Ribavirin

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.