Precautions and warnings

Patients with severe liver scarring, kidney problems, or anemia need special care. Doctors should check a complete blood count (CBC) before starting treatment and regularly during it. Women, and female partners of men getting this treatment, should use birth control while on the medication and for at least six months after stopping it. People with anemia also have a higher risk of heart attacks, which can be fatal or nonfatal.

Drug Interactions

This medicine can make interferon alfa–caused neutropenia (low white blood cells) worse. It may also raise the risk of side effects when taken with nucleoside reverse transcriptase inhibitors.

Serious Warning: When used with didanosine, it can cause deadly liver failure, nerve damage (peripheral neuropathy), and pancreatitis. It can also cause more serious neutropenia and anemia if used with zidovudine.

Contraindications

Allergy to this medication. Pregnancy or breastfeeding. Serious heart problems, blood disorders, or low kidney function (CrCl).

Mode of actions

Ribavirin is a man-made drug that works against viruses like respiratory syncytial virus, influenza virus, and herpes simplex virus. Scientists are not exactly sure how it works, but it seems to block the viruses from making their genetic material by affecting certain enzymes in the cell. The drug’s antiviral effects come from its mono- and triphosphate forms.

Dosage & Administration

Adult: PO: Ribavirin + Interferon
W/ interferon alfa-2a or interferon alpha-2b. Dosage depends on viral genotype.
For genotype 1 or 4: All < 75 kg= (400+600) mg 3 MIU 3 times weekly 48 weeks subcutaneously. or > 75 kg= (600+600) mg
For genotype 2 or 3: (400+400) mg/day.

Ribavirin + Peg-Interferon
W/ Peg-Interferon alpha-2a Duration or Peg-interferon alpha-2b
For genotype 1 or 4: < 75 kg= (400+600) mg, once weekly 48 weeks. > 75 kg= (600+600) mg subcutaneously.
For genotype 2 or 3: (400+400) mg 24 weeks
For co-infection w/ HIV: 800 mg/day (regardless of viral genotype).

To be given in 2 divided doses for 48 wk (genotype 1 or 4 or HIV co-infection) or 24 wk (genotype 2 or 3).
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.

Child: >3 yr: recommended dosing regimen (Rebetol (Schering Plough)): 15 mg/kg daily, given in 2 divided doses. Used in combination with interferon alfa-2b. For patients

Pregnancy & Lactation

This medicine must not be used during pregnancy. It can be absorbed through the skin and lungs caused can damage your unborn child’s organs and cause congenital disabilities. Strict two effective types of birth control starting one month before and during treatment and for three years after stopping this medicine. Discuss with your doctors if you are not sure which types of birth control are effective for you. You must need to take pregnancy tests regularly during your treatment with this medicine and for at least three years after taking this medicine. If it seems that you do become pregnant stop taking this medicine and call your doctor immediately. If you really become pregnant, miss a menstrual period, or have sex without using two forms of birth control. In some cases, your doctor can prescribe emergency contraception to prevent pregnancy. People on this medicine should not donate blood during the treatment and for three years afterward.

This medicine is also contraindicated breast milk. Breastfeeding is not recommended while using this medication and for three years afterward.

Pack Size & Price