Is Nitrofurantoin Safe in Pregnancy

Status

caution Last reviewed: 2026-05-16 · Confidence: high

Reason

Usually used in pregnancy, but avoid at term, during labor, or if labor may start soon; use only if clearly needed.

Drug Information

Brand Name
Macrobid, Macrodantin, Furadantin
Generic Name
nitrofurantoin
Drug Class
nitrofuran antibiotic
FDA Category
B
Rx Status
prescription

Safe Amount

Dosage must be determined by your provider based on individual risk/benefit.

Effects

Pregnancy
Generally used when needed for UTI in pregnancy, but not recommended at term or during labor.
Mother
Can treat lower urinary tract infection. Rare hemolysis risk is greater with G6PD deficiency.
Baby
May rarely cause hemolytic anemia, especially near term or in newborns with immature red blood cell systems or G6PD deficiency.

Trimester Notes

1st Trimester
May be used if needed; some guidance advises caution because data are limited, but official labeling does not show a clear fetal harm signal.
2nd Trimester
May be used if needed for UTI treatment, based on provider judgment and infection sensitivity.
3rd Trimester
Avoid at 38 to 42 weeks, during labor and delivery, or when labor may start soon because of hemolytic anemia risk.

Risk-Benefit Note

If you have a UTI in pregnancy, the infection itself can cause harm. Your prescriber should choose the antibiotic and timing, especially near delivery.

Conditions & Warnings

  • Consult OB/GYN or prescriber
  • G6PD deficiency
  • Near-term pregnancy (38 to 42 weeks)
  • Labor or delivery imminent

Alternatives

  • Cephalexin
  • Amoxicillin-clavulanate
  • Fosfomycin

References

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