Ribavirin

width = Ribavirin is a drug with an antiviral effect, used in combination therapy for chronic hepatitis C.

Highly active against herpes simplex virus type 1 and 2, cytomegalovirus, adenovirus, influenza A and In parainfluenza, hepatitis C virus, mumps, hemorrhagic fever, smallpox and some other viruses. Insensitive to the drug: the herpes zoster virus, smallpox, pseudorabies, enteroviruses, rhinoviruses.

The maximum concentration of this antiviral drug in the blood is noted after, hours after administration. Plasma accumulates in large quantities. It is excreted from the body with urine very slowly (about 300 h. after discontinuation of administration).

Clinical and pharmacological group

An antiviral agent.

Terms of sale from pharmacies

You can buy without a doctor's prescription.

Price

How much does Ribavirin cost in pharmacies? The average price is at the level of135 rubles.

Composition and form of release

The drug Ribavirin is available in the form of a tablet for oral administration.

The active substance of the drug is ribavirin. Tablets, in addition, contain MCC, calcium hydrophosphate dihydrate, talc, corn starch and magnesium stearate.
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Tablets are packaged in a package of 20, 30, 60 and 90 pieces. Cardboard pack contains instructions for the use of the drug.

pharmachologic effect

Ribavirin has a pronounced antiviral effect. It is active against DNA and RNA viruses. The active substance quickly penetrates into the cells affected by the virus and is metabolized there. The drug suppresses the division of viral RNA, inhibiting the appearance of new cells. Ribavirin does not adversely affect the RNA of healthy cells.

The viruses of influenza A and B, herpes, parotitis, parainfluenza, reoviruses, cytomegalovirus and hepatitis C viruses are most sensitive to Ribavirin.

Indications for use

Ribavirin is prescribed for the treatment of chronic hepatitis C (in combination with interferon alpha-2b / peginterferon alfa-2b) in the following situations:

Immunity to monotherapy with interferon alfa-2b and peginterferon alfa-2b;
exacerbation of the disease after completion of the course of monotherapy with interferon alfa-2b and peginterferon alfa-2b preparations;
not previously conducted therapy with the use of interferon alfa-2b and peginterferon alfa-2b.

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Contraindications

Ribavirin is contraindicated in:

Renal failure (with QC less than 50 ml / min);
Diseases of the thyroid gland that can not be treated by conventional methods;
Hemoglobinopathies (including thalassemia and sickle-cell anemia);
Expressed depression, suicidal thoughts and attempts, incl. in the anamnesis;
Severe heart diseases (including uncontrolled and unstable forms), and also within 6 months after their treatment;
Decompensated liver cirrhosis;
Severe hepatic insufficiency;
Autoimmune diseases, incl. with autoimmune hepatitis;
Hypersensitivity to the drug.

In addition, Ribavirin is not prescribed for children and adolescents under the age of 18, for women during pregnancy and during lactation.

Special observation during treatment with ribavirin is necessary when:

Diseases of the heart;
Violation of blood clotting, incl. with pulmonary embolism and thrombophlebitis;
Diabetes mellitus, accompanied by attacks of ketoacidosis;
Significant oppression of the hematopoietic function of the bone marrow;
Severe lung diseases, including chronic obstructive disease;
Simultaneous use of highly active antiretroviral therapy in patients with concomitant HIV infection.

Dosage and route of administration

As indicated in the instructions for the use of tablets and capsules, Ribavirin is taken orally, washed down with water, without chewing, while eating.

Recommended dosing regimen: 800-1200 mg per day, divided into 2 doses (morning and evening), combined with interferon alfa-2b - 3 million IU subcutaneously 3 times a week or peginterferon alfa-2b-po, mcg / kg subcutaneously 1 time in Week.

The daily dose of ribavirin in combination with interferon alpha-2b, depending on the patient's body weight:

& l; 5 kg - 1000 mg (400 mg in the morning and 600 mg in the evening);
≥75 kg - 1200 mg (600 mg in the morning and 600 mg in the evening).

The daily dose of ribavirin in combination with peginterferon alfa-2b, depending on the patient's body weight:

& l; 5 kg - 800 mg (400 mg in the morning and 400 mg in the evening);
65-85 kg - 1000 mg (400 mg in the morning and 600 mg in the evening);
≥85 kg - 1200 mg (600 mg in the morning and 600 mg in the evening).

