Rifampicin

Date: April 2020, Version 1.0

What is it?

Rifampicin is an antibiotic used to treat infection, including tuberculosis and Legionnaire’s disease. It may occasionally be prescribed to pregnant women with obstetric cholestasis (also called intrahepatic cholestasis of pregnancy [ICP]), alongside another medicine called ursodeoxycholic acid (UDCA).

For specific information on ICP, please see the bump leaflet Treatment of intrahepatic cholestasis of pregnancy.

Is it safe to use rifampicin in pregnancy?

When deciding whether or not to take rifampicin during pregnancy it is important to weigh up how necessary this is, against the possible risks to you or your baby, some of which will depend on how many weeks pregnant you are. The timely and correct treatment or prevention of severe infection during pregnancy may be crucial to the health of both mother and baby. Additionally, severe ICP can increase the chance of some adverse pregnancy outcomes including stillbirth. Your doctor is the best person to help you decide what is right for you and your baby.

What if I have already used rifampicin during pregnancy?

It is always a good idea to let your doctor know that you are pregnant if you have taken any medicines in case you need any additional monitoring or treatment.

This leaflet summarises the scientific studies relating to the effects of rifampicin a baby in the womb.

Can use of rifampicin in pregnancy cause my baby to be born with birth defects?

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.

There is no evidence that use of rifampicin in early pregnancy causes birth defects. However, because so few pregnant women taking rifampicin have been studied, further research into this subject is ideally required.

Can use of rifampicin in pregnancy cause miscarriage?

There is no evidence that use of rifampicin in early pregnancy causes miscarriage. However, because miscarriage has been studied in so few women taking rifampicin in pregnancy, and because the studies did not use the most up-to-date analysis techniques, further research is required to confirm this finding.

Can use of rifampicin in pregnancy cause stillbirth?

No studies have investigated the chance of stillbirth following use of rifampicin in pregnancy.

Can use of rifampicin in pregnancy cause preterm birth or my baby to be small at birth (low birth weight)?

Two small studies each found that women using rifampicin in pregnancy were more likely to have a preterm birth and a baby with a low birth weight. However, this was thought to be due to the illnesses that rifampicin was being used to treat rather than any direct effect of rifampicin itself.

Can taking rifampicin in pregnancy cause learning or 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.

No studies have assessed the learning and behaviour of children exposed in the womb to rifampicin.

Will my baby need extra monitoring during pregnancy?

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.

There is no evidence that using rifampicin during pregnancy causes any problems that would require extra monitoring of your baby. However, women who have experienced a serious infection during pregnancy or who have ICP will be offered additional monitoring to check both their and their baby’s wellbeing.

Are there any risks to my baby if the father has used rifampicin?

We would not expect any increased risk to your baby if the father used rifampicin before or around the time you became pregnant.

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 healthcare 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.