnant? This article delves into the details of Nitrofurantoin's use during pregnancy, breastfeeding, and its potential effects on fertility.

Nitrofurantoin During Pregnancy - Is Nitrofurantoin Safe ?

Nitrofurantoin may be taken during pregnancy, but it is generally best avoided in the third trimester. Here's why:

  • Third Trimester Concerns: There's a small chance that Nitrofurantoin could cause problems with the baby's red blood cells in the third trimester. Most babies will not have this issue, but a different antibiotic may be recommended if you are in the third trimester of pregnancy.
  • Contraindications: According to some authorities, the use of Nitrofurantoin is contraindicated in pregnant patients during labour and delivery or when the onset of labour is imminent. Some guidelines also suggest caution when used at term (38 to 42 weeks gestation).
  • Risk Summary: Malformative risk with the use of Nitrofurantoin in pregnant women is unlikely. Animal studies have failed to reveal evidence of fetotoxicity or teratogenicity
  • Concerns and Studies: Nitrofurantoin use in pregnancy continues to be of concern for several reasons, including potential links to craniosynostosis and haemolytic anaemia in newborns and foetuses.

Is Macrobid Safe in Pregnancy?

Macrobid, a brand name for Nitrofurantoin, shares the same considerations for use during pregnancy. It is generally considered safe, especially in the first and second trimesters. However, specific concerns arise in the third trimester:

Macrobid may pose risks to the baby's red blood cells in the third trimester, so alternative antibiotics may be recommended.

As with Nitrofurantoin, it's essential to consult with healthcare providers to ensure that Macrobid is the right choice for your specific situation during pregnancy.

These guidelines align with the broader considerations for Nitrofurantoin use during pregnancy. The safety profile of Macrobid makes it a viable option for treating urinary tract infections in pregnant women, but individual circumstances must always be taken into account.

Nitrofurantoin and Breastfeeding

Nitrofurantoin passes into breast milk in small amounts and is unlikely to cause side effects in the baby. But it's best to take Nitrofurantoin only for a short time. If you need to take it for longer than a few weeks, talk to your doctor or pharmacist. However, there are specific considerations:

  • General Use: If your doctor or health visitor says your baby is healthy, you can take Nitrofurantoin whilst breastfeeding.
  • Infant Considerations: Do not take Nitrofurantoin whilst breastfeeding if your baby has jaundice or glucose-6-phosphate dehydrogenase (G6PD) deficiency. Some experts recommend avoiding use if the infant is younger than 1 month or has G6PD deficiency.
  • Excretion into Human Milk: Nitrofurantoin is excreted into human milk in trace amounts. The time of peak amounts in milk depends on food taken with the drug and the dosage form.
  • Other Concerns: If your baby is not feeding as well as usual, has a stomach upset, or has oral thrush (a fungal infection in their mouth), or if you have any other concerns about your baby, talk to your doctor, pharmacist, health visitor, or midwife.

Nitrofurantoin and Fertility

There's no evidence to suggest that taking Nitrofurantoin reduces fertility in either men or women. However, in men, this drug can reduce sperm counts and produce abnormal testicular histology suggestive of arrested spermatogenesis.


The use of Nitrofurantoin during pregnancy requires careful consideration and consultation with healthcare providers. Whilst it may be prescribed during the early stages of pregnancy, caution is advised, especially as the term approaches. Breastfeeding mothers and those concerned about fertility should also discuss their specific situations with healthcare professionals to ensure the safe use of Nitrofurantoin.

Please note that the information provided in this article is for informational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always consult with your healthcare provider for personalised recommendations.


NHS, 2021. Pregnancy, breastfeeding, and fertility whilst taking Nitrofurantoin.

NCBI, 2021. Nitrofurantoin in Pregnancy., 2021. Nitrofurantoin Pregnancy and Breastfeeding Warnings.

Authored & Reviewed By

Mohamed Imran Lakhi

MPharm - Lead Pharmacist
Imran Lakhi is the superintendent pharmacist and founder at Prescription Doctor. He has been at the core of our team.

Published on: 25/08/2023 Reviewed on: 01/11/2023
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