Generic
Ribavirin
8 brands available in the market
At a glance
Ribavirin is an antiviral used in combination with Peginterferon alfa-2a or Interferon alfa for the treatment of chronic hepatitis C (CHC) virus infection in patients 5 years and older with compensated liver disease.
Description
Ribavirin is a synthetic nucleoside with inhibitory action against respiratory syncytial virus, influenza virus, and herpes simplex virus. The mechanism of action is not clear, but it may interfere with viral nucleic acid synthesis through cellular enzymes. The mono- and triphosphate derivatives are responsible for the antiviral action.
Indications
- Chronic hepatitis C (CHC) virus infection (in combination with Peginterferon/Interferon)
Therapeutic class
Hepatic viral infections (Hepatitis C)
Pharmacological class
Antiviral (Synthetic Nucleoside Analog)
Pharmacology
Ribavirin is a synthetic nucleoside that interferes with viral nucleic acid synthesis. The mechanism of action is not fully clear, but it may act through cellular enzymes. The mono- and triphosphate derivatives are responsible for the antiviral activity.
Mechanism of action
Prevents viral replication by interfering with viral nucleic acid synthesis.
Dosage
Adult Dose (Oral):
- In combination with Peginterferon/Interferon: 800-1200 mg daily in two divided doses (morning and evening)
- Treatment duration: 24-48 weeks (Genotypes 2 and 3: 24 weeks)
- Renal impairment (CrCl ≤50 mL/min): Dose reduction required
Pediatric Dose (≥5 years):
- Same as adult (based on weight and genotype)
Administration
- Take with food
- Drink plenty of water (to prevent dehydration and kidney damage)
- Take at the same time each day
Missed dose
If you miss a dose, take it as soon as possible; if almost time for next dose, skip it; do not double the dose.
Side effects
Side Effects:
- Hemolytic anemia (primary adverse reaction)
- Cough
- Anxiety
- Depression
- Dizziness
- Nausea
- Vomiting
- Flu-like symptoms (fever, chills, sore throat, muscle aches)
- Headache
- Abdominal pain
- Diarrhea
- Constipation
- Chest pain
- Tachycardia
- Dyspnea
- Neutropenia
- Thrombocytopenia
Precautions & warnings
- Ribavirin monotherapy is not effective; do not use alone
- Cardiac disease may be worsened by anemia; ECG before treatment
- Monitor hemoglobin, CBC, platelets, liver function, electrolytes, creatinine
- Pregnancy: Highly unsafe; effective contraception during and for 6 months after treatment
- Lactation: Avoid use
Contraindications
- Hypersensitivity to ribavirin or any excipient
- Pregnant women
- Men with pregnant female partners
- Hemoglobinopathies (thalassemia major or sickle cell anemia)
- Autoimmune hepatitis
- Hepatic decompensation before or during treatment
Drug interactions
- Didanosine, zidovudine, azathioprine: Do not use concomitantly
Food interactions
It is not known whether it is safe to consume alcohol with Ribavirin.
Use in pregnancy
Use in Pregnancy: Highly unsafe during pregnancy; teratogenic effects; negative pregnancy test required before treatment; monthly pregnancy tests and contraception during and for 6 months after treatment.
Pregnancy Category: X — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Unknown if excreted in human milk; due to potential adverse reactions, decide whether to discontinue nursing or not initiate therapy.
Pediatric use
Safety and efficacy not evaluated in children under 5 years.
Geriatric use
No sufficient clinical studies in patients 65 years and older; caution required.
Renal / hepatic impairment
Renal Impairment: CrCl ≤50 mL/min: Daily dose reduction required; not recommended in moderate-severe kidney disease; consult your doctor.
Hepatic Impairment: Limited information on use in liver disease; consult your doctor.
Overdose effects
No overdose information available; consult your doctor if taken in excess.
Storage conditions
Store at temperature not exceeding 30°C in a dry place; protect from light; keep out of reach of children.
Chemical structure
Ribavirin