Ribavirin

Introduction

Ribavirin is a medication used as part of a combination treatment for hepatitis C. It is a type of nucleoside analogue known as a guanosine analogue, or "nucleoside analogue polymerase inhibitor".

Uses For

Ribavirin is used as part of a combination therapy to treat chronic hepatitis C. It works by reducing the amount of the virus in the body.

Brand Name	Ribavirin
Type
Weight
Generic	Ribavirin
Manufacturer
Available in	English বাংলা

Mechanism of Action

Ribavirin works by interfering with protein synthesis in the virus, preventing replication. It also works to reduce the inflammation and damage caused by the virus.

How Long Does It Take to Work?

Ribavirin takes several weeks to begin to work, and typically 4-6 months of treatment before the full effects are seen.

Absorption

Ribavirin is rapidly absorbed in the gastrointestinal tract, with peak concentrations occurring 2 to 4 hours after administration.

Route of Elimination

Ribavirin is eliminated mainly in the urine as unchanged drug and metabolites.

Dosage

The recommended duration of treatment for patients previously untreated with interferon is 24 to 48 weeks. After 24 weeks of treatment virologic response should be assessed. Treatment discontinuation should be considered in any patient who has not achieved an HCV RNA below the limit of detection of the assay by 24 weeks. There are no safety and efficacy data on treatment for longer than 48 weeks in the previously untreated patient population. In patients who relapse following interferon therapy, the recommended duration of treatment is 24 weeks. There are no safety and efficacy data on treatment for longer than 24 weeks in the relapse patient populations.

Ribavirin + Interferon: Genotype Ribavirin Daily Interferon alpha-2a Duration or interferon alpha-2b.

• All <75 kg: (400+600) mg 3 MIU 3 times weekly 48 weeks Genotypes subcutaneously (Genotype1&4)
• >75 kg: (600+600) mg 24 weeks (Genotype2&3)

Ribavirin + Peg-Interferon: Genotype Ribavirin Daily Peg-Interferon alpha-2a Duration or Peg-interferon alpha-2b:

• 1 & 4 < 75 kg: (400+600) mg 180 gm once weekly 48 weeks
• > 75 kg: (600+600) mg subcutaneously 2 & 3 (400+400) mg 24 weeks

Ribavirin may be administered without regard to food, but should be administered in a consistent manner. Drink plenty of water while being treated with this medication; drinking water will decrease the risk of serious side effects. The usual recommended dose is 800-1200mg taken orally twice daily in divided doses. The dosage should be tailored according to the patient's weight and the type of virus being treated (i.e. genotype).

Administration

Ribavirin should be taken with food and with plenty of fluids. Do not crush, chew, or break the tablets. Take all of the medication exactly as prescribed.

Side Effects

Common side effects of Ribavirin include nausea, vomiting, headache, fatigue, hair loss, rash, abdominal pain, and shortness of breath.

Toxicity

The maximum tolerated dose (MTD) of Ribavirin is unknown, though it is generally well-tolerated at normal doses.

Precautions

Ribavirin should not be taken if you are pregnant or breastfeeding. It should also be avoided in people with kidney or liver disease, heart problems, or certain genetic conditions.

Interactions

Ribavirin is known to interact with other drugs and substances. Before taking Ribavirin , tell your doctor about all prescription and over-the-counter medications, as well as herbal remedies, vitamins, and supplements.

Disease Interactions

Ribavirin can interact with certain diseases, such as HIV, cytomegalovirus (CMV), and tuberculosis (TB). It can also interact with other liver or kidney diseases, or blood disorders.

Drug Interactions

Certain medications, including anticoagulants, anticonvulsants, narcotic analgesics, antifungals, sulfonamides, and diuretics, may interact with Ribavirin and should be avoided or adjusted.

Food Interactions

Avoid taking Ribavirin with grapefruit or grapefruit juice as it can increase the amount of drug in the system.

Pregnancy Use

Ribavirin should not be used during pregnancy as it can cause fetal harm.

Lactation Use

Ribavirin should not be used while breastfeeding as it can pass into breastmilk and harm the baby.

Acute Overdose

Acute overdose of Ribavirin is rare, but can cause seizures, hypertension, and cardiac arrhythmias.

Contraindications

Ribavirin is contraindicated in pregnant women, lactating mothers, patients with kidney or liver disease, heart conditions, or certain genetic conditions.

Use Directions

Follow the directions on your prescription label exactly. Do not take more or less of the medication than prescribed. Take all of the medication exactly as prescribed, with food and plenty of fluids. Do not crush, chew, or break the tablets.

Storage Conditions

Ribavirin should be stored at room temperature, away from heat and direct light.

Volume of Distribution

Ribavirin has a volume of distribution of approximately 4.2 L/kg.

Half Life

The half life of Ribavirin is approximately 2 hours.

Clearance

Ribavirin has an oral clearance of approximately 0.07 L/h/kg.

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Some Frequently Asked Questions About Ribavirin