Ribavirin, Oral
Antiviral, Systemic · Antiviral
Indications
Severe respiratory syncytial virus bronchiolitis in infants and children; in combination with peginterferon alfa-2b or interferon alfa for chronic hepatitis C not previously treated in patients without liver decompensation and who have fibrosis or high inflammatory activity or for relapse following previous response to interferon alfa.
Dosage
Chronic hepatitis C: Adults: over 18 yr, body-weight under 65 kg, 400 mg twice daily; body-weight 65-85 kg, 400 mg in the morning and 600 mg in the evening; body-weight over 85 kg, 600 mg twice daily. Children: 15-20 mg/kg body weight daily in three divided dosage for 5-7 days.
Adverse Effects
Haemolytic anaemia; also reported (in combination with peginterferon alfa-2b or interferon alfa-2b), nausea, vomiting, dry mouth, stomatitis, glossitis, dyspepsia, abdominal pain, diarrhoea, constipation, pancreatitis, anorexia, weight loss; chest pain, tachycardia, syncope, flushing; dyspnoea, cough, rhinitis, pharyngitis; sleep disturbances, asthaenia, impaired concentration, irritability, aggression, anxiety, depression, dizziness, tremor, hypertonia, myalgia, arthralgia, paraesthesia, influenza-like symptoms, headache; thyroid disorders, menstrual disturbances, reduced libido; rash, pruritus, photosensitivity, alopecia, dry skin; taste disturbance, blurred vision, tinnitus; neutropenia, thrombocytopenia, aplastic anaemia, lymphadenopathy, hyperuricaemia, blood dyscrasias, anaemia.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Contraindicated in pregnancy. Lactation: Contraindicated or not recommended. Contraindications: Severe cardiac disease, including unstable or uncontrolled cardiac disease in previous 6 months; haemoglobinopathies; severe debilitating medical conditions; renal impairment; severe hepatic dysfunction or decompensated cirrhosis; autoimmune disease (including autoimmune hepatitis); history of severe psychiatric condition. Precautions: Exclude pregnancy before treatment; effective contraception essential during treatment and for 4 months after treatment in women and for 7 months after treatment in men; routine monthly pregnancy tests recommended; condoms must be used if partner of male is pregnant (ribavirin excreted in semen); cardiac disease (assessment including ECG recommended before and during treatment, discontinue if deterioration); gout; determine full blood count,…
Interactions
NRTIs, azathioprine.
Advice to Patient
Tablets: Take with meals. Capsule/Solution/Syrup: Take with or without meals in a constant manner (always with meals or always without meals). When capsules are to be taken in combination with peginterferon alfa 2b, take with meals. Contact prescriber if there is fever, chills, rash, unusual bruising or bleeding, unhealed sores, infection, white plaques in mouth, weakness/tingling/pain in extremities. Regular blood tests are required during therapy. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Avoid highly crowded places to prevent infections. Do not get vaccinated without consulting prescriber.
Pharmacokinetics
Metabolism: Hepatically and intracellularly. Bioavailability: Oral: 64%. Half-life elimination, plasma: Adults: Oral: Cap, single dose: 24 hrs in healthy adults, 44 hrs with chronic hepatitis C infection (increases to approx. 298 hrs at steady state). Tab, single dose: Approx. 120-170 hrs. Time to peak, serum: Oral cap: Multiple doses: Children and Adolescents 3-16 yrs: Approx. 2 hrs. Adults: 3 hrs. Tab: 2 hrs. Excretion: Oral cap: Urine (61%). Faeces (12%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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