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Virazole

ribavirin

Used for Lower Respiratory Infection

Virazole (ribavirin) is an inhaled solution used to treat respiratory syncytial virus (RSV) infections in children. It must be given by a healthcare provider in the hospital.

Reviewed by:

Hope Chang, PharmD, AAHIVP

Allison Gourley, PharmD

Last reviewed on September 27, 2021

Basics Side effects Pros & cons Pharmacist tips FAQs Warnings Dosage Interactions Contraindications Alternatives Prices Medicare

What is Virazole (ribavirin)?

What is Virazole (ribavirin) used for?

Severe respiratory synctial virus (RSV) infection in hospitalized infants and children

How Virazole (ribavirin) works

Virazole (ribavirin) is an antiviral medication that works against the respiratory syncytial virus (RSV). It's not clear how the medication treats RSV, but it's thought to stop the virus from making copies of itself in the lungs.

Are you looking for information on ribavirin (Rebetol) for hepatitis C instead?

Drug Facts

Common BrandsVirazole

Drug ClassAntiviral

Controlled Substance ClassificationNot a controlled medication

Generic StatusNo lower-cost generic available

AvailabilityPrescription only

What are the side effects of Virazole (ribavirin)?

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

Worsening lung function
Anemia (low blood count)
Rash

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.

Worsening lung function

Source: DailyMed

The following 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 or nurse immediately if any of the following side effects occur:

Incidence not known

Back, leg, or stomach pains

bleeding gums

bluish color of fingernails, lips, skin, palms, or nail beds

blurred vision

chest pain or discomfort

confusion

cough

coughing that sometimes produces a pink frothy sputum

dark urine

difficult, fast, noisy breathing, sometimes with wheezing

dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly

extremely shallow or slow breathing

fast, slow, pounding, or irregular heartbeat or pulse

fatigue

fever or chills

general body swelling

headache

increased sweating

lightheadedness, dizziness, or fainting

loss of appetite

low blood pressure or pulse

nausea or vomiting

nosebleeds

not breathing

pale skin

severe pain in chest

shortness of breath

sneezing

sore throat

stopping of heart

sudden onset of severe breathing problems

sweating

swelling in the legs and ankles

tightness in the chest

trouble with breathing when moving or walking

unconsciousness

unusual bleeding or bruising

unusual tiredness or weakness

yellow eyes or 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:

Incidence not known

Burning, dry, or itching eyes

eye discharge or excessive tearing

rash

redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid

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.

Pros and cons of Virazole (ribavirin)

Pros

One of the few antiviral medications with activity against RSV

As an inhaled medication, unlikely to have interactions with oral or injectable medications

Can shorten the time of hospital stay

Cons

Can only be used in hospitalized children with severe RSV infections

Some infants have had worsening lung function after using this medication.

Can't be used for prevention of RSV infection like other medications

Pharmacist tips for Virazole (ribavirin)

Virazole (ribavirin) is only used to treat severe RSV infections and will always be administered by a healthcare provider.

In the hospital, Virazole (ribavirin) will be given with "supportive care," which will help make sure your child's body is getting enough oxygen. Supportive care may include oxygen, fluids, and a ventilator if needed.

Always make sure the hospital has an updated list of your child's medication allergies. Anyone who has had an allergic reaction to Virazole (ribavirin) in the past shouldn't be given the medication again.

Frequently asked questions about Virazole (ribavirin)

Can Virazole (ribavirin) be used for COVID-19?

No, Virazole (ribavirin) has no anti-viral activity against COVID-19. It's only used for RSV infections.

Can Virazole (ribavirin) be used in adults?

Virazole (ribavirin) is not FDA-approved for treatment of RSV in adults. This may be due to the design of the clinical trials, since most people who are infected with RSV are young children and infants.

Why is Virazole (ribavirin) only used for severe infections?

Virazole (ribavirin) is only used for severe RSV infections, because most people with mild-to-moderate infections don't need antiviral medications. Those with mild-to-moderate infections are treated in the clinic setting with treatment depending on their symptoms.

Can Virazole (ribavirin) be given at home?

No, Virazole (ribavirin) is only for severe infections in the hospital with the use of a SPAG-2 device. If someone has an infection that's severe enough to require Virazole (ribavirin), they should be in the hospital so they can also receive important supportive care. Some people given Virazole (ribavirin) have also had worsening lung function after using the medication, which the hospital staff will monitor.

Can Virazole (ribavirin) be taken by mouth for RSV?

No, Virazole (ribavirin) needs to be inhaled through a face mask covering the mouth and nose when used for treatment of RSV. This allows the medication to get to the lungs and lowers the risk of side effects.

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What are the risks and warnings for Virazole (ribavirin)?

Virazole (ribavirin) 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.

WORSENING LUNG FUNCTION

Some people have had worsening lung function after starting Virazole (ribavirin). The healthcare providers in the hospital will closely monitor your child's lung function if they're receiving Virazole (ribavirin). If your child's lung function worsens, they may stop the medication.

FERTILITY PROBLEMS

Virazole (ribavirin) is not currently approved for use in adults. This may be due to the fact that RSV is most often seen in young children. Nevertheless, it should be noted that ribavirin has been shown to harm unborn babies and cause testicular lesions in animal studies. Given ribavirin's potential to harm an unborn baby when taken by mouth, it's likely that the inhaled medication may have the same effect. If you are an adult who may get exposed to Virazole (ribavirin) (e.g., healthcare staff) and are pregnant or may become pregnant, let your provider or employer know right away, so that the appropriate steps can be taken.

PROPER HANDLING

Specially-trained healthcare providers will help administer Virazole (ribavirin) if it needs to be used in someone who's mechanically ventilated. These experts will know how to administer Virazole (ribavirin) correctly to lower the risk of mechanical ventilator malfunction and potential lung problems that it can cause.

DEATH

There have been cases of people treated with Virazole (ribavirin) who have died during or shortly after the medication was given. It's not known if this was caused by the medication, the infection, or mechanical ventilator malfunction.

Virazole (ribavirin) dosage forms

Typical dosing for Virazole (ribavirin)

Virazole (ribavirin) will be given to your child by a healthcare provider in the hospital. In general, the recommended dose is a 20 mg/mL solution administered through nebulization during 12 to 18 hours in a day for 3 to 7 days. Nebulization is the process of turning the inhalation solution into a mist that your child can inhale through their mouth and nose and into their lungs using a machine called a SPAG-2 nebulizer.

Interactions between Virazole (ribavirin) and other drugs

Virazole (ribavirin) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Virazole (ribavirin). Please note that only the generic name of each medication is listed below.

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 receiving 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.

Didanosine

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

Virazole (ribavirin) contraindications

Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Virazole (ribavirin) will not be safe for you to take.

Currently pregnant or may become pregnant during exposure to Virazole (ribavirin)

What are alternatives to Virazole (ribavirin)?

There are a number of medications that your doctor can prescribe in place of Virazole (ribavirin). Compare a few possible alternatives below.

Virazole (ribavirin)

Used for:

Severe respiratory synctial virus (RSV) infection in hospitalized infants and children

View Prices

Synagis (palivizumab)