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Information about Ribavirin
Ribavirin is a nucleoside analogue and antiviral agent used in therapy of chronic hepatitis C and other flavivirus infections.
Liver safety of Ribavirin
Ribavirin has not been associated with clinically apparent liver injury.
Mechanism of action of Ribavirin
Ribavirin (rye" ba vye' rin) is a guanosine nucleoside analogue which has antiviral activity against many RNA and DNA viruses in vitro, but has been found to have clinical effects in humans mostly against flaviviruses, including the hepatitis C virus (HCV), respiratory syncytial virus (RSV), and perhaps the Ebola and Hanta viruses. The in vitro antiviral activity of ribavirin appears to be mediated by depletion of intracellular guanosine through inhibition of inosine monophosphate dehydrogenase (a necessary enzyme in purine nucleoside synthesis). Ribavirin may also have indirect effects on viral replication caused by increasing interferon induced gene expression and modulating immune responses. Ribavirin is indicated as adjunctive therapy with alpha interferon or peginterferon in combination with an HCV specific protease inhibitor (boceprevir or telaprevir) in chronic hepatitis C. Ribavirin is also used by inhalation for acute RSV infection. Ribavirin has been used experimentally to treat chronic hepatitis E, and is currently under evaluation in interferon-free regimens for hepatitis C in combination with other oral direct acting antivirals.
FDA approval information for Ribavirin
Ribavirin was approved for use in hepatitis C in 1998 and was initially widely used for that indication. With the development of potent, all oral, direct acting antiviral agents for hepatitis C, ribavirin has been used far less frequently, although it is occasionally still used in patients who relapse or fail to respond to optimal direct acting agents for hepatitis C. Ribavirin is available as capsules of 200 mg in generic forms and under the brand names of Copegus and Rebetol.
Dosage and administration for Ribavirin
The recommended dose of ribavirin in adults is 800 to 1200 mg daily in two divided doses for 24 to 48 weeks in combination with peginterferon, with or without boceprevir or telaprevir. Side effects include hemolytic anemia, pruritus and nasal stuffiness.
The following are drugs for Hepatitis C:
HCV NS5A Inhibitors
HCV NS5B (Polymerase) Inhibitors
HCV Protease Inhibitors
- Asunaprevir, Boceprevir, Glecaprevir, Grazoprevir, Paritaprevir, Simeprevir, Telaprevir, Voxilaprevir