ribavirin at a glance
Medicine class
Antiviral nucleoside analogue
Licensed role
Combination treatment for chronic hepatitis C
Key safety issue
Can cause haemolytic anaemia and needs blood-test monitoring
What is ribavirin used for?
Uses include:
Chronic hepatitis C, combined with other antiviral treatments.
Specialist use outside its licence for hepatitis E, including chronic infection in selected patients.
The selected capsule product is also licensed for combination treatment in previously untreated children aged 3 years and over and adolescents without liver decompensation.
How does ribavirin work?
Ribavirin is a synthetic nucleoside analogue converted inside cells into active forms that affect nucleotide pathways and viral replication. Its precise role in clearing hepatitis C with other antivirals is not fully understood.
ribavirin preparations and strengths
Capsule
Route: Oral
Strengths: 200 mg
Tablet
Route: Oral
Strengths: 200 mg
How to take ribavirin
Follow the specialist team's instructions and the leaflet for your supplied formulation.
Take with food.
Swallow film-coated tablets whole. Do not break or crush them because ribavirin can harm an unborn baby.
Do not alter or stop treatment without consulting the specialist team.
If swallowing capsules is difficult, ask a prescriber or pharmacist about an appropriate formulation.
ribavirin side effects
Common or expected effects
- Anaemia, tiredness or weakness
- Nausea, vomiting, diarrhoea or abdominal discomfort
- Headache, dizziness or difficulty sleeping
- Cough or shortness of breath
- Itching, rash or dry skin
- Muscle or joint pain
Get urgent medical advice
- Severe allergic reaction, including facial swelling, wheezing or breathing difficulty
- Severe skin reaction with blistering or peeling
- Severe anaemia causing chest pain, fainting or marked breathlessness
- New suicidal thoughts, severe depression or major behavioural change, particularly with interferon treatment
- Sudden or significant visual disturbance
ribavirin in pregnancy
The selected products are contraindicated during pregnancy because ribavirin is potentially teratogenic and remains in the body for a long time. Pregnancy must be excluded before treatment. Effective contraception and pregnancy testing are required during and after treatment; precautions also apply to male patients and their partners. Contact the specialist team promptly if pregnancy occurs or is suspected.
ribavirin while breastfeeding
Breastfeeding must be stopped before starting either selected product because transfer into human milk is unknown and harm to a breastfed child cannot be excluded.
ribavirin interactions
Have the complete regimen and all other medicines checked before treatment; interaction effects can persist after ribavirin is stopped.
Didanosine
Avoid concurrent use because of increased risk of mitochondrial toxicity, including lactic acidosis, pancreatitis and potentially fatal liver failure.
Zidovudine
Concurrent use is not recommended because anaemia may worsen.
Common questions about ribavirin
Answers are fully visible for fast scanning and source review.
Can ribavirin clear hepatitis C by itself?
No. For chronic hepatitis C, it must be combined with other treatments.
Why are blood tests needed?
Ribavirin can destroy red blood cells and may affect other blood counts, liver markers and uric acid.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.