Is Nitrofurantoin Safe in Pregnancy
Status
cautionReason
Usually used in pregnancy, but avoid at term, during labor, or if labor may start soon; use only if clearly needed.
Drug Information
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
- FDA label for Macrobid (nitrofurantoin)
https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/020064Orig1s029lbl.pdf - FDA label for Furadantin (nitrofurantoin)
https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/009175Orig1s050lbl.pdf - NHS: Pregnancy, breastfeeding and fertility while taking nitrofurantoin
https://www.nhs.uk/medicines/nitrofurantoin/pregnancy-breastfeeding-and-fertility-while-taking-nitrofurantoin/