Ribavirin

What is Ribavirin?

In combination with certain interferon drugs, ribavirin is prescribed to treat chronic hepatitis C. It is always used with another drug. By itself, ribavirin is not effective against hepatitis C.

What is the most important information I should know about Ribavirin?

Extreme care should be taken to avoid pregnancy when a woman or her partner is taking ribavirin. The drug poses a significant risk of serious harm to developing infants, even at lower doses, and it can also cause abnormalities in a man's sperm. The doctor will want to see a negative pregnancy report immediately before starting ribavirin therapy; and pregnancy tests should be done every month during therapy and for 6 months after it stops. Use at least two forms of birth control during treatment and for six months afterwards.

Within 2 weeks of starting treatment with ribavirin, about one patient in 10 develops a severe form of anemia. Your doctor will order blood tests periodically to check for this condition. Severe anemia is a serious condition that can lead to a potentially fatal heart attack. Ribavirin should be used with caution if you have a heart condition. Your doctor will perform heart tests such as an ECG before you begin treatment and will monitor your heart closely while you are taking ribavirin. You may have to discontinue therapy if you develop heart-related problems or if your heart condition gets worse.

Treatment with ribavirin and interferon drugs can have other serious side effects, including depression and suicidal thoughts (especially in adolescents), blood disorders, pancreas and lung problems, diabetes, autoimmune disorders, and infections. If you develop symptoms of these conditions, your doctor may have to discontinue treatment with ribavirin.

The risk of side effects is greater for individuals with poor kidney function. If you have this problem, your doctor will monitor you closely and adjust your dosage if necessary. Since many older adults have impaired kidney, liver, and heart function, the dosage of ribavirin is often decreased for these individuals.

The safety and effectiveness of ribavirin treatment have not been established for individuals with organ transplants, uncontrolled liver disease, and hepatitis B or unstable HIV infection. Your doctor will have your liver function tested before you begin taking ribavirin.

Who should not take Ribavirin?

Do not take ribavirin if you are pregnant or planning to become pregnant during treatment or during the 6 months after treatment has ended, are breastfeeding, or if you are a man and have a female partner who fits these criteria. In addition, you should not take ribavirin if you have hepatitis caused by your immune system attacking your liver (autoimmune hepatitis); have certain blood disorders, such as thalassemia major or sickle-cell anemia; have severe or unstable heart disease or liver disease; have severe kidney dysfunction; or have ever had an allergic reaction to any of the ingredients in this medication.

What should I tell my doctor before I take the first dose of Ribavirin?

Tell your doctor about all prescription, over-the-counter, and herbal medications you are taking before beginning treatment with this drug. Also, talk to your doctor about your complete medical history, especially if you have kidney or liver problems, heart problems, hepatitis B or unstable HIV infection, have had an organ transplant, or if you are pregnant, plan to become pregnant, or are breastfeeding.

What is the usual dosage?

The information below is based on the dosage guidelines your doctor uses. Depending on your condition and medical history, your doctor may prescribe a different regimen. Do not change the dosage or stop taking your medication without your doctor's approval.

Adults and children: Your doctor will determine the best dosage based on your condition, how much you weigh, and how your body responds to the drug. Your dosage will be lowered if you develop anemia while taking ribavirin.

How should I take Ribavirin?

Ribavirin is available in various forms, including tablets, capsules, and an oral solution.

Take it with food, and make sure you drink plenty of water while taking ribavirin, especially when you first begin treatment.

What should I avoid while taking Ribavirin?

Avoid becoming pregnant or breastfeeding while taking ribavirin.

Avoid becoming dehydrated; to reduce damage to teeth and oral membranes from dry mouth, brush your teeth and floss regularly.

What are possible food and drug interactions associated with Ribavirin?

If you are taking didanosine, treatment with ribavirin is not recommended. Serious and even fatal reactions have occurred.

If ribavirin is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining ribavirin with HIV drugs known as nucleoside analogues, such as lamivudine and zidovudine.

What are the possible side effects of Ribavirin?

Side effects cannot be anticipated. If any develop or change in intensity, tell your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking this drug.

Side effects may include: anxiety, anemia (possibly severe), blood disorders, chills, depression, dizziness, fatigue, fever, hair loss, headache, insomnia, irritability, joint or muscle pain, nausea, shortness of breath, skin problems, vomiting, weight loss

Can I receive Ribavirin if I am pregnant or breastfeeding?

Ribavirin may cause birth defects or death in the developing infant. Neither a woman nor her partner should take ribavirin while she is pregnant. Use two forms of contraception if either partner is taking ribavirin. Continue using two forms of contraception for 6 months after treatment is finished. If pregnancy occurs during ribavirin therapy or within 6 months afterwards, contact your doctor immediately.

It is not known whether ribavirin appears in breast milk. Because of the potential for serious adverse effects on the nursing infant, you should not breastfeed your baby while taking ribavirin.

What should I do if I miss a dose of Ribavirin?

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule. Never take two doses at once.

How should I store Ribavirin?

Store at room temperature.