Is Ribavirin compatible with breastfeeding? Do we have alternatives for Ribavirin?

Ribavirin

May 1, 2016 (Low Risk)

Synthetic drug and nucleoside analogue which is structurally related to guanine with antiviral activity.
It is used in infants and newborns for treatment of respiratory syncytial virus (RSV) and adenovirus. Along with interferon for treatment of hepatitis C (authorized on these cases from the 3 years of life).

At latest update no published data on excretion into breast milk were found.

Its large volume of distribution makes it unlikely that may occur the passage of significant amounts to the milk.
Its low oral bioavailability hinder the passage toward infant’s plasma from ingested milk, except in preterm milk and immediate neonatal period, for which there may be an increased intestinal permeability.

Since it is used as treatment on infants and its pharmacokinetic data are favorable, it should be regarded as compatible with breastfeeding for short-term exposures, however, to be cautiously used on long-term treatments.

Alternatives

Very Low Risk

Compatible. Not risky for breastfeeding or infant.

Low Risk

Moderately safe. Mild risk possible. Follow up recommended. Read the Comment.

High Risk

Poorly safe. Evaluate carefully. Use a safer alternative. Read the Comment.

Very High Risk

Not recommended. Cessation of breastfeeding or alternative.

Synonyms

  • Tribavirin

Writings

  • ριμπαβιρίνη (Greek)
  • ريبافيرين (Arabic)
  • Рибавирин (Cyrillic)
  • 利巴韦林 (Chinese)
  • リバビリン (Japanese)
  • C8H12N4O5 (Molecular formula)

Drug trade names

References

  1. Ronchi A, Doern C, Brock E, Pugni L, Sánchez PJ. Neonatal adenoviral infection: a seventeen year experience and review of the literature. J Pediatr. 2014Abstract
  2. Christensen VB, Nordly S, Fischler B, Kjær MS, Jørgensen MH. [Hepatitis C infection in children.] Ugeskr Laeger. 2014Abstract
  3. Le Campion A, Larouche A, Fauteux-Daniel S, Soudeyns H. Pathogenesis of hepatitis C during pregnancy and childhood. Viruses. 2012Abstract Full text (link to original source) Full text (in our servers)
  4. Durmaz O. Hepatitis C infection in childhood. Clin Res Hepatol Gastroenterol. 2012Abstract
  5. Arshad M, El-Kamary SS, Jhaveri R. Hepatitis C virus infection during pregnancy and the newborn period--are they opportunities for treatment? J Viral Hepat. 2011Abstract
  6. Ventre K, Randolph A. WITHDRAWN: Ribavirin for respiratory syncytial virus infection of the lower respiratory tract in infants and young children. Cochrane Database Syst Rev. 2010Abstract
  7. Ksiezakowska K, Laszczyk M, Wilczyński J, Nowakowska D. [SARS-CoV infection and pregnancy]. Ginekol Pol. 2008Abstract
  8. Fischler B. Hepatitis C virus infection. Semin Fetal Neonatal Med. 2007Abstract
  9. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006Abstract Full text (link to original source) Full text (in our servers)
  10. Davison C, Ventre KM, Luchetti M, Randolph AG. Efficacy of interventions for bronchiolitis in critically ill infants: a systematic review and meta-analysis. Pediatr Crit Care Med. 2004Abstract Full text (link to original source) Full text (in our servers)