RIBAVIRIN

Fetal Risk Summary

Ribavirin demonstrated dose-related teratogenicity or embryolethality in all animal species tested (1). Malformations observed in the offspring of hamsters, rats, and rabbits included defects of the skull, palate, eye, jaw, limbs, skeleton, and gastrointestinal tract.

According to the manufacturer, ribavirin is still present in human blood 4 weeks after dosing. The drug is concentrated in red blood cells and persists for the life of the cell (1).

Only a single case of human pregnancy exposure has been located (2). A 34-year-old woman, at 33 weeks' gestation, was treated with ribavirin inhalation therapy for influenza pneumonia complicated by respiratory failure. Shortly after treatment, a cesarean section was performed because of worsening maternal cardiopulmonary function. A normal female infant was delivered, who is alive and well at 1 year of age.

The Centers for Disease Control and the manufacturer consider the use of ribavirin during pregnancy to be contraindicated (1,3). In a 1988 statement addressing the issue of ribavirin exposure among health care personnel, the CDC commented: “...health-care workers who are pregnant, or may become pregnant should be advised of the potential risks of exposure during direct patient care when patients are receiving ribavirin through oxygen tent or mist mask and should be counseled about risk-reduction strategies, including alternative job responsibilities” (3).

Breast Feeding Summary

No data are available.

References

1. Product information. Virazole. ICN Pharmaceuticals, 2000.
2. Kirshon B, Faro S, Zurawin RK, Samo TC, Carpenter RJ. Favorable outcome after treatment with amantadine and ribavirin in a pregnancy complicated by influenza pneumonia: a case report. J Reprod Med 1988;33:399–401.
3. Centers for Disease Control. Assessing exposures of health-care personnel to aerosols of ribavirin-California. MMWR 1988;37:560–3.