Ribavirin

Ribavirin shows strong antiviral activity; is an artificial substance with a large range of therapeutic effects.

It has a significant drug effect on a relatively large number of viruses, although the exact principle of the effect of drugs has not been fully determined. It has been suggested that the drug weakens the intracellular pool of guanosine 3-phosphate, thereby helping to inhibit the production of viral nucleic acids.

[1],

Indications Ribavirin

It is used for inhalations at the hospital for infants and young children suffering from infectious infections of the lower region of the respiratory ducts to a severe degree caused by RSV.

Adults often use it in the form of an element of combination therapy. The drug is used internally for hepatitis C varieties, as well as hemorrhagic fever Lassa.

Parenteral drug administration is prescribed in the case of a hemorrhagic fever, accompanied by renal syndrome.

[2], [3], [4], [5], [6], [7]

Release form

The release of the component is realized in capsules, powder or tablets.

[8], [9]

Pharmacokinetics

After oral administration of a drug, its bioavailability level is 45%. Cmax values are recorded after 0.5-1.5 hours. The active component is not synthesized with intraplasma protein, but can accumulate inside the red blood cells. The substance also overcomes the BBB.

Biotransformation is realized inside the liver; excretion mainly occurs along with urine. The term half-life in the use of 1-time portion is 27-36 hours, and in the case of stable values within the blood of 6 days.

After administration via inhalation, approximately 30-55% of the drug is excreted in the form of metabolic components along with urine (over a period of 72-80 hours).

[10], [11], [12], [13], [14]

Dosing and administration

Capsules or tablets medication is required to be taken orally, along with food. Per day they often consume 0.8-1.2 g of a substance. The portion should be divided into 2 applications. The therapeutic cycle usually lasts 0.5-1 year. However, the treating doctor for each patient personally selects the duration of treatment.

To introduce the drug in / in the method can be exclusively at the hospital. The mode of use and the size of servings are selected by a medical professional.

Inhalation medication should be performed to young children during the first 3 days of infection. Such procedures should be carried out exclusively at the hospital.

Inhalation should be carried out every day for 12-18 hours. The whole cycle lasts 3-7 days. During the day you need to enter 10 mg / kg of the drug substance. In the 1st ml of the liquid contains 20 mg of the drug component.

To make a liquid, it takes 6 g of powder, which is dissolved in injectable water (0.1 l). The resulting mixture is poured into a special inhalation device, and then topped up with water to obtain a volume of 0.3 l.

[20], [21], [22]

Use Ribavirin during pregnancy

Ribavirin should not be prescribed to breastfeeding or pregnant women.

Contraindications

The main contraindications:

• CHF (2-3 stages of the disease);
• kidney failure (the level of QC is less than 50 ml per minute);
• severe stage of hepatic failure;
• autoimmune pathologies;
• severe degree of depression, in which there is a tendency to suicide;
• ribavirin intolerance;
• anemia that is severe;
• hepatic cirrhosis in the decompensated stage;
• incurable thyroid disease.

[15], [16], [17]

Side effects Ribavirin

Among the possible side effects:

• circulatory dysfunction: thrombocyto-, neutro-, leuco- or granulocytopenia, as well as anemia (if negative manifestations develop, a blood test should be performed at 2-week intervals);
• allergy symptoms: epidermal irritation or rashes, photosensitivity, erythema, urticaria, hyperthermia, SJS, anaphylaxis, TEN and angioedema, and in addition conjunctivitis (after inhalation) and chills (after intravenous administration of drugs);
• lesions affecting the cardiovascular system: asystole, reduction in blood pressure or bradycardia (it is required to monitor the patient's condition all the time);
• hepatic disorders: hyperbilirubinemia;
• problems with NA function: severe irritability, depression, malaise, asthenic syndrome, dizziness, confusion and insomnia, and besides anxiety, headaches, emotional instability, fatigue and systemic weakness;
• disorders associated with the respiratory system: pulmonary atelectasis, pneumothorax, pharyngitis and dyspnea. In addition, bronchial spasm, sinusitis, pulmonary edema, runny nose, cough, hypoventilation syndrome and apnea (when performing inhalation);
• digestive disorders