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Is it safe to have Nitrofurantoin during pregnancy?

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Posted on Mon, 1 Jun 2015
Question: I am 23.5 weeks pregnant. Keep having bad menstrual like cramps. I went to labor and delivery yesterday- cervix was closed baby ok but they thought i might have a uti. Will find out for sure in 2 days but in meantime prescribed nitrofurantion 100mg twice a day. I looked this up online and it looked scary. Also it said not to take in last month of pregnancy and i am frightened that all these cramps are gearing me up for preterm baby and if so this med could hurt her chances. Still cramping today. Should i take the med or wait to hear if culture is possible? Or ask for different med?
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Answered by Dr. Deepti Verma (22 minutes later)
Brief Answer:
Nitrofurantoin safe in second trimester

Detailed Answer:
Hi XXXX, I have gone through your question and understand the concerns. Nitrofurantoin is FDA pregnancy category B drug which means that no adverse effects are seen in animal studies, however no controlled studies are done in humans.Nitrofurantoin should be used during pregnancy only if clearly needed; use of nitrofurantoin is contraindicated at term (38 to 42 weeks gestation), during labor and delivery, and when onset of labor is imminent because of possibility of hemolytic anemia due to immature erythrocyte enzyme systems (glutathione instability).
However, at 23.5 weeks of pregnancy, it can be safely given.
Menstrual like crampings at this gestation can be due to urinary tract infection, preterm labour, or threatened preterm labour. In this condition, you should be admitted and uterine contractions monitored. If present, then medicines to cause uterine relaxation (to stop threatened preterm labour) should be given, along with progesterone support in the form of injections or capsules.
Preterm labour pains can be due to UTI, vaginal infection or idiopathic( no cause found). So, apart from your urine tests, a high vaginal swab should also be sent for culture and sensitivity, and treatment should be done effectively.
In the meantime, you can start taking nitrofurantoin.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Deepti Verma

OBGYN, Maternal and Fetal Medicine

Practicing since :2009

Answered : 5068 Questions

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Is it safe to have Nitrofurantoin during pregnancy?

Brief Answer: Nitrofurantoin safe in second trimester Detailed Answer: Hi XXXX, I have gone through your question and understand the concerns. Nitrofurantoin is FDA pregnancy category B drug which means that no adverse effects are seen in animal studies, however no controlled studies are done in humans.Nitrofurantoin should be used during pregnancy only if clearly needed; use of nitrofurantoin is contraindicated at term (38 to 42 weeks gestation), during labor and delivery, and when onset of labor is imminent because of possibility of hemolytic anemia due to immature erythrocyte enzyme systems (glutathione instability). However, at 23.5 weeks of pregnancy, it can be safely given. Menstrual like crampings at this gestation can be due to urinary tract infection, preterm labour, or threatened preterm labour. In this condition, you should be admitted and uterine contractions monitored. If present, then medicines to cause uterine relaxation (to stop threatened preterm labour) should be given, along with progesterone support in the form of injections or capsules. Preterm labour pains can be due to UTI, vaginal infection or idiopathic( no cause found). So, apart from your urine tests, a high vaginal swab should also be sent for culture and sensitivity, and treatment should be done effectively. In the meantime, you can start taking nitrofurantoin. Hope you found the answer helpful. Please do get back for further queries. Wishing you good health. Regards, Dr Deepti Verma.