HIV Medications and Pregnancy

Doctors: The following is a list of HIV meds and summary information on their degree of safety during pregnancy. Use patient-resistance profiles to create appropriate regimens. For more details on the safety and toxicity of HIV medications during pregnancy, see the National Institutes of Health guidelines. For guidelines about the use of HIV medications during pregnancy and information about short-course treatment (during delivery only), click here.

Patients: Lay-friendly details about HIV medication and pregnancy can be found at aidsmeds.com. But if you are HIV positive and pregnant, think you may be pregnant or are thinking about becoming pregnant, please speak with your doctor.

HIV DRUGS FOUND TO BE SAFE WITH PREGNANCY

NRTIs: AZT (Retrovir): should not be used with Zerit; Epivir (lamivudine, 3TC)

PIs: Viracept (nelfinavir); Invirase (saquinavir mesylate capsules): Soft gel capsule formulation Fortovase (saquinavir SGC) will be discontinued in the first quarter of 2006); Kaletra (lopinavir/ritonavir)

ALTERNATIVES/DRUGS TO USE WITH CAUTION

NRTIs: Videx/Videx EC (didanosine; ddI): used in combination with Zerit (d4T) can cause lactic acidosis, a buildup of acid in the blood, with an even greater risk in pregnant women; Emtriva (emtricitabine): no studies in pregnant women, but similar to Epivir and considered safe; Zerit (stavudine; d4T): used in combination with Videx/Videx EC (didanosine ddI) can cause lactic acidosis, a buildup of acid in the blood, with an even greater risk in pregnant women; Ziagen (abacavir): can cause a hypersensitivity reaction in 3-5 percent of patients; rate of such reactions in pregnant patients undetermined.

NNRTIs: Viramune (nevirapine): commonly prescribed, but recently been found to increase the risk of liver toxicity and rash in women with CD4 counts above 250.

PIs: Norvir (ritonavir): limited data in pregnant women; recommended only for use as booster to other protease inhibitors; Crixivan (indinavir)

USE ONLY WHEN SIDE EFFECTS OR RESISTANCE PREVENT THE USE OF ALTERNATIVES

NRTIs: Hivid (zalcitabine; ddC); Viread (tenofovir)

NNRTIs: Rescriptor (delavirdine)

PIs: Agenerase (amprenavir): Liquid formulation contains propylene glycol which may not be metabolized fully; not recommended for use in pregnant women; Lexiva (fosamprenavir); Reyataz (atazanavir)

CONTRAINDICATED/NOT RECOMMENDED FOR USE WITH PREGNANCY

NNRTIs: Sustiva (efavirenz)

Entry Inhibitor: Fuzeon (enfuvirtide, T-20)