Ribavirin

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Date: April 2020, Version 3

What is it?

Ribavirin (Rebetol®) is an antiviral medicine used to treat chronic (long-term) hepatitis C infection, usually in combination with other antiviral medicines. Ribavirin is also occasionally used to treat severe flu and other viral infections affecting the lungs.

Is it safe to take ribavirin in pregnancy?

When deciding whether to use ribavirin during pregnancy it is important to weigh up the potential benefits to your health and wellbeing against any possible risks to you or your baby, some of which may depend on how many weeks pregnant you are. Your doctor or specialist will be able to help you make decisions about your treatment.

What if I have already taken ribavirin during pregnancy?

If you are taking any medicines while pregnant, you can discuss this with your doctor. You can then decide together whether ongoing treatment is appropriate, and if so, your doctor will ensure that you are taking the most effective dose.

Can taking ribavirin in pregnancy cause birth defects in the baby?

A baby’s body and most internal organs are formed during the first 12 weeks of pregnancy. It is mainly during this time that some medicines are known to cause birth defects.

It is currently unclear whether ribavirin use in pregnancy can cause birth defects in the baby. Only 18 women who took ribavirin in early pregnancy have been studied. One of the babies had hypospadias (where the opening of the penis is not in the usual place), but it is impossible to say whether this might have been linked to ribavirin exposure. Large studies are therefore required to determine if there may be a link between ribavirin use and birth defects in the baby.

Ribavirin stays in the body for quite a long time (a few months) after treatment has finished. Small studies of pregnant women who recently took ribavirin do not raise alarm of a link with birth defects in the baby. Again, further, larger studies are ideally required to confirm this.

Can taking ribavirin in pregnancy cause miscarriage?

The likelihood of miscarriage has been studied in fewer than 150 women taking ribavirin. While there is currently no proof that ribavirin use in early pregnancy is linked to miscarriage, ongoing research is required to confirm this.

Can taking ribavirin in pregnancy cause stillbirth, preterm birth, or my baby to be small at birth (low birth weight)?

It is currently unclear whether use of ribavirin in pregnancy may be linked to stillbirth, preterm birth or low birth weight in the baby because no studies have investigated these outcomes.

Can taking ribavirin in pregnancy cause learning and behavioural problems in the child?

A baby’s brain continues to develop right up until the end of pregnancy. It is therefore possible that taking certain medicines at any stage of pregnancy could have a lasting effect on a child’s learning or behaviour.

It is currently unclear whether ribavirin exposure in the womb affects learning and behaviour, as no studies have been carried out to investigate this. There is a single case report of a baby who was exposed in the womb to ribavirin and who was developing normally at 22 months of age. More research into the learning and development of children exposed in the womb to ribavirin is ideally required.

Will my baby need extra monitoring?

As part of their routine antenatal care most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects and to check the baby’s growth. Taking ribavirin in pregnancy is not known to cause any problems that would require extra monitoring. Women with chronic (long-term) hepatitis C are likely to be more closely monitored during pregnancy to ensure that they remain well throughout and that their baby is growing and developing as expected.

Are there any risks to my baby if the father has taken ribavirin?

No studies have specifically investigated whether ribavirin used by the father can harm the baby through effects on the sperm, however most experts agree that this is very unlikely. More research on the effects of medicine use in men around the time of conception is needed.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet, please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.

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