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What is Ribavirin
Ribavirin (1-beta-D-ribofuranosyl-1,2,4-triazole-3-carboxamide) is a synthetic guanosine analog with antiviral activity.
It was originally synthesized in the 1970s and has been shown to be active against many DNA and RNA viruses. Oral ribavirin monotherapy is not effective in the treatment of chronic hepatitis C; however, in combination with interferon alfa, peginterferon alfa, or a nucleotide analog NS5B polymerase inhibitor (i.e., sofosbuvir) or NS3/4A protease inhibitor (i.e., simeprevir), it has activity against this disease.
Indications & Dosage
- adenovirus
- adenovirus infection
- Colorado tick fever virus
- Crimean-Congo hemorrhagic fever virus
- Crimean-Congo virus hemorrhagic fever (CCVHF)
- Crimean-Congo virus hemorrhagic fever (CCVHF) prophylaxis
- cytomegalovirus (CMV)
- encephalitis
- Hantaan virus
- Hantaan virus infection
- hemorrhagic fever with renal syndrome (HFRS)
- hepatitis A virus
- hepatitis C infection
- hepatitis C virus
- herpes simplex virus type 1
- herpes simplex virus type 2
- human immunodeficiency virus (HIV)
- influenza A virus
- influenza B virus
- Junin virus
- Lassa fever infection
- Lassa fever prophylaxis
- Lassa fever virus
- measles virus
- Muerto Canyon virus
- mumps virus
- parainfluenza virus
- reovirus
- respiratory syncytial virus (RSV)
- respiratory syncytial virus (RSV) infection
- rhinovirus
- Rift Valley fever virus
- rotavirus
- severe acute respiratory syndrome (SARS)
- subacute sclerosing panencephalitis virus
- variola virus (smallpox)
- viral hemorrhagic fever (VHF)
- West Nile virus
- West Nile virus infection
- yellow fever virus
Side Effects
- abdominal pain
- agitation
- alopecia
- anemia
- angina
- anorexia
- anxiety
- aplastic anemia
- apnea
- arthralgia
- asthenia
- back pain
- blurred vision
- bradycardia
- bronchospasm
- cardiac arrest
- chest pain (unspecified)
- chills
- cholangitis
- clastogenesis
- coma
- conjunctivitis
- constipation
- cough
- cyanosis
- dehydration
- depression
- diabetes mellitus
- diarrhea
- dizziness
- dysgeusia
- dyspepsia
- dyspnea
- eczema vaccinatum
- emotional lability
- fatigue
- fever
- flushing
- growth inhibition
- hallucinations
- headache
- hearing loss
- hemolytic anemia
- hepatic failure
- hepatomegaly
- hyperthyroidism
- hypotension
- hypothyroidism
- hypoventilation
- infection
- injection site reaction
- insomnia
- irritability
- lacrimation
- leukopenia
- lymphopenia
- malaise
- menstrual irregularity
- musculoskeletal pain
- myalgia
- nausea
- neutropenia
- ocular inflammation
- ocular irritation
- pancreatitis
- peptic ulcer
- peripheral neuropathy
- pharyngitis
- pneumothorax
- pruritus
- psychosis
- pulmonary edema
- pulmonary embolism
- pulmonary hypertension
- rash
- red cell aplasia
- respiratory depression
- retinal detachment
- rhinitis
- sinus tachycardia
- sinusitis
- Stevens-Johnson syndrome
- suicidal ideation
- teratogenesis
- thrombocytopenia
- thrombotic thrombocytopenic purpura (TTP)
- tinnitus
- toxic epidermal necrolysis
- vertigo
- vomiting
- weight loss
- xerostomia
Monitoring Parameters
- CBC with differential
- echocardiogram
- hemoglobin/hematocrit
- LFTs
- plasma hepatitis C RNA
- pregnancy testing
- serum uric acid
- thyroid function tests (TFTs)
Contraindications
- anemia
- angina
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- cerebrovascular disease
- children
- contact lenses
- contraception requirements
- coronary artery disease
- dialysis
- geriatric
- growth inhibition
- heart failure
- hemoglobinopathy
- hemolytic anemia
- hepatic disease
- hepatitis
- hepatitis C and HIV coinfection
- infants
- infection
- infertility
- influenza
- male-mediated teratogenicity
- myocardial infarction
- neonates
- ocular exposure
- organ transplant
- pancreatitis
- pregnancy
- pregnancy testing
- renal failure
- renal impairment
- reproductive risk
- requires an experienced clinician
- respiratory depression
- respiratory insufficiency
- ribavirin monotherapy
- sickle cell disease
- thalassemia
- thyroid disease
- viral infection
Interactions
- Abacavir
- Abacavir; Dolutegravir; Lamivudine
- Abacavir; Lamivudine, 3TC
- Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
- Amprenavir
- Atazanavir
- Atazanavir; Cobicistat
- Azathioprine
- Bictegravir; Emtricitabine; Tenofovir Alafenamide
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Delavirdine
- Didanosine, ddI
- Dolutegravir; Lamivudine
- Dolutegravir; Rilpivirine
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir alafenamide
- Emtricitabine; Tenofovir disoproxil fumarate
- Etravirine
- Fosamprenavir
- Indinavir
- Lamivudine, 3TC
- Lamivudine, 3TC; Zidovudine, ZDV
- Lamivudine; Tenofovir Disoproxil Fumarate
- Lopinavir; Ritonavir
- Nelfinavir
- Nevirapine
- Non-nucleoside reverse transcriptase inhibitors
- Ombitasvir; Paritaprevir; Ritonavir
- Protease inhibitors
- Rilpivirine
- Ritonavir
- Saquinavir
- Stavudine, d4T
- Talimogene Laherparepvec
- Telbivudine
- Tipranavir
- Zalcitabine, ddC
- Zidovudine, ZDV