Duration of therapy in different patient categories:

Previously not treated - 24 weeks or more;
With the hepatitis C virus of genotype 1 - 48 weeks;
Immune to monotherapy with peginterferon alfa-2b or interferon alpha-2b, and also in the case of relapse - from six months to a year, depending on the clinical course of the disease and the response to the ongoing treatment.

Side effect

Possible side effects of ribavirin:

Allergic reactions: erythema, skin rash, hives, anaphylaxis, angioedema, erythema multiforme, toxic epidermal necrolysis, bronchospasm, Stevens-Johnson syndrome;
From the cardiovascular system: increased or decreased blood pressure, palpitations, tachycardia, bradycardia, cardiac arrest;
On the part of the respiratory system: otitis media, cough, dyspnea, bronchitis, rhinitis, pharyngitis, sinusitis;
From the musculoskeletal system: myalgia, arthralgia;
From the metabolism: a violation of the thyroid gland, a change in the level of TSH;
On the part of the genitourinary system: dysmenorrhea, menorrhagia, amenorrhea, decreased libido, hot flashes, prostatitis;
From the digestive tract: a decrease in appetite, dryness of the oral mucosa, nausea, abdominal pain, diarrhea or constipation, vomiting, flatulence, bleeding from the gums, glossitis, hyperbilirubinemia, stomatitis, pancreatitis;
From the hemopoietic system and hemostasis: thrombocytopenia, leukopenia, hemolytic anemia, granulocytopenia, neutropenia; very rarely - aplastic anemia;
From the nervous system and sensory organs: general weakness, dizziness, malaise, headache, insomnia, anxiety, irritability, emotional lability, depression, nervousness, asthenia, agitation, confusion, aggressive behavior; rarely - increased smooth muscle tone, conjunctivitis, lesion lacrimal gland, visual impairment, hypoesthesia, hyperesthesia, syncope, paresthesia, tremor, taste distortion, tinnitus, hearing impairment / loss, suicidal inclinations;
Other: alopecia, photosensitivity, hair structure disorder, hypothyroidism, thirst, dry skin, flu-like syndrome, chest pain cell, lymphadenopathy, hyperthermia, sweating, fungal and viral (including herpes) infections, with intravenous administration - pain at the injection site, chills.

In case of an overdose of ribavirin, an increase in the severity of side effects is possible. Hemodialysis is practically ineffective, treatment is symptomatic.

The medical staff working with the drug can also develop unwanted reactions: headache, bronchitis, otitis media, rhinitis, pharyngitis, itching, puffiness of the eyelids, lacrimal gland damage, redness of the eye apples.

Overdose

Overdose increases the severity of side effects.

Removing Ribavirin is required to eliminate symptoms. Symptomatic therapy is also provided.

special instructions

Medical personnel using ribavirin should take into account its teratogenicity.

Use only in a hospital with a specialized resuscitation department. The use of ribavirin in patients who require mechanical ventilation is possible only by specialists with experience in resuscitation.

Use with caution in women of reproductive age (the onset of pregnancy is undesirable), in patients with decompensated diabetes mellitus (with seizures ketoacidosis), with COPD, pulmonary embolism, chronic heart failure, with thyroid disease (including thyrotoxicosis), with disorders of blood clotting, with thrombophlebitis, myelodepression, hemoglobinopathy (including thalassemia, sickle cell anemia), depression, suicidal tendencies (including history) associated with HIV infection (combined with highly active antiretroviral therapy - risk of lactic acidosis), in elderly patients age.

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Interaction with other drugs

When using the drug, it is necessary to take into account the interaction with other drugs:

With simultaneous use with interferons, therapeutic effectiveness is increased.
With simultaneous use with ribavirin, a decrease in the effectiveness of stavudine and zidovudine is possible.
The possibility of drug or other interaction with ribavirin may persist for up to two months (5 cycles of T1 / 2 ribavirin) after discontinuation of its use due to delayed excretion.

Reviews

We offer you to read reviews of people who used the drug Ribavirin:

Ivan. I already take this medication for two months now I feel fine. The disease slowly recedes from the hepatitis with hepatitis 1
Vova. I take about a month, (since the flora of the metral valve, the extrosystole), the pain in the liver is much reduced, I am taken with amystin, the work of the heart is much improved, I stopped to take a konko, astrology improved, a pleasant flax appeared, the meaning brightened, avery not the normal state of liver-bile very much affect the work heart.
Alexey. A good drug, helps to control hepatitis and generally improves quality of life. It's a pity a lot of restrictions on life for ribavirin and not everyone goes, then in general a pipe, because there are no adequate substitutes for it now 🙁