Nitrofurantoin mono mac 100mg caps pregnancy

The drug has been viewed as a safe and effective alternative treatment for UTIs associated with E coli. Thus, nitrofurantoin is used extensively in pregnant women.

Sulfonamides are also prescribed for pregnant women, although not as frequently. The study by Crider et al 1 was based on the National Birth Defects Prevention Study, an ongoing, population-based case control study of an estimated annual birth population of roughly ,, including cases identified by birth defects surveillance registries in 10 states. Exposure to antibacterials from 1 month prepregnancy through the end of the first trimester was recorded. Crider et al interviewed all the participants up to 24 months after delivery to obtain their exposure history to penicillins, erythromycins, nitrofurantoin, sulfonamides, cephalosporins, quinolones, tetracyclines, other miscellaneous beta-lactams, aminoglycosides, antimycobacterial agents, and other antibiotics.

Nitrofurantoin Pregnancy and Breastfeeding Warnings

Exposure to antivirals, antifungals, and antiparasitic agents was not addressed. Penicillins were the most commonly used antibiotics. Some links between other antibiotics and birth defects were also found. For example, erythromycins were associated with anencephaly and transverse limb deficiency, penicillins with intercalary limb deficiency, and cephalosporins with atrial septal defects.

The authors noted, however, that these agents, which are commonly prescribed for pregnant women, were not associated with many birth defects—and that because of limited sample sizes for these drug classes, the associations may be spurious. Previous case studies and meta-analysis have shown no link between the use of nitrofurantoin and congenital abnormalities. This is the first large-scale study evaluating the risk of birth defects associated with antibiotic use during pregnancy, and therefore provides evidence of risk not previously available.

Nitrofurantoin Use During Pregnancy | agfox.com

The retrospective case-control methodology used in this study leaves open the possibility of recall bias, misclassification bias, and confounding bias. The data gathered were not cross-verified against medical records, and other issues, such as the possible effect of medications for other infections eg, antivirals and antifungals , could not be measured.

• Nitrofurantoin Pregnancy Warnings.
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However, women who did not know or were unsure of their medication exposure history were excluded from the analysis, which should reduce the risk of this potential bias. The investigators also controlled for several important sources of potential confounding bias, and the reporting rates were similar among participants in both the case and control groups. These measures provide some assurance that the outcomes are valid. It would be unethical and extraordinarily expensive to conduct a prospective randomized controlled trial to confirm these findings.

Is Nitrofurantoin Safe During Pregnancy?

Case-control methodology is the most practical way to assess for the risk of birth defects, and our literature review suggests that this is the most rigorous study to date. In our view, the potential harm from continuing to use these antibiotics for pregnant women and women who may become pregnant far outweighs the risk that these findings may be erroneous.

That said, a final caveat is the fact that even a several-fold increase in the risk of a rare major birth defect such as those reported in this study is still a rare risk. Moreover, the rates of negative pregnancy outcomes such as stillbirth and neonatal mortality, low birth weight, preterm delivery, transfer to NICU, or Apgar score lower than 7 at 5 minutes were no different among the study groups. However, neonates exposed to nitrofurantoin in the last 30 days before delivery had a significantly higher rate of neonatal jaundice requiring treatment compared with neonates exposed to pivmecillinam during the same stage of pregnancy This significant difference held up after multivariate analysis that adjusted for prematurity, neonatal sex, year of birth, use of oxytocin to induce labor, neonatal systemic antibiotic treatment, maternal age, parity, and smoking at the end of pregnancy.

It is important to note that the difference in incidence of neonatal jaundice did not affect pregnancy outcomes in the study population. While no neonates in the registry were identified as having glucosephosphate dehydrogenase deficiency, there was no difference in the incidence of hemolytic anemia. In isolation, this study would suggest that nitrofurantoin should be avoided in the last 30 days of pregnancy.

ILLUSTRATIVE CASE

However, the American College of Obstetricians and Gynecologists Committee Opinion on sulfonamides, nitrofurantoin, and risk of birth defects state that if other treatment options are not able to be used eg, cephalosporins, erythromycin , then sulfonamides and nitrofurantoin may be used as first-line agents for the treatment of UTI during the second and third trimesters.

References Furadantin nitrofurantoin oral suspension [prescribing information]. Atlanta, GA: Sciele Pharma, Inc; Accessed January 14, Neonatal outcomes after gestational exposure to nitrofurantoin. Obstet Gynecol. American College of Obstetricians and Gynecologists. Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

What if I take too much? Taking an extra dose of nitrofurantoin by accident is unlikely to harm you. Talk to your pharmacist or doctor if: Like all medicines, nitrofurantoin can cause side effects, although not everyone gets them.

• Treating UTIs in reproductive-age women—Proceed with caution;
• STUDY SUMMARY: First trimester use linked to many defects?
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Common side effects These common side effects of nitrofurantoin happen in more than 1 in people. Keep taking the medicine, but talk to your doctor if these side effects bother you or don't go away: Serious side effects Serious side effects are rare and happen in less than 1 in 1, people. Call a doctor straight away if you get: Contact a doctor straight away if: What to do about: It may also help if you avoid rich or spicy food. Take small, frequent sips if you feel sick. Signs of dehydration include peeing less than usual or having strong-smelling pee. Do not take any other medicines to treat diarrhoea or vomiting without speaking to a pharmacist or doctor.

If it helps, eat smaller meals more often than usual. Snack when you're hungry. Have nutritious snacks that are high in calories and protein, such as dried fruit and nuts. Do not drink too much alcohol. Painkillers you can buy without a prescription, such as paracetamol and ibuprofen , are safe to take with nitrofurantoin. Speak to your doctor if these don't help with the headaches or the headaches are severe. It's usually safe to take nitrofurantoin during pregnancy and while breastfeeding.

Nitrofurantoin and breastfeeding Tell your doctor before taking nitrofurantoin if you're breastfeeding. Important Tell your doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding. There are some medicines that don't mix well with nitrofurantoin. Tell your doctor if you're taking these medicines before you start nitrofurantoin treatment: Mixing nitrofurantoin with herbal remedies and supplements There are no known problems with taking herbal remedies and supplements with nitrofurantoin.

Important For safety, tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements. How does nitrofurantoin work? Nitrofurantoin works in a different way from other antibiotics. Nitrofurantoin kills the bacteria by entering their cells and damaging their genetic material.

When will I feel better?

You should feel better within a few days. What if I don't get better? Will it give me thrush?

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• Treating UTIs in reproductive-age women—Proceed with caution!

Ask your pharmacist or doctor for advice if this happens to you. Will it stop my contraception working? Will it reduce my fertility? Can I drive or ride a bike? Can I drink alcohol with it? Yes, you can drink alcohol with nitrofurantoin. Is there any food or drink I need to avoid?

You can eat and drink normally while taking nitrofurantoin. Can drinking cranberry juice help urinary tract infection? Can lifestyle changes help urinary tract infections? Once treated, there are many steps you can take to stop urinary tract infections coming back: