Can Nitrofurantoin Cause Numbness? What You Need to Know About Peripheral Neuropathy

October 12, 2025 •

3 min read

While typically a safe and effective antibiotic for urinary tract infections (UTIs), a rare but serious side effect of nitrofurantoin is peripheral neuropathy, which can cause numbness, tingling, and pain. This nerve damage is more likely to occur with long-term use and in individuals with specific underlying health conditions.

Quick Summary

This article explains how the antibiotic nitrofurantoin can cause numbness by inducing peripheral neuropathy, a condition of nerve damage. It covers the risk factors, the symptoms to watch for, and the crucial steps to take if you experience nerve-related sensations.

Key Points

Peripheral Neuropathy Risk: Nitrofurantoin, while rare, can cause peripheral neuropathy, leading to symptoms like numbness and tingling.
Long-Term Use: The risk of developing peripheral neuropathy increases significantly with prolonged or long-term nitrofurantoin treatment.
Key Risk Factors: Impaired kidney function, diabetes, anemia, and vitamin B deficiency are major risk factors for this side effect.
Immediate Action: If you experience numbness or other nerve symptoms, stop the medication and contact your doctor immediately to prevent irreversible damage.
Formulation Differences: Both Macrodantin and Macrobid carry the risk of neuropathy, but Macrobid's twice-daily dosing may offer better convenience.
Irreversible Damage: If left unaddressed, the nerve damage from nitrofurantoin-induced peripheral neuropathy can become irreversible.
Symptom Progression: Neuropathy often begins as pins and needles or tingling in the lower extremities and can progress to weakness and more severe symptoms.

What is Peripheral Neuropathy?

Peripheral neuropathy is a condition affecting the peripheral nerves, which connect the central nervous system to the rest of the body. This damage can lead to various symptoms like numbness, tingling, pain, and muscle weakness, often starting in the hands and feet. While numerous factors can cause peripheral neuropathy, certain medications, including nitrofurantoin, are known culprits.

The Link Between Nitrofurantoin and Numbness

Nitrofurantoin, prescribed for UTIs, can induce peripheral neuropathy, a rare but serious adverse effect. This nerve damage can manifest as tingling, pins and needles, or numbness, particularly in the hands and feet. In some instances, it may progress to severe pain or muscle weakness. Continued use after symptoms appear can result in permanent nerve damage. The risk is higher with long-term therapy, such as when the drug is used to prevent recurrent UTIs. For patients on long-term treatment, monitoring for neurological symptoms is recommended.

Key Risk Factors for Developing Peripheral Neuropathy

Certain conditions increase the likelihood of developing nitrofurantoin-induced nerve damage. Healthcare providers should assess these factors before prescribing long-term nitrofurantoin.

Impaired Kidney Function: Reduced kidney function prevents efficient drug clearance, increasing nerve toxicity. Nitrofurantoin is generally not advised for patients with an eGFR below 60 mL/minute.
Long-Term Treatment: The risk of neuropathy rises significantly with prolonged nitrofurantoin use, typically exceeding six months. Alternative options may be considered for chronic UTI prevention.
Diabetes Mellitus: Diabetes-related neuropathy can be worsened by nitrofurantoin.
Anemia and Vitamin B Deficiency: These conditions, along with electrolyte imbalances, increase susceptibility.
Debilitating Diseases and Elderly Patients: Older adults and those with other serious health issues face a higher risk.

What to do if you Experience Numbness

If you are taking nitrofurantoin and experience tingling, pins and needles, or numbness, immediate action is crucial. Stop the medication at the first sign of these symptoms and contact your doctor. If symptoms are severe, such as sudden muscle weakness, seek emergency medical help. Many patients see improvement after stopping the drug, but some nerve damage can be irreversible.

Types of Nitrofurantoin and Formulation Differences

Nitrofurantoin comes in two main formulations: macrocrystals (Macrodantin) and a dual-release form (Macrobid). While both can cause peripheral neuropathy, they differ in use and potential side effects.


Feature	Macrodantin (Macrocrystals)	Macrobid (Monohydrate/Macrocrystals)
Formulation	Large crystals.	Dual-release (25% macrocrystals, 75% monohydrate).
Dosing Frequency	Typically four times a day.	Twice a day for convenience.
Absorption Rate	Slower due to larger crystals.	Slower release from monohydrate gel.
GI Side Effects	May cause more gastrointestinal issues.	Better gastrointestinal tolerance.
Use in Prophylaxis	Used historically, requires monitoring.	Can be used, requires monitoring.
Neuropathy Risk	Same risk as Macrobid.	Same risk as Macrodantin.

Conclusion

Nitrofurantoin is an effective treatment for UTIs, but the risk of peripheral neuropathy, causing numbness, tingling, and pain, is a significant concern, especially with long-term use. Recognizing risk factors like impaired kidney function, diabetes, and prolonged therapy is vital. Stopping the medication immediately upon experiencing neurological symptoms is essential to potentially prevent permanent nerve damage. Discuss your health history and potential risks with your doctor before taking nitrofurantoin. For detailed drug information, consult reliable medical resources like MedlinePlus.

List of Potential Symptoms of Peripheral Neuropathy

Tingling or pins-and-needles sensation
Numbness in hands, feet, arms, or legs
Burning or sharp pain
Muscle weakness
Coordination or balance difficulties
Unusual skin sensitivity
Loss of reflexes
Muscle wasting in severe cases

Frequently Asked Questions

No, peripheral neuropathy leading to numbness is a rare but serious side effect of nitrofurantoin. The risk is low for short-term treatment but increases with prolonged use.

Individuals with impaired kidney function, diabetes, anemia, vitamin B deficiency, or other debilitating diseases are at a higher risk of developing this side effect.

The initial symptoms often include a tingling or pins-and-needles sensation (paresthesia), typically starting in the hands and feet.

Yes. While symptoms may resolve after discontinuing the drug, nerve damage can be irreversible if the medication is not stopped early enough.

You should stop taking the medication and contact your doctor immediately. Do not wait for your appointment or to finish the course of antibiotics.

No. Both Macrobid and Macrodantin, which are different formulations of nitrofurantoin, carry the same risk of peripheral neuropathy. The main difference lies in their dosing and potential for gastrointestinal side effects.

Yes. Other serious but rare side effects include lung problems (inflammation), liver damage, and blood cell damage (hemolysis). Always read the medication information and consult your doctor.