Dolutegravir

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Date: May 2025, Version 2.0

Quick read

Dolutegravir can be used in pregnancy if recommended by a specialist.

What is it?

Dolutegravir (TivicayÒ) is used to treat HIV infection, often in combination with other medicines.

Benefits

What are the benefits of taking dolutegravir in pregnancy?

Dolutegravir protects your immune system from damage caused by HIV infection. Dolutegravir can also prevent HIV from passing to your unborn baby during pregnancy and birth.

Risks

Are there any risks of taking dolutegravir during pregnancy?

One study has shown a slightly increased chance of the baby having a neural tube defect like spina bifida following use of dolutegravir in early pregnancy. Other studies show no increased chance of neural tube defects in babies exposed to dolutegravir.

For every 1,000 pregnancies in women in the background population, there is expected to be one baby with a neural tube defect. 

One study suggested that for every 1,000 women taking dolutegravir in early pregnancy, two babies would be born with a neural tube defect. 

If there is a risk of neural tube defects from dolutegravir, the risk is very small. Most women (at least 998 out of every 1,000) taking dolutegravir will have a baby without a neural tube defect.

Alternatives

Are there any alternatives to taking dolutegravir?

Possibly, as other drugs can be used to treat HIV. However, if dolutegravir is recommended for you, this is because it is the best option to keep you well and prevent HIV from passing to your unborn baby.

No treatment

What if I prefer not to take medicines during pregnancy?

It is very important to continue to treat HIV infection during pregnancy to make sure you and your unborn baby stay well.

Will my baby need extra monitoring?

All pregnant women in the UK are offered a very detailed anomaly scan at around 20 weeks of pregnancy as part of their routine antenatal care. Women who take dolutegravir in early pregnancy will be offered this scan as usual.

Women with HIV will be more closely monitored during pregnancy to ensure that they remain well, that their baby is growing as expected, and that their medication dose can be adjusted to reduce the risk of HIV passing to the baby.

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

We do not expect any increased risk to your baby if the father takes dolutegravir.

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.