Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Ribavirin is an antiviral drug. It is used in combination with interferon for the treatment of
chronic hepatitis C. Although the exact mechanism of its action is unknown, it is thought to interfere with the production and/or action of viral DNA and RNA which are critical to the survival and multiplication of the virus.
GENERIC: no
PRESCRIPTION: yes
PREPARATIONS: Capsule: 200 mg.
STORAGE: Ribavirin should be refrigerated at 2-8 C (36-46 F).
PRESCRIBED FOR: Ribavirin capsules are used in combination with interferon to treat patients with chronic hepatitis C who have not been treated with interferon previously or who have had a return of hepatitis C following successful treatment with interferon.
DOSING: Ribavirin dosing is individualized based upon a patient's weight and previous use of interferon.
Ribavirin may be taken with or without food. When taken orally, it should be taken consistently. For example, it should be taken at the same time or times each day and with or without food each time.
DRUG INTERACTIONS: Ribavirin used at the same time as other antiviral drugs with similar mechanisms of action may cause a condition in which lactic acid accumulates in the blood (lactic acidosis) which can lead to serious medical problems. Other such antiviral drugs include those used to
manage HIV infection, for example, zidovudine (Retrovir), zalcitabine (Hivid) or stavudine (Zerit).
Adding ribavirin treatment among patients taking
azathioprine (Imuran, Azasan) increases the chance of severe pancytopenia (a reduction in the numbers of all types of blood cells) due to azathioprine. This occurs because ribavirin reduces the breakdown of a harmful chemical produced during the breakdown of azathioprine.
PREGNANCY: There are no studies of ribavirin in
pregnant women; however, in pregnant animals receiving ribavirin in smaller doses than those given to humans there have been fetal birth defects and death. Therefore, ribavirin should not be taken by pregnant women. In addition, women who are receiving ribavirin therapy should wait at least
6 months after ribavirin is stopped before becoming pregnant in order to prevent potential effects of ribavirin on the fetus.
Since ribavirin may cause abnormalities in sperm, men taking ribavirin should avoid attempts to impregnate sexual partners and should wait six months after discontinuing the drug before attempting to impregnate.
NURSING MOTHERS: Although it is unknown if ribavirin is excreted in human milk during lactation, studies in animals have shown interferons to be excreted into milk, and the potential exists for serious adverse effects from combination therapy. Therefore,
breastfeeding should be discontinued during treatment.
SIDE EFFECTS: The most common side effect seen with the combination of ribavirin and interferon is a flu-like syndrome consisting of body aches and pains, fever, chills, headache, and malaise.
The most serious side effect seen with ribavirin is anemia. Careful consideration is advised if ribavirin is used in patients with heart or circulation problems since the anemia may aggravate these conditions.
Hepatitis C is an inflammation of the liver due to the hepatitis C virus (HCV), which is usually spread by
blood transfusion, hemodialysis, and needle sticks, especially with intravenous
drug abuse. Chronic hepatitis C may be treated with interferon, usually in combination with anti-virals.
Hepatitis is most often viral, due to infection with one of the hepatitis viruses (A, B, C, D, E, F (not confirmed), and G) or another virus (such as those that cause infectious mononucleosis, cytomegalovirus disease). The main nonviral causes of hepatitis are alcohol and drugs. Many patients infected with hepatitis A, B, and C have few or no symptoms of illness. For those who do develop symptoms of viral hepatitis, the most common are flu- like symptoms including: loss of appetite, nausea, vomiting, fever, weakness, tiredness, and aching in the abdomen. Treatment of viral hepatitis is dependant on the type of hepatitis.
Respiratory syncytial virus (RSV) is a highly contagious viral infection. Symptoms include fever and nasal congestion and discharge. Treatment focuses on supportive care.
HCV is one of several viruses that cause hepatitis (inflammation of the
liver).
Up to 85% of individuals who are initially (acutely) infected with HCV will
fail to eliminate the virus and will become chronically infected.
HCV is spread most commonly through inadvertent
exposure to infected blood. Intravenous
drug abuse is the most common mode of transmission. The risk of
acquiring HCV through sexual contact is low.
Generally, patients do not develop symptoms of chronic infection with HCV
until they have extensive scarring of the liver (cirrhosis). Some individuals,
however, may have fatigue and other non-specific symptoms in the absence of
cirrhosis. A minority of patients with HCV have symptoms from organs outside of
the liver.
In the U.S., Infection with HCV is the most common cause of chronic
hepatitis and the most common reason for liver transplantation.
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