Rifampicin

(Date: April 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?

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.

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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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