COVID-19 antiviral drugs and their affect on reproductive health
Antiviral drugs prescribed for COVID-19 infection can temporarily affect reproductive health.
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists
The following updated advice is available for people who are prescribed antiviral therapy for COVID-19 infection.
Antiviral drugs have just become more widely available in Australia and are also available in Aotearoa New Zealand. These drugs can temporarily affect reproductive health in both men and women.
The two brands approved for prescription in Australia and New Zealand, Lagevrio and Paxlovid, have different potential effects on reproduction as well as pre-existing health issues.
Lagevrio (Molnupiravir) is an antiviral medicine taken orally in capsule form. When started within five days after COVID-19 symptom onset, Molnupiravir reduces the risk of hospitalisation or death in unvaccinated adults with COVID-19 who have a risk of progressing to severe COVID-19.
Lagevrio is not recommended during pregnancy and while breastfeeding. Effective birth control is recommended for people of childbearing potential. Men are recommended to use contraception while being treated with the drug (Lagevrio), and for three months afterwards. While it is unknown how Lagevrio affects sperm, sexually active people with a partner of childbearing potential should use a reliable contraception method during treatment and for 3 months after the last dose.
Paxlovid (Nirmatrelvir and ritonavir) is a combination antiviral medicine taken orally in tablet form. People taking Paxlovid should use effective forms of contraception during treatment and for seven days after treatment.
People prescribed with antiviral therapy are advised to consult their health professional.
Australia: NPS Medicinewise information on Lagevrio
Australia: NPS Medicinewise information on Paxlovid
Aotearoa New Zealand: MedSafe advice
The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) is the lead body for women’s health in Australia and New Zealand and carries the responsibility for advice, dissemination of information and support of our members, our patients and the community during the COVID-19 pandemic.
The College respects the role of government, health departments and health administrators in coordinating a national response. Our public statements are made following consultation with officials, and medical experts, and with the understanding that the impacts of the pandemic are evolving, multifactorial and that action in one area will have intended, and unintended, effects on other areas.
RANZCOG will continue to provide information and advice that is the best available, to our knowledge. Given the recency of COVID-19 and the paucity of data, particularly in pregnancy, the accuracy of any advice may be rapidly superseded. We will endeavour to regularly update our communication as new information becomes available. Furthermore, RANZCOG will not comment on areas beyond our remit.
RANZCOG commentary on COVID-19 should be considered advisory, and not proscriptive, and all health workers, and the general public, should heed the advice of government and health authorities.