Ribavirin - pharmacological agents from the group of antiviral agents.
Structure and Composition
According to the instructions of ribavirin produced in tablet form (0, 2 g). Active ingredient - ribavirin. Auxiliary components of the preparation: lactose, potato starch, magnesium stearate, methylcellulose soluble.
Externally ribavirin pills white. Produced the drug in blisters or in plastic containers.
Mode of action of ribavirin
According to the instructions of ribavirin has a pronounced antiviral effect, a broad spectrum of its activity, the drug is active against various DNA and RNA viruses. Ribavirin is rapidly penetrates into the cells affected by the virus and metabolized. The active metabolites of the drug has an antiviral effect. The exact mechanism of action of ribavirin is not clear, it is known that the drug inhibits cell viral RNA inhibits the formation of new virus cells. This Ribavirin has no negative effect on RNA normally functioning cells. Most sensitive to the drug herpes viruses, influenza viruses A and B, parainfluenza, mumps, reoviruses, cytomegalovirus.
Ribavirin is also active against hepatitis C virus mechanism of action has not been elucidated completely. It is assumed that the active metabolite RBV reduce the synthesis of viral cells.
After oral administration, the drug is rapidly absorbed. Bioavailability is about 45% of it. Ribavirin distributed serum airway mucous secretions and erythrocytes. After prolonged use of the drug is determined in the cerebrospinal fluid.
Excretion Ribavirin is excreted slowly, after the end of the drug appears about 300 hours. Basically, Ribavirin kidneys displayed.
Treatment of chronic hepatitis C (in a combination therapy with interferon drugs). The drug is recommended for use as in previously untreated patients and in patients with an exacerbation after a course of interferon alfa-2b (peginterferon alfa 2b), and in patients not responsive to interferon monotherapy.
Contraindications to the use of Ribavirin
- Hypersensitivity to the ingredients of the drug;
- severe heart failure;
- myocardial infarction;
- severe anemia (less than 80 g / l);
- severe renal failure;
- hepatic impairment;
- decompensated liver disease;
- autoimmune diseases;
- severe depression;
- Children up to age 18;
- pregnancy and lactation.
Be wary of ribavirin, according to the instructions, should be used in severe diabetes, chronic obstructive pulmonary disease, thromboembolism, thrombophlebitis, thyroid disorders, bleeding disorders, depression, and in the elderly.
Use during pregnancy and lactation
According to the instructions Ribavirin teratogenic (causing fetal malformations). Therefore, pregnancy during treatment with Ribavirin is highly undesirable. During treatment with this drug (and for 7 months after treatment) for women of childbearing age should use reliable methods of contraception.
Dosing and dose of ribavirin
According to the instructions of ribavirin taken orally, not liquid, during a meal. Normal dosage is 0, 8-1, 2 g per day (divided into two steps). The drug may be combined with interferon-alpha 2b (3 million subcutaneously three times per week) or peginterferon alfa 2b (1, 5 mg / kg 1 time a week).
The duration of treatment of Ribavirin is 24-48 weeks (determined by the physician individually).
In the opinion of ribavirin, may cause side effects, especially at the beginning of treatment.
Cardio - vascular system: decrease / increase in blood pressure, palpitations, tachycardia.
From the nervous system: dizziness, headache, insomnia, emotional lability, weakness, fatigue, irritability, depression, aggressive behavior, confusion. In rare cases, we observed hypersensitivity, tremors, fainting, increased muscle tone.
From the side of hematopoiesis may develop hemolytic anemia, leukopenia, thrombocytopenia. In very rare cases of aplastic anemia developed.
On the part of the gastrointestinal tract ribavirin, reviews, can cause dry mouth, change in appetite, nausea, diarrhea, abdominal pain, bloating, constipation, glossitis, gingivitis, pancreatitis, increased levels of bilirubin in the blood.
On the part of the respiratory system may cause coughing, sore throat, shortness of breath, otitis media, sinusitis, bronchitis.
From the urinary tract ribavirin, reviews, can contribute to the development of prostatitis, dysmenorrhea, change in libido, hot flashes.
From the senses during therapy Ribavirin may cause conjunctivitis, blurred vision, hearing loss, tinnitus.
Allergic reaction to ribavirin, reviews, are rare. Perhaps the development of urticaria, erythema, bronchospasm, angioedema, anaphylaxis, photosensitivity, Stevens-Johnson syndrome, toxic epidermal necrolysis.
In case of overdose with this drug may increase adverse reactions. Treatment is symptomatic.
Interaction with other drugs
According to the instructions of ribavirin with medicaments containing compounds of magnesium and aluminum, and simethicone reduces the bioavailability of the drug.
When concomitant administration with interferon alfa 2b (pegylated interferon alpha 2b) marked synergism.
The use of ribavirin during therapy with zidovudine (stavudine) can cause HIV viremia, which will require changes in treatment regimen.
Ribavirin analogues are arviron, virazole, Rebetol, ribavin, ribavirin Wert, ribamidil, ribapeg, trivorin. Regarding the replacement of analogue ribavirin should consult a doctor. Self-medication can be dangerous to your health.
Ribavirin should be administered under medical supervision. Before treatment and at 2 and 4 weeks of therapy should be carried out laboratory testing (blood count, determination of creatinine, transaminases, electrolytes in the blood).