Ribavirin

Administration

• Type: Antiviral- FDA approved for Hepatitis C, severe RSV infection. Off-label use: herpes simplex, influenza, viral hemorrhagic fever
• Dosage Forms: 200 tab, 200 cap
• Routes of Administration: Oral, inhalation
• Common Trade Names: Copegus, Rebetol, Ribasphere

Adult Dosing

• 200-1000mg daily (dose depends on genotype and concurrent treatment with interferon)

Pediatric Dosing

• Hep C: >2 years old: 15mg/kg daily OR 400-1200mg daily
• RSV (severe cases): 20mg/ml aerosolized over 12-18 hours x 3-7 days

Special Populations

• Pregnancy Rating: X
• Lactation risk: Infant risk cannot be ruled out
• Renal dosing: reduced doses for mild-moderate impairment, do not use if CrCl <50

Contraindications

• Allergy to class/drug
• Autoimmune hepatitis
• Coadministration with didanosine
• Hemoglobinopathy (e.g. thalassemia, sickle cell)
• Pregnant or potentially pregnant women, men who may impregnate someone
• Renal impairment (CrCl <50)

Adverse Reactions

Serious

• Hemolytic anemia, TTP
• Bacterial disease
• Hepatotoxicity
• MI
• Suicide

Common

• Neutropenia
• Nausea, vomiting, diarrhea
• Asthenia, dizziness, fatigue
• Weight loss
• Pruritus

Pharmacology

• Half-life: ~300 hours
• Metabolism:
• Excretion: Mostly renal

Mechanism of Action

• Mechanism not well understood

See Also

• Viral hepatitis
• Hepatitis C