Can You Take Acyclovir While Pregnant?

Viral infections can attack anyone, and acyclovir is one of the most popular and widely used medicines for the treatment of viral infections caused by HSV (Herpes Simplex Virus) or varicella-zoster virus. But can this medicine be consumed if you suffer from any of these viral infections during pregnancy? Does it have any side effects? Since these viral infections are hazardous for the mother and her unborn baby, it is important to eliminate these infections with suitable and safe medications. Let’s dig in a little more on the use of acyclovir in pregnancy, its potential benefits and side effects, and whether it is safe for the mother and the unborn baby.

What Is Acyclovir?

Acyclovir is an antiviral medicine, which is available in the form of tablets, topical ointments, and intravenous injections, for the prevention or treatment of chickenpox, shingles, genital herpes, and cold sores. People with weakened immunity may also be given this medicine to improve their immunity. Although it may not aid in the complete removal of the virus, it may help reduce the impact of the viral attack.

How Does It Work to Treat Herpes and Chickenpox?

Acyclovir can help in decreasing the severity of herpes and chickenpox virus. It may even help in reducing the length and severity of the outbreaks. Using this medicine may heal sores faster and even lessen the pain. However, this medicine is more effective if you begin using it when the first outbreak happens.

Is It Safe to Take Acyclovir During Pregnancy?

Acyclovir is considered a safe medicine and can be used during pregnancy, too. However, it should only be used after being prescribed by your registered medical practitioner. This category B drug has no proven side effects. But, if acyclovir is taken during the first trimester of pregnancy, it may cause complications in the pregnancy or may lead to congenital disabilities in your baby. Therefore, in most cases, your doctor may prescribe this medicine only in the later stages of pregnancy if the potential benefits outweigh the potential risks.

As per the American Academy of Family Physicians, the use of acyclovir in the first trimester does not elevate fetal birth defects. The board has also recommended the drug to be the antiviral drug of choice in early pregnancy.

In a 2010 study aimed to investigate associations between the exposure to acyclovir, valacyclovir, and famciclovir in the first trimester of pregnancy and birth defects risks, no statistically significant correlations were found between antiviral exposure and any specific category of major birth defects in cases where exposure occurred within four weeks before conception or during the second and third trimesters of pregnancy.

What If You Have Already Taken Acyclovir in Pregnancy?

If you’ve been using acyclovir before becoming pregnant or have used it without a prescription, it’s crucial to inform your healthcare provider. They will assess your situation and determine whether you should maintain your current medication regimen or reduce the dosage to the minimum necessary. It’s important to avoid discontinuing the medication abruptly without your doctor’s guidance.

Recommended Dosage of Acyclovir for Pregnant Women

The dosage of acyclovir during pregnancy mainly depends on the severity of your condition decided by your healthcare practitioner. Acyclovir in pregnancy dosage may be as follows: you may be prescribed 200 mg, which should be taken 4 to 5 times a day, or 400 mg, taken 3 times a day, depending on your condition. You may have to take medicine for a week to 10 days or longer in some cases. The regular usage of the medicine may not only ensure the reduction in the outbreaks, but it may also prevent the infection from getting passed on to your baby.

Side Effects of Taking Acyclovir

Acyclovir is a safe drug; however, it may sometimes cause some mild to severe side effects in people. We shall be discussing both side effects of acyclovir in pregnancy separately in the following section.

1. Mild Side Effects

• Hair loss
• Fever
• Headache
• Nausea
• Stomach trouble
• Changes in vision

2. Severe Side Effects

• Bloody diarrhoea
• Loss of sensation or tingling sensation in legs or arms
• Abdominal cramps or pain
• Problem in sleeping
• Change in skin colour (skin may turn yellowish)
• Redness, blistering, or peeling of the skin
• Chest pain
• Dark urine or difficulty in urinating
• Hallucinations, tremors, or confusion
• Seizures
• Sensitivity to sunlight
• Allergic reactions on the skin may include itching, swelling on the face, lips, tongue, etc.

If any of these side effects are observed after taking this medicine, you must report the same to your doctor immediately.

