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The
Doctor is in Q and A:
Ribavirin and
Pregnancy
Question
from Reader
 “I've
been treated with PegIntron
[peginterferon alfa-2b] and Rebetol (ribavirin)
for a year and successfully cleared my HCV as of now.
I actually couldn't handle the side
effects of the Rebetol
any more so I stopped it about 3 months ago and continued
with the interferon injections. My doctor said that's
bad, but I am also in college so I needed to be well enough
to make it to classes.
Anyway,
I just found out I'm pregnant.
I have no idea how this happened because I've been on the
pill. I don't want to get an abortion, but I'm very scared
that my baby will have birth defects. What advice can
you give me? Please let me know as soon as possible.”
Answer
by Douglas Dieterich, MD
Dr. Dieterich is Vice Chair and Chief
Medical Officer Department of Medicine at The Mount Sinai
Medical Center. He is also an attending physician at New York
University Tisch Hospital
That
is a really tough question. There is a pregnancy registry
run by the pharmaceutical companies that you should contact
[1-800-727-7064]. Most people advise that you not get
pregnant for 6 months after stopping ribavirin. However, I
have seen a few pregnancies after 3 months off ribavirin turn
out OK. That is no guarantee, however. There may be more fear
than is necessary, but certainly the chances of a problem
with the baby are increased, but not as much as if you were
taking the medication.
Of
course you should discuss this important issue with your physician
and take careful note of the WARNINGS AND PRECAUTIONS
concerning pregnancy printed on the Ribavirin product label.
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Pregnancy Section of WARNINGS on Ribavirin
(Rebetol, Copegus) from the Copegus and Rebetol Product
Information Sheets:
Ribavirin may cause birth defects and/or
death of the exposed fetus. Extreme care must be taken
to avoid pregnancy in female patients and in female
partners of male patients. Ribavirin has demonstrated
significant teratogenic and/or embryocidal effects in
all animal species in which adequate studies have been
conducted. These effects occurred at doses ad low as
one twentieth of the recommended human dose of ribavirin.
RIBAVIRIN THERAPY SHOULD NOT BE STARTED
UNLESS A REPORT OF A NEGTIVE PREGNANCY TEST HAS BEEN
OBTAINED IMMEDIATELY PRIOR TO PLANNED INITIATION OF
THERAPY.
Patients should be instructed to use
at least two forms of effective contraception during
treatment and for 6 months after treatment has been
stopped. Pregnancy testing should occur monthly during
ribavirin therapy and for 6 months after therapy has
stopped (see CONTRAINDICATIONS and PRECAUTIONS: Information
for Patients and Pregnancy: Category X).
If
pregnancy occurs in a patient or partner of a patient
during treatment or during the 6 months after treatment
stops, physicians are encouraged to report such cases
by calling (800) 727-7064.
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Selected Articles on Pregnancy
and Hepatitis C Posted on HIV and Hepatitis.com:
Link
to HCV Treatments Main Page
07/25/05
Sources
REBETOL® Prescribing
Information
Copegus Medication Guide
Copegus
Product Information
HIV
and Hepatitis.com: HCV Treatments Main Page 
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