Lopinavir and ritonavir

(Date: May 2020. Version: 1)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by Public Health England on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

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What is it?

Lopinavir/ritonavir is an antiviral medicine for the treatment of HIV. It is also being used in clinical trials to treat coronavirus (COVID-19).

Is it safe to use lopinavir/ritonavir in pregnancy?

When deciding whether to use lopinavir/ritonavir 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 used lopinavir/ritonavir 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 using lopinavir/ritonavir 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.

Around 3,000 women have used lopinavir/ritonavir in pregnancy. While there are no concerns that lopinavir/ritonavir causes birth defects, ongoing research is needed.

Can using lopinavir/ritonavir in pregnancy cause miscarriage stillbirth, preterm birth, or my baby to be small at birth (low birth weight)?

There is no information on the chance of miscarriage in women taking lopinavir/ritonavir.

There is no evidence to suggest that stillbirth is more common following treatment with lopinavir/ritonavir.

Preterm birth and low birth weight may be more common in babies exposed to lopinavir/ritonavir. However, the effects of HIV infection in the mother may have contributed to this. Further research is needed in this area.

Can using lopinavir/ritonavir in pregnancy cause learning and behavioural problems in the child?

Brain development continues throughout pregnancy. Medication taken at any stage of pregnancy could potentially affect a child’s learning or behaviour.

Exposure to lopinavir/ritonavir does not seem to affect a child’s learning and behaviour, according to one study that followed children up to the age of 13 years. Further research is ideally required to support this finding.

Will my baby need extra monitoring?

As part of routine antenatal care, women will be offered a scan at around 20 weeks of pregnancy to look for any problems and to check the baby’s growth. Use of lopinavir/ritonavir in early pregnancy does not require extra monitoring. Women with conditions that lopinavir/ritonavir is used to treat are likely to be more closely monitored during pregnancy to ensure that they remain well and that their baby is growing and developing as expected.

Are there any risks to my baby if the father has taken lopinavir/ritonavir?

There is currently no evidence that lopinavir/ritonavir used by the father can harm the baby through effects on the sperm, and most experts agree that this is unlikely.

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.

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

   

www.medicinesinpregnancy.org

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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