ribavirin
Ribavirin (Rebetol) is an antiviral medication used with other antivirals for the treatment of chronic hepatitis C infection. It has a lot of side effects, so it's usually reserved for people with harder-to-treat chronic hepatitis C infection.
What is Ribavirin (Rebetol)?
What is Ribavirin (Rebetol) used for?
- Chronic hepatitis C infection
- Chronic hepatitis C with HIV coinfection (tablets only)
How Ribavirin (Rebetol) works
Ribavirin (Rebetol) is an antiviral medication that stops viruses from making copies of themselves in the body.
Drug facts
Side effects of Ribavirin (Rebetol)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
In clinical trials ribavirin (Rebetol) was always given with another medication called interferon. It's possible that many of these side effects were caused by interferon.
- Headache
- Fever
- Muscle aches
- Tiredness or weakness
- Shaking chills
- Nausea
- Changes in mood, feeling more irritable
- Vomiting
- Not feeling as hungry
Less Common Side Effects
- Sweating
- Hard time concentrating
- Stomach pain
- Infections
- Change in taste
- Difficulty falling asleep
- Constipation
- Blurred vision
Ribavirin (Rebetol) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Severe allergic reactions (hives, difficulty breathing, swelling of face, mouth, lips, or throat)
- Severe stomach pain that spreads to your back along with nausea and vomiting (signs of pancreatitis)
- Serious eye problems that can lead to loss of vision
- Serious blood disorders that can lead to heart attacks
- Serious lung infections
- Worsening of depression or thoughts of harm to self or others
The following Ribavirin (Rebetol) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
black, tarry stools
body aches or pain
congestion
cough or hoarseness
crying
depersonalization
difficult or labored breathing
discouragement
dryness of the throat
dysphoria
euphoria
feeling sad or empty
feeling unusually cold
fever or chills
general feeling of discomfort or illness
headache
hyperventilation
irregular heartbeats
irritability
joint pain
lack of appetite
loss of interest or pleasure
lower back or side pain
mental depression
muscle aches and pains
nervousness
painful or difficult urination
pale skin
paranoia
poor concentration
quick to react or overreact emotionally
rapidly changing moods
restlessness
right upper abdominal or stomach pain
shaking
shivering
shortness of breath
sores, ulcers, or white spots on the lips or in the mouth
sweating
tender, swollen glands in the neck
tightness in the chest
trouble with concentrating
trouble with sleeping
trouble with swallowing
troubled breathing with exertion
unable to sleep
unusual bleeding or bruising
unusual tiredness or weakness
voice changes
vomiting
Less common
Bleeding gums
blood in the urine or stools
depressed mood
dry skin and hair
feeling cold
husky voice
muscle cramps and stiffness
pinpoint red spots on the skin
right upper abdominal or stomach fullness
slowed heartbeat
Incidence not known
Blistering, flaking, or peeling of the skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Acid or sour stomach
being forgetful
belching
blurred vision
bone pain
change in taste or bad, unusual, or unpleasant (after) taste
cracked, scaly skin
crusting, irritation, itching, or reddening of the skin
difficulty with moving
dizziness or lightheadedness
feeling of constant movement of self or surroundings
hair loss or thinning of the hair
indigestion
lack or loss of strength
menstrual changes
pain or tenderness around the eyes and cheekbones
rash
sensation of spinning
stomach discomfort, upset, or pain
swelling
swollen joints
Less common
Back pain
burning, dry, or itching eyes
discharge, excessive tearing
feeling of warmth
redness of the face, neck, arms, and occasionally, upper chest
redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid
skin rash, encrusted, scaly, and oozing
Incidence not known
Change in hearing
loss of hearing
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Ribavirin (Rebetol)
Pros
- Higher chance of cure when added to other antiviral medications for hard-to-treat chronic hepatitis C
- Available as generic which can be more affordable
- Can be used in both children and adults
- Treatment is usually shorter than 1 year.
Cons
- Must be taken two times every day with food
- Can cause low red blood cells and is not a good choice for people with a history of heart problems
- Can harm an unborn baby and can't be used in pregnant women or male partners of women who can become pregnant
- Not effective if used by itself; must be combined with other antivirals
Pharmacist tips for Ribavirin (Rebetol)
- Take the capsules whole with food. Never open, crush, or break the capsules.
- Ribavirin (Rebetol) is only effective in treating chronic hepatitis C when it's used with other medications. Don't take ribavirin (Rebetol) by itself.
- Ribavirin (Rebetol) can cause serious harm to an unborn baby. It is recommended to use 2 forms of birth control to avoid pregnancy while taking this medication and for at least 6 months after you stop the medication. Female partners of men taking ribavirin (Rebetol) should also not become pregnant during the same time period.
- Ribavirin (Rebetol) can cause a drop in red blood cells, which can be dangerous. Tell your provider right away if you notice fatigue, shortness of breath, or chest pain while taking ribavirin (Rebetol).
- Make sure to get your blood test done regularly while taking this medication. Your provider will need to check things like your liver function, blood cell count, and the amount of hepatitis viruses in your body.
Common questions about Ribavirin (Rebetol)
No, ribavirin (Rebetol) is an oral antiviral medication and is only used for the treatment of chronic hepatitis C. It can't be used for other types of infections.
