Antibiotics Home > Macrobid Warnings and Precautions

In rare cases, Macrobid has been reported to cause serious liver problems. Other warnings and precautions with Macrobid apply to women who are near the end of pregnancy, people with anemia, and people who take this medicine long-term (they should have their kidney function monitored regularly). You shouldn't take Macrobid if you have severe kidney problems or allergies to any of the ingredients in it.

What Should I Tell My Healthcare Provider?

You should talk to your healthcare provider prior to taking Macrobid® (nitrofurantoin monohydrate/macrocrystalline) if you have:
  • Kidney disease, such as kidney failure (renal failure)
  • Glucose-6-phosphate dehydrogenase deficiency
  • Anemia
  • Diabetes
  • An electrolyte imbalance
  • Vitamin B deficiency
  • Any allergies, including to food, dyes, or preservatives.
Also, let your healthcare provider know if you are:
  • Pregnant or thinking of becoming pregnant
  • Breastfeeding.
Be sure to tell your healthcare provider about all other medicines you are taking, including prescription and nonprescription medications, vitamins, and herbal supplements.

Specific Macrobid Precautions and Warnings

Warnings and precautions to be aware of prior to taking Macrobid include the following:
  • Serious lung problems have occurred in people taking nitrofurantoin (the active ingredient in Macrobid). Such problems are rare but are more common in people taking nitrofurantoin for six months or longer.
People who take this medication long-term should have their lungs monitored carefully. Be sure to report any lung symptoms, such as shortness of breath or an unexplained cough, to your healthcare provider right away. This drug is not approved for long-term use.
  • In rare cases, people taking Macrobid have experienced liver damage, including fatal liver problems. If you take this medication long-term (or frequently), your healthcare provider may want to monitor your liver function.
  • Macrobid can cause nerve problems, which can sometimes be quite serious. Let your healthcare provider know if you experience any unusual sensations, such as burning, numbness, or tingling, especially in the hands or feet. People with poor kidney function, anemia, diabetes, an electrolyte imbalance, or a vitamin B deficiency may be more likely to experience such problems.
  • People who take this medication long-term should have their kidney function monitored regularly (using a simple blood test).
  • There have been cases of hemolytic anemia (destruction of red blood cells) linked to nitrofurantoin, particularly in people with glucose-6-phosphate dehydrogenase deficiency.
  • Macrobid is considered a pregnancy Category B medicine. This means that this medication is probably safe for use during pregnancy, although the full risks are currently unknown. However, this medicine is not recommended for women who are near the end of pregnancy (see Macrobid and Pregnancy for more information).
  • Many antibiotics have been known to cause pseudomembranous colitis (severe diarrhea). This is a serious condition that can potentially be fatal. If you experience severe, bloody, or prolonged diarrhea, contact your healthcare provider right away.
  • Macrobid can react with certain medications (see Macrobid Drug Interactions).
  • Macrobid passes through breast milk in trace amounts. Therefore, if you are breastfeeding, be sure to check with your healthcare provider before taking this drug (see Macrobid and Breastfeeding).
Written by/reviewed by:
Last reviewed by: Kristi Monson, PharmD;
Last updated/reviewed:
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