Precautions to Take While Taking Acyclovir During Pregnancy

Exercising some of the following precautions may be helpful in reducing the side effects of the medicine:

• Refrain from taking more than the recommended dosage. If it occurs due to negligence, seek medical help at once.
• You should drink lots of water while taking this medicine as it may help in reducing your chances of experiencing any side effects.
• If any allergies are experienced after taking the medicine, you must stop taking it at once.
• If you have any kind of kidney, liver, or nerve abnormality, it must be brought to your doctor’s notice.

FAQs

Here are some questions related to taking this medication that have been answered for you:

1. When Can You Start Taking Acyclovir in Pregnancy?

Women with a history of genital herpes are given prescribed acyclovir, starting around 34 or 36 weeks, to suppress any episodes of herpes so they can have a vaginal birth.

2. Can Acyclovir Cause Birth Defects During Pregnancy?

Your baby’s internal organs get formed in the first trimester of pregnancy. If any kind of medicine with potential side effects is consumed during this time, it may cause congenital disabilities in babies. However, there is no scientific evidence available that states any probable birth defects in babies after mothers have been prescribed acyclovir in the second or third trimester of pregnancy.

3. Can Consumption of Acyclovir During Pregnancy Cause Behaviour and Learning Issues in a Child?

Brain development of a baby happens in the later stages of the pregnancy, too. Hence, mothers are worried about whether the consumption of this medicine would cause a problem in their babies or not. However, there is no substantial medical study available supporting that consumption of acyclovir during pregnancy can cause behaviour and learning problems in a child or an increase in congenital disabilities in unborn babies.

4. Does Acyclovir Cause Miscarriage, Preterm Birth, Stillbirth, or Low Birthweight in a Baby?

There are no scientific proofs available stating that taking acyclovir during pregnancy causes miscarriage, preterm birth, stillbirth, or low birth weight in babies.

5. Can You Use Acyclovir Cream When Pregnant?

It is safe to apply acyclovir cream during pregnancy. It can be used to treat cold sores by applying a small amount to the affected area.

Every pregnant woman wishes to have a healthy pregnancy; however, if any medical emergency strikes, you should trust your doctor and take the prescribed medicines to feel better and recover. Acyclovir and pregnancy can be a safe combination if used cautiously and after a doctor’s consultation. Therefore, it is best recommended to always consult a health expert before starting a medication, especially during pregnancy.

References/Resources:

1. Crawford-Faucher. A; Acyclovir Safe for Treating Herpes Infection in Early Pregnancy; American Family Physician; https://www.aafp.org/pubs/afp/issues/2011/0801/p320a.html; August 2011

2. ZOVIRAX®; US Food & Drug Administration; https://www.accessdata.fda.gov/drugsatfda_docs/label/2004/18603slr027_zovirax_lbl.pdf

3. Management of Genital Herpes in Pregnancy; RCOG; https://www.rcog.org.uk/guidance/browse-all-guidance/other-guidelines-and-reports/management-of-genital-herpes-in-pregnancy/

4. Herpes and Pregnancy; American Sexua; Health Association; https://www.ashasexualhealth.org/herpes-and-pregnancy/

5. Acyclovir; MedlinePlus; https://medlineplus.gov/druginfo/meds/a681045.html

6. Pasternak. B, Hviid. A; Use of Acyclovir, Valacyclovir, and Famciclovir in the First Trimester of Pregnancy and the Risk of Birth Defects; JAMA; https://jamanetwork.com/journals/jama/fullarticle/186468; August 2010

7. Stone. K. M, Reiff-Eldridge. R, White. A. D, et al.; Pregnancy outcomes following systemic prenatal acyclovir exposure: Conclusions from the international acyclovir pregnancy registry, 1984-1999; Birth Defects Res A Clin Mol Teratol.; PubMed; https://pubmed.ncbi.nlm.nih.gov/15108247/; April 2004

8. Cold sores in Pregnancy and Breastfeeding; NSW Medications in Pregnancy and Breastfeeding Service; https://www.seslhd.health.nsw.gov.au/sites/default/files/migration/Mothersafe/documents/ColdSores-Mar2016.pdf

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