Is nitrofurantoin-macro safe at 38 weeks pregnant?

Answer 1

I will avoid answering the question by saying that the reason why physicians use caution when prescribing nitrofurantoin for use in pregnant women at term is because of the possibility of affecting the newborn's bilirubin and hemoglobin levels. Bilirubin is a break-down product of hemoglobin, the molecule that carries oxygen in the blood. Bilirubin levels rise in newborns after birth. This is normal and reflects the destruction of fetal hemoglobin, which gets replaced by adult hemoglobin during the first few weeks of life. If the bilirubin levels rise high enough, the baby will be have a yellow hue to his skin. This is called physiologic jaundice of the newborn. It is both common and harmless. If the bilirubin levels are too high (rare), however, brain damage can occur. Nitrofurantoin crosses the placenta and may accelerate the process destroying fetal hemoglobin in the newborn. This may cause the bilirubin levels to rise too high or the level of hemoglobin to fall too low. This potential is greatest when the nitrofurantoin level in the newborn's blood is high _and_ the baby is born at that time. Since nitrofurantoin (instant release form) leaves the mother's blood quickly (approximately 50% every 20 minutes), very little medication is left in the blood after 2 hours for transfer into the placenta. I have no information on how quickly nitrofurantoin is cleared from the newborn's blood, but, very rapid clearance into the amniotic fluid (where the baby may re-ingest it, however) and/or back into the mother's blood is probably what occurs. Thus, there is probably a small window of time during which the risk of nitrofurantoin use for the newborn is greatest (for example, administering the medication late in labor). A quick search on pubmed.gov yielded only 1 case report on this topic: Bruel H, et al. "Hemolytic anemia in a newborn after maternal treatment with nitrofurantoin at the end of pregnancy" Arch Pediatr. 2000 Jul;7(7):745-7. The article is in French, but this doesn't matter to me since I can't access the article anyhow. The abstract only states that the mother too the medication "in the last month of pregnancy," which is less than helpful. In summary, I have no idea if the medication is safe or not, but I strongly suspect it would be hard to cause any real harm to a newborn with this medication under normal circumstances (eg, the mother has functional kidneys). It probably will cause _some_ measurable change in fetal hemoglobin/bilirubin levels, however, whether or not this _actually_ matters is the real question. This is probably why physicians prescribe this medication even late in pregnancy.

Answer 2

Pregnant women should not take this medicine within two weeks of their delivery date and should not use it during labor and delivery, as this could cause problems in the baby.

Answer 3

Nitrofurantoin is considered as safe in pregnancy. But then cephalexin is better choice.

Answer 4

Yes. This drug is safe at this stage of pregnancy.

Answer 5

is nifuroxazide safe for pregnant weomen