It's not recommended to drink alcohol while taking ribavirin (Rebetol). It's not known if alcohol interacts with the medication, but alcohol and chronic hepatitis C can both damage the liver, which your healthcare providers would like to avoid.
Ribavirin (Rebetol) can stay in your system for up to 6 months. This means that side effects from ribavirin (Rebetol) might not go away right after you stop taking the medication.
Ribavirin (Rebetol) causes anemia by directly destroying red blood cells. This is different than other medications that may cause anemia by acting on the bone marrow.
It's not likely that heptitis C will come back after successful treatment. Treatment of hepatitis C doesn't give you immunity, so it's possible to become reinfected. After treatment, it's important to continue to protect yourself from hepatitis C and not receive unsterile tattoos or share things like razors and needles.
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Risks and warnings for Ribavirin (Rebetol)
Ribavirin (Rebetol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
HARM TO UNBORN BABY
- Risk factors: Pregnancy
Ribavirin (Rebetol) can harm an unborn baby and should not be used during pregnancy. This medication can stay in the body for up to 6 months after taking it. A female should not become pregnant if she or her male partner is taking ribavirin (Rebetol) and for 6 months after the completion of treatment. Use at least two different forms of birth control during this time. Your provider might require you to have a negative pregnancy test prior to starting this medication.
LOW RED BLOOD CELLS
- Risk factors: History of heart disease and heart attacks
Ribavirin (Rebetol) can damage red blood cells which can lead to anemia. This can lead to serious problems including heart attacks, especially if you have a history of heart problems. Let your provider know right away if you have any trouble breathing or chest pain while taking this medication. Your provider will order blood tests for you before starting ribavirin (Rebetol) and within 2-4 weeks of taking it to monitor your red blood cell levels.
RIBAVIRIN ALONE
Taking ribavirin (Rebetol) by itself will not treat chronic hepatitis C infection. Ribavirin should always be used in addition to other antiviral medications.
PANCREATITIS
Some people taking ribavirin (Rebetol) have experienced a condition called pancreatitis, where your pancreas becomes inflamed. Talk to your healthcare provider if you suddenly have severe abdominal pain, nausea, and vomiting.
DENTAL PROBLEMS
- Risk factors: Dry mouth
Some people have had dental problems while taking ribavirin (Rebetol), especially those who may experience dry mouth as a side effect of the medication. Make sure to thoroughly brush your teeth twice a day and have regular visits to the dentist. If you vomit right after taking ribavirin (Rebetol), make sure to rinse out your mouth well afterwards.
BREATHING PROBLEMS
Ribavirin (Rebetol) can cause serious lung infections which can lead to breathing problems. If you experience shortness of breath, chest tightness, or difficulty breathing while taking this medication, let your provider know right away.
INTERACTIONS WITH AZATHIOPRINE
Ribavirin (Rebetol) when combined with a medication called azathioprine can cause a decrease in blood cell count. This can lead to serious and potentially life-threatening blood disorders. You should get blood tests done before and during treatment to make sure that your blood cell count is within normal range.
CHANGES IN LABS
Ribavirin (Rebetol) can affect your blood, liver, and other parts of your body. It's important to get regular blood tests done while taking this medication to make sure that you're healthy enough to continue with treatment. It's also necessary to check on the virus count to make sure that you are responding to treatment.
WEIGHT AND HEIGHT IN CHILDREN
Ribavirin (Rebetol) can cause weight loss and slow growth in children. These side effects typically go away once the medication is stopped. Talk to your child's healthcare provider if you're concerned with the effects of ribavirin (Rebetol) on your child's growth.
VISION PROBLEMS
Ribavirin (Rebetol) can cause vision problems or worsen a current eye condition. You should get your eyes checked prior to starting this medication. Let your provider know if there are any changes to your vision while taking ribavirin (Rebetol).
Ribavirin (Rebetol) dosage
Typical dosage for Ribavirin (Rebetol)
For chronic hepatitis C, in combination with interferon alfa-2b (capsule dosage form):
- Adults: Dose is based on body weight. The dose is usually 1,000 mg to 1,200 mg by mouth per day, given in 2 divided doses.
- Children age 3 or older: Dose is based on body weight. The dose is usually 15 mg/kg by mouth per day, given in 2 divided doses.
For chronic hepatitis C, in combination with peginterferon alfa-2b (capsule dosage form):
- Adults: Dose is based on body weight. The dose is usually 800 mg to 1,400 mg by mouth per day, given in 2 divided doses.
- Children age 3 or older: Dose is based on body weight. The dose is usually 15 mg/kg by mouth per day, given in 2 divided doses.
For chronic hepatitis C, in combination with peginterferon alfa-2a (tablet dosage form):
- Adults: Dose is based on body weight. The dose is usually 800 mg to 1,200 mg by mouth per day, given in 2 divided doses.
- Children age 5 or older: Dose is based on body weight. The dose is usually 400 mg to 1,200 mg by mouth per day, given in 2 divided doses.
For chronic hepatitis C with HIV coinfection, in combination with peginterferon alfa-2a (tablet dosage form):
- Adults: The dose is usually 800 mg by mouth per day.
Interactions between Ribavirin (Rebetol) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Interferon Alfa-2b
How much does Ribavirin (Rebetol) cost?
$39.90
What are alternatives to Ribavirin (Rebetol)?
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