Nitrofurantoin contraindications and warnings


The following provides information on contraindications to the use of nitrofurantoin in general, pregnancy & breastfeeding and children. Please note that the contraindications may vary depending on the dosage form of a drug (eg tablet, syringe, ointment).

When should nitrofurantoin not be used?

Nitrofurantoin must not be used with:

  • localized or generalized neuritis
  • existing or suspected deficiency in the enzyme glucose-6-phosphate dehydrogenase (indicated by haemolytic anemia)
  • urine dripping or urinary retention
  • Kidney disease and urinary tract infections suspected of having kidney involvement. Nitrofurantoin will not reach a high enough concentration in the urine and may cause nerve damage.

Nitrofurantoin should only be used if the physician is under strict risk-benefit assessment

  • asthma
  • Pulmonary fibrosis (connective tissue transformation of lung tissue)
  • allergy
  • Hepatitis and biliary disorders.

More generally, the use of nitrofurantoin should be limited to those urinary tract infections that other antibiotics have not helped.

What should you watch out for during pregnancy and lactation?

In the first six months of pregnancy, the drug should be used only after careful consideration of the benefit and risk by the physician. Nitrofurantoin must not be taken during the last trimester of pregnancy, as it causes anemia in newborns.

The active substance passes into breast milk. Therefore, infants with known or suspected glucose-6-phosphate dehydrogenase deficiency (signs: hemolytic anemia) should not be breastfed if the mother is taking nitrofurantoin.

What should be considered in children?

Newborns and infants up to the age of three may not receive nitrofurantoin at all. With them, there is a risk that an anemia will be triggered.

Even in older children, the application should be made only after a strict medical benefit-risk assessment.

Warnings and Precautions

  • Elderly people with impaired kidney function should refrain from taking the drug.
  • If respiratory distress, fever, nerve complaints, skin rashes or gall bladder problems occur, the medication should be discontinued immediately and a doctor should be consulted.
  • There may be a harmless browning of the urine while taking the drug.
  • During treatment with the drug, the blood count should be monitored regularly.
  • The medicine should only be used for a short time.
  • If breathing difficulties, coughing, fluid retention in the lungs and fever occur during treatment, consult a doctor.
  • Reactivity may be limited by the active substance to such an extent that active participation in road traffic or the use of machinery are dangerous.
  • Simultaneous alcohol consumption further reduces responsiveness.

Sometimes medications release allergic reactions.
If you notice any signs of allergic reaction, tell your doctor or pharmacist immediately.