USE OF ANTHELMINTICS IN PREGNANCY

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(Date of issue: January 2018, Version: 2)

This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a pregnancy reporting form. Please encourage all women to complete an online reporting form.

A corresponding patient information leaflet on anthelmintic use in pregnancy is available at www.medicinesinpregnancy.org.

Summary

Threadworm/pinworm infestation (enterobiasis), unless overwhelming, is not usually considered a serious threat to health, therefore infestation in pregnancy should, if possible, be eradicated by rigorous attention to hygiene for at least six weeks.  If drug treatment is considered necessary, it should ideally be delayed until after the first trimester.

The data on first trimester mebendazole use do not suggest an increased risk of congenital malformations overall, or of any specific malformations, although the data consist of only ~1,200 first trimester exposures so are insufficient to exclude a risk.  No increase in the rate of spontaneous abortion, perinatal death, small for gestational age, or differences in gestational age at delivery were found between exposed and unexposed infants.  No studies were identified which investigated neurodevelopment, neonatal complications or carcinogenicity in the offspring.

In the treatment of threadworm/pinworm in pregnancy, mebendazole could be considered after first attempting rigorous hygiene measures.  When used in the treatment for hookworm, and if required during the first trimester, the benefit of treatment with mebendazole may outweigh any risk.

Exposure to mebendazole at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy or any additional fetal monitoring.  However, other risk factors may be present in individual cases which may independently increase the risk of adverse pregnancy outcome.  Clinicians are reminded of the importance of consideration of such factors when performing case-specific risk assessments.

This document is regularly reviewed and updated. Only use full UKTIS monographs downloaded directly from TOXBASE.org to be sure you are using the most up-to-date version. The summaries of these monographs are openly available on UKTIS.org.

This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to health care professionals at www.toxbase.org.

If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.

If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.

Disclaimer: Every effort has been made to ensure that this monograph was accurate and up-to-date at the time of writing, however it cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes of the measures recommended. The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. This material may be freely reproduced for education and not for profit purposes within the UK National Health Service, however no linking to this website or reproduction by or for commercial organisations is permitted without the express written permission of this service. This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from TOXBASE.org or UKTIS.org to ensure you are using the most up-to-date version.