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Doravirine Pregnancy and Breastfeeding Warnings

Brand names: Pifeltro

Medically reviewed by Drugs.com. Last updated on Oct 12, 2023.

Doravirine Pregnancy Warnings

According to some authorities: As a precaution, use should be avoided.

AU TGA pregnancy category: B1
US FDA pregnancy category: Not assigned.

Risk summary: No data available on use of this drug in pregnant women to inform a drug-related risk.

Comments:
-A pregnancy exposure registry is available.

Animal studies have failed to reveal evidence of embryofetal toxicity at exposures about 9 times (rats) and 8 times (rabbits) the exposure in humans at the recommended human dose; placental transfer to the fetus was observed with fetal plasma levels of up to 40% (rabbits) and 52% (rats) that of maternal levels on gestation day 20. There are no controlled data in human pregnancy.

To monitor maternal-fetal outcomes of pregnant women exposed to antiretroviral therapy, an Antiretroviral Pregnancy Registry has been established. Healthcare providers are encouraged to prospectively register patients. For additional information: apregistry.com

AU TGA pregnancy category B1: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have not shown evidence of an increased occurrence of fetal damage.

US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.

See references

Doravirine Breastfeeding Warnings

Breastfeeding is not recommended during use of this drug.

Excreted into human milk: Unknown
Excreted into animal milk: Yes

Comments:
-No published data available regarding use during breastfeeding; an alternate agent may be preferred.
-The effects in the nursing infant are unknown; potential for HIV-infected infants developing viral resistance and breastfed infants developing side effects
-The US CDC, American Academy of Pediatrics, and manufacturer advise HIV-infected women not to breastfeed to avoid postnatal transmission of HIV to a child who may not yet be infected.
-Local guidelines should be consulted if replacement feeding is not an option.

See references

References for pregnancy information

  1. Product Information. Pifeltro (doravirine). Merck Sharp & Dohme LLC. 2022;SUPPL-7.
  2. Product Information. Pifeltro (doravirine). Merck Sharp & Dohme (UK) Ltd. 2022.
  3. Product Information. Pifeltro (doravirine). Merck Sharp & Dohme (Australia) Pty Ltd. 2020;CCDS-MK1439-T-102017.

References for breastfeeding information

  1. Infant feeding and transmission of human immunodeficiency virus in the United States. Pediatrics. 2013;131:391-6.
  2. Product Information. Pifeltro (doravirine). Merck Sharp & Dohme LLC. 2022;SUPPL-7.
  3. Product Information. Pifeltro (doravirine). Merck Sharp & Dohme (UK) Ltd. 2022.
  4. Product Information. Pifeltro (doravirine). Merck Sharp & Dohme (Australia) Pty Ltd. 2020;CCDS-MK1439-T-102017.
  5. Bethesda (MD): National Institute of Child Health and Human Development (US). Doravirine - Drugs and Lactation Database (LactMed) https://www.ncbi.nlm.nih.gov/books/NBK532499/ 2024.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.