The Basics

What is Paritaprevir?

Used as part of combination therapy to treat chronic Hepatitis C.

Brand names for Paritaprevir

Daklinza

How Paritaprevir is classified

Antiviral Agents, Protease Inhibitors

Paritaprevir During Pregnancy

Paritaprevir pregnancy category

Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Paritaprevir while pregnant

No adequate human data are available to determine whether or not DAKLINZA poses a risk to pregnancy outcomes. In animal reproduction studies in rats and rabbits, no evidence of fetal harm was observed with oral administration of daclatasvir during organogenesis at doses that produced exposures up to 6 and 22 times, respectively, the recommended human dose (RHD) of 60 mg of DAKLINZA. However, embryofetal toxicity was observed in rats and rabbits at maternally toxic doses that produced exposures of 33 and 98 times the human exposure, respectively, at the RHD of 60 mg of DAKLINZA . In rat pre-and postnatal developmental studies, no developmental toxicity was observed at maternal systemic exposure (AUC) to daclatasvir approximately 3.6 times higher than the RHD of DAKLINZA. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. If DAKLINZA and sofosbuvir are administered with ribavirin, the combination regimen is contraindicated in pregnant women and in men whose female partners are pregnant. Refer to the ribavirin prescribing information for more information on use in pregnancy.

Taking Paritaprevir While Breastfeeding

What are recommendations for lactation if you're taking Paritaprevir?

Paritaprevir has not been studied in nursing mothers being treated for hepatitis C infection. Because it is greater than 97% bound to maternal plasma proteins, amounts in breastmilk are likely to be very low. Some sources recommend against breastfeeding when paritaprevir is used with ribavirin. Hepatitis C is not transmitted through breastmilk[1][2] and breastmilk has been shown to inactivate hepatitis C virus (HCV).[3][4] However, the Centers for Disease Control recommends that mothers with HCV infection should consider abstaining from breastfeeding if their nipples are cracked or bleeding. It is not clear if this warning would apply to mothers who are being treated for hepatitis C. Infants born to mothers with HCV infection should be tested for HCV infection; because maternal antibody is present for the first 18 months of life and before the infant mounts an immunologic response, nucleic acid testing is recommended.[1][2]

Maternal / infant drug levels

Paritaprevir has not been studied in nursing mothers being treated for hepatitis C infection. Because it is greater than 97% bound to maternal plasma proteins, amounts in breastmilk are likely to be very low. Some sources recommend against breastfeeding when paritaprevir is used with ribavirin. Hepatitis C is not transmitted through breastmilk[1][2] and breastmilk has been shown to inactivate hepatitis C virus (HCV).[3][4] However, the Centers for Disease Control recommends that mothers with HCV infection should consider abstaining from breastfeeding if their nipples are cracked or bleeding. It is not clear if this warning would apply to mothers who are being treated for hepatitis C. Infants born to mothers with HCV infection should be tested for HCV infection; because maternal antibody is present for the first 18 months of life and before the infant mounts an immunologic response, nucleic acid testing is recommended.[1][2]

Possible effects of Paritaprevir on milk supply

Relevant published information was not found as of the revision date.

Possible alternatives to Paritaprevir

(Hepatitis C) Interferon Alfa, Interferon Alfacon-1, Peginterferon Alfa.

List of References

Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Cottrell EB, Chou R, Wasson N et al. Reducing risk for mother-to-infant transmission of hepatitis C virus: A systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2013;158:109-13. PMID: 23437438
2. Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64:1-137. PMID: 26042815
3. Pfaender S, Heyden J, Friesland M et al. Inactivation of hepatitis C virus infectivity by human breast milk. J Infect Dis. 2013;208:1943-52. PMID: 24068703
4. Tovo PA, Calitri C, Scolfaro C et al. Vertically acquired hepatitis C virus infection: Correlates of transmission and disease progression. World J Gastroenterol. 2016;22:1382-92. PMID: 26819507

Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.

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