Safety of Small Molecule Anti-SARS-CoV-2 Drugs During Pregnancy and Lactation
OBJECTIVE Pregnant women are at a high risk of severe/critical SARS-CoV-2 infection,which can cause serious harm to both mothers and fetuses.Therefore,safe and effective medications are urgently needed.The current circulating strain Omicron variant JN.1 has been observed to elicit immune escape,leading to a decline in the efficacy of vaccines and neutralizing antibody drugs.As a result,the importance of small molecule antiviral drugs has become increasingly apparent,but their safety in pregnant and lactating women are not clear.METHODS Through searching domestic and international literature and databases,this paper reviews the safety data and experience of the approved small molecule anti-SARS-CoV-2 drugs(including remdesivir,molnupiravir,azvudine,renmindevir,nirmatrelvir/ritonavir,simnotrelvir/ritonavir,and leritrelvir)during pregnancy and lactation.The paper also presents in-formation on genetic toxicity,animal and human reproductive toxicity,placental transport,and milk secretion.RESULTS Among them,the research data on remdesivir and nirmatrelvir/ritonavir are relatively sufficient.Animal studies have not found obvious repro-ductive toxicity,and the use of these drugs during human pregnancy has not shown serious adverse effects on mothers and fetuses.However,remdesivir is not yet listed in our country.CONCLUSION Nirmatrelvir/ritonavir may be an option for anti-SARS-CoV-2 treatment during pregnancy,and breast-feeding should be done after the drug is cleared.
万方数据
维普
