The Basics
What is Nitrofurantoin?
Used to treat urinary tract infections.
Brand names for Nitrofurantoin
Macrobid
How Nitrofurantoin is classified
Anti-Infective Agents – Urinary, Antibacterial Agents, Nitrofurans
Nitrofurantoin During Pregnancy
Nitrofurantoin pregnancy category
Category BNote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.
What we know about taking Nitrofurantoin while pregnant
N/A
Taking Nitrofurantoin While Breastfeeding
What are recommendations for lactation if you're taking Nitrofurantoin?
Administration of nitrofurantoin directly to infants under 1 month of age and in those with glucose-6-phosphate dehydrogenase (G6PD) deficiency is contraindicated because of potential hemolysis in these infants. However, the time of greatest risk for hemolysis in fullterm newborns without G6PD deficiency might be as short as 8 days after birth.[1] Nitrofurantoin doses in milk are low and it can be used while breastfeeding older infants, but alternate drugs are preferred in mothers of infants under 8 days of age, or infants with G6PD deficiency of any age. Observe infants for possible diarrhea.
Maternal / infant drug levels
Administration of nitrofurantoin directly to infants under 1 month of age and in those with glucose-6-phosphate dehydrogenase (G6PD) deficiency is contraindicated because of potential hemolysis in these infants. However, the time of greatest risk for hemolysis in fullterm newborns without G6PD deficiency might be as short as 8 days after birth.[1] Nitrofurantoin doses in milk are low and it can be used while breastfeeding older infants, but alternate drugs are preferred in mothers of infants under 8 days of age, or infants with G6PD deficiency of any age. Observe infants for possible diarrhea.
Possible effects of Nitrofurantoin on milk supply
In a prospective follow-up study, 1 of 6 nursing mothers who took nitrofurantoin (dosage unspecified) reported a decrease in milk supply.[6] It is not known if there was a causal relationship.
Possible alternatives to Nitrofurantoin
Ciprofloxacin, Levofloxacin, Trimethoprim.
List of References
Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Zao J, Koren G, Bozzo P. Using nitrofurantoin while breastfeeding a newborn. Can Fam Physician. 2014;60:539-40. PMID: 24925943
2. Hosbach RE, Foster RB. Absence of nitrofurantoin from human milk. JAMA. 1967;202:1057. Letter. PMID: 6072610
3. Varsano I, Fischl J, Shochet SB. The excretion of orally ingested nitrofurantoin in human milk. J Pediatr. 1973;82:886-7. PMID: 4735457
4. Pons G, Rey E, Richard MO et al. Nitrofurantoin excretion in human milk. Dev Pharmacol Ther. 1990;14:148-52. PMID: 2364853
5. Gerk PM, Kuhn RJ, Desai NS et al. Active transport of nitrofurantoin into human milk. Pharmacotherapy. 2001;21:669-75. PMID: 11401180
6. Ito S, Blajchman A, Stephenson M et al. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993;168:1393-9. PMID: 8498418
Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.
