Ribavirin

(Date: April 2020. Version: 3)

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.

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.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 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.

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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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