ribavirin, Rebetol, Copegus (cont.)

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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.

Ribavirin should be avoided among patients who have severe kidney disease and have lost most of their kidneys' function.

Therapy with ribavirin and interferon may aggravate psychiatric conditions or may trigger a psychiatric condition such as depression, psychosis, aggressive behavior, hallucinations, or violent behavior. Patients should be closely monitored for the development of these psychiatric conditions.

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