Ribavirin

Brand Canonpharma

In stock 999 Items

Available since: 2019-09-19

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Clinical Pharmacology

Antiviral agent. Ribavirin quickly penetrates cells and acts inside virus-infected cells. Intracellular ribavirin is easily phosphorylated by adenosine kinase to mono-, di-, and triphosphate metabolites. Ribavirin triphosphate is a strong competitive inhibitor of inosine monophosphate dehydrogenase, influenza virus RNA polymerase and guanylyl transferase messenger RNA, the latter is manifested by inhibition of the informational RNA membrane coating process. These diverse effects lead to a significant reduction in the amount of intracellular guanosine triphosphate, as well as inhibition of the synthesis of viral RNA and protein. Ribavirin inhibits the replication of new virions, which reduces viral load, selectively inhibits the synthesis of viral RNA, without suppressing the synthesis of RNA in normally functioning cells.

Indications

Treatment of chronic hepatitis C in adults (in combination with interferon alfa-2b or peginterferon alfa-2b).

Composition

1 capsule contains:

Active substance: ribavirin 200 mg

Ribavirin is marketed under different brands and generic names, and comes in different dosage forms:

Brand name	Manufacturer	Country	Dosage form
Ribavirin	Canonpharma	Russia	capsules
Ribavirin	Vertex	Russia	capsules
Devirs	Vertex	Russia	cream
Rebetol	Schering-Plough	USA	capsules

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Dosage and Administration

Ribavirin is taken orally, during meals, without chewing, drinking water.

When hepatitis C is recommended to take the drug at the rate of 15 mg per 1 kg of body weight. Patients with a body weight of less than 75 kg - 1000 mg per day (400 mg in the morning and 600 mg in the evening), patients with a body weight of more than 75 kg - 1200 mg per day (600 mg in the morning and evening).

The duration of the course of combination therapy with alpha-interferon is 24-48 weeks. For previously untreated patients - at least 24 weeks; for patients with genotype I virus - 48 weeks; for patients who are not susceptible to monotherapy with alpha-interferon and with the relapse of the disease - at least 6 months.

Adverse reactions

On the part of the central nervous system and peripheral nervous system: headache, dizziness, weakness, malaise, insomnia, asthenia, depression, irritability, anxiety, emotional lability, nervousness, agitation, aggressive behavior, confused consciousness; rarely - suicidal tendencies, increased smooth muscle tone, tremor, paresthesias, hyperesthesia, hypoesthesia, syncope.

Since the cardiovascular system: decrease or increase in blood pressure, brady- or tachycardia, palpitations, cardiac arrest.

From the side of blood-forming organs: hemolytic anemia, leukopenia, neutropenia, granulocytopenia, thrombocytopenia; extremely rarely - aplastic anemia.

On the part of the respiratory system: dyspnea, cough, pharyngitis, shortness of breath, bronchitis, otitis media, sinusitis, rhinitis.

On the part of the digestive system: dry mouth, decreased appetite, nausea, vomiting, diarrhea, abdominal pain, constipation, taste perversion, pancreatitis, flatulence, stomatitis, glossitis, gingival bleeding, hyperbilirubinemia.

On the part of the senses: damage to the lacrimal gland, conjunctivitis, blurred vision, impairment / loss of hearing, tinnitus.

From the musculoskeletal system: arthralgia, myalgia.

On the part of the genitourinary system: hot flashes, decreased libido, dysmenorrhea, amenorrhea, menorrhagia, prostatitis.

Contraindications

Chronic heart failure IIB-III stage, myocardial infarction, renal failure (CC - less than 50 ml / min), severe anemia, severe liver failure, decompensated cirrhosis of the liver, autoimmune diseases (including autoimmune hepatitis), which are not amenable to treatment of the disease thyroid gland, severe depression with suicidal tendencies, children and adolescents under 18 years of age, pregnancy, lactation, sensitivity to ribavirin.

Drug interactions

The combined use of ribavirin and alpha-interferon indicates synergism of their actions.

With the clinical use of various drugs in therapeutic doses in combination with ribavirin, no significant interactions were found.

Prescription of ribavirin during treatment with Zidovudine and / or Stavudine with simultaneously present HIV infection is accompanied by a decrease in the phosphorylation of these drugs, which leads to HIV viremia and requires a change in treatment regimen.

No interaction of ribavirin and non-nucleoside reverse transcriptase inhibitors or protease inhibitors was detected. Therefore, the combined use of ribavirin and these drugs for the treatment of patients with HIV co-infection with hepatitis C is possible.

Drugs containing compounds of magnesium and aluminum, simethicone reduce the bioavailability of the drug.

Special instructions

Consider the teratogenicity of the drug, men and women of reproductive age during treatment and within 7 months after the end of therapy should use effective contraceptives.

Laboratory studies (clinical blood analysis with calculation of leukocyte formula and platelet count, determination of electrolytes, creatinine, functional liver samples) should be carried out before the start of therapy, at 2 and 4 weeks, and then regularly.

In the process of treatment with ribavirin, the maximum decrease in hemoglobin content in most cases is observed after 4-8 weeks from the start of treatment. With a decrease in hemoglobin below 110 mg / ml, the dose of ribavirin should be temporarily reduced by 400 mg per day; with a decrease in hemoglobin below 100 mg / ml, the dose should be reduced to 50% of the initial dose. In most cases, the recommended dose changes ensure recovery of hemoglobin levels. With a decrease in hemoglobin below 85 mg / ml, the drug should be stopped.

In case of acute hypersensitivity (urticaria, angioedema, bronchospasm, anaphylaxis), use of the drug should be immediately stopped. Transient rash does not warrant interruption of treatment.

During the period of treatment, persons experiencing fatigue, drowsiness or disorientation, should refrain from driving vehicles and practicing potentially hazardous activities that require increased concentration and psychomotor speed.

Use in elderly patients: In connection with a possible deterioration in renal function in elderly patients, before using the drug, it is necessary to determine renal function, in particular, creatinine clearance.