Daclatasvir Pregnancy: What You Need to Know Before Taking It

When you're pregnant and living with hepatitis C, daclatasvir, a direct-acting antiviral used to treat chronic hepatitis C virus infection. Also known as Daklinza, it's one of the most effective drugs for clearing the virus—but its use during pregnancy isn't straightforward. Unlike older treatments like ribavirin, which are known to cause birth defects, daclatasvir hasn’t been studied enough in pregnant women to say it’s completely safe. The FDA classifies it as Category B, meaning animal studies showed no harm, but human data is still limited. That doesn’t mean you avoid it—it means you and your doctor weigh the risks of untreated hepatitis C against the unknowns of the drug.

Untreated hepatitis C during pregnancy can lead to serious problems: a higher chance of preterm birth, low birth weight, and even passing the virus to your baby. About 5% of babies born to mothers with HCV get infected, and that risk goes up if you also have HIV. So while we don’t have a mountain of data on daclatasvir in pregnancy, we do know that curing HCV before or after pregnancy is one of the best things you can do for your child’s health. Many doctors now recommend waiting until after delivery to start daclatasvir if your liver isn’t severely damaged. But if you have advanced cirrhosis or other complications, delaying treatment could be riskier than taking the drug.

What about the other drugs in your regimen? Daclatasvir is almost always used with sofosbuvir, a nucleotide analog polymerase inhibitor often combined with daclatasvir for HCV treatment. Together, they form a potent combo that clears the virus in over 95% of cases. But sofosbuvir also lacks solid pregnancy safety data. The good news? Neither drug is known to cross the placenta in large amounts, and animal studies haven’t shown developmental toxicity. Still, the CDC and AASLD don’t yet give a strong recommendation for use during pregnancy—so most providers treat it as off-label unless the benefits clearly outweigh the risks.

If you’re planning a pregnancy and have hepatitis C, talk to your doctor about getting treated first. Many women successfully clear the virus with daclatasvir-sofosbuvir and go on to have healthy babies. If you’re already pregnant and diagnosed with HCV, your doctor might suggest monitoring your liver function closely and delaying treatment until after birth. Breastfeeding is generally considered safe while taking daclatasvir—only tiny amounts pass into milk, and no harm has been reported in nursing infants.

What you’ll find below are real, practical guides from people who’ve been there: women who took daclatasvir during pregnancy, doctors explaining how they make decisions, and comparisons with other HCV drugs like atazanavir, an HIV protease inhibitor sometimes used in pregnant women with HIV/HCV coinfection. You’ll see how treatment choices differ based on liver health, co-infections, and trimester. No fluff. No guesswork. Just clear info to help you ask the right questions and make the best call for you and your baby.