Last update Dec. 25, 2021

Nitrofurantoin

Compatible

Safe substance and/or breastfeeding is the best option.

It is an antibacterial used in the treatment and prophylaxis of uncomplicated lower urinary-tract infections. Oral administration four times daily.

Excretion into breast milk is clinically non-significant or undetectable (Gerk 2001, Pons 1990, Varsano 1973, Hosbach 1967) with no side-effects observed among breastfed infants from treated mothers except rare cases of diarrhea.(Ito 1993)

Do not use in premature infants, while the infant is younger of two weeks of age or suffers hyperbilirubinemia or G-6-P dehydrogenase (G6PD) deficiency to avoid likelihood of hemolysis. (Zao 2014, WHO 2002, AAP 2001, Mactal 2001).

Be aware the possibility of developing diarrhea due to bacterial flora imbalance.

Expert authors consider the use of nitrofurantoin to be safe during breastfeeding (Hale, LactMed, Briggs 2015, Schaefer2015, Zao 2014, Amir 2011, Mactal 2001). American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001). List of WHO essential medicines: compatible with breastfeeding. (WHO / UNICEF 2002)

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

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Other names

Nitrofurantoin in other languages or writings:

Group

Nitrofurantoin belongs to this group or family:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 40 - 90 %
Molecular weight 238 daltons
Protein Binding 60 - 90 %
VD 0.8 l/Kg
pKa 8.2 -
Tmax 1.5 - 5 hours
T½ 0.3 - 1 hours
M/P ratio 0.3 - 6 -
Theoretical Dose 0.075 - 0.41 mg/Kg/d
Relative Dose 1 - 6 %
Ped.Relat.Dose 1 - 6 %

References

  1. LactMed. Drugs and Lactation Database (LactMed). Internet. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/ 2006 - Consulted on April 16, 2024 Full text (link to original source)
  2. Hale TW. Medications & Mothers' Milk. 1991- . Springer Publishing Company. Available from https://www.halesmeds.com Consulted on April 10, 2024 Full text (link to original source)
  3. van Wattum JJ, Leferink TM, Wilffert B, Ter Horst PGJ. Antibiotics and lactation: An overview of relative infant doses and a systematic assessment of clinical studies. Basic Clin Pharmacol Toxicol. 2019 Jan;124(1):5-17. Abstract
  4. Schaefer C, Peters P, Miller RK. Drugs During Pregnancy and Lactation. Treatment options and risk assessment. Elsevier, Third Edition. 2015
  5. Briggs GG, Freeman RK, Towers CV, Forinash AB. Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk. Wolters Kluwer Health. Tenth edition (acces on line) 2015
  6. Zao J, Koren G, Bozzo P. Using nitrofurantoin while breastfeeding a newborn. Can Fam Physician. 2014 Abstract Full text (link to original source)
  7. Amir LH, Pirotta MV, Raval M. Breastfeeding--evidence based guidelines for the use of medicines. Aust Fam Physician. 2011 Sep;40(9):684-90. Review. Abstract Full text (link to original source) Full text (in our servers)
  8. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  9. Gerk PM, Kuhn RJ, Desai NS, McNamara PJ. Active transport of nitrofurantoin into human milk. Pharmacotherapy. 2001 Abstract
  10. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
  11. Mactal-Haaf C, Hoffman M, Kuchta A. Use of anti-infective agents during lactation, Part 3: Antivirals, antifungals, and urinary antiseptics. J Hum Lact. 2001 Abstract
  12. Ito S, Blajchman A, Stephenson M, Eliopoulos C, Koren G. Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication. Am J Obstet Gynecol. 1993 May;168(5):1393-9. Abstract
  13. Pons G, Rey E, Richard MO, Vauzelle F, Francoual C, Moran C, d'Athis P, Badoual J, Olive G. Nitrofurantoin excretion in human milk. Dev Pharmacol Ther. 1990 Abstract
  14. Varsano I, Fischl J, Shochet SB. The excretion of orally ingested nitrofurantoin in human milk. J Pediatr. 1973 Abstract
  15. Hosbach RH, Foster RB. Absence of nitrofurantoin from human milk. JAMA. 1967 Abstract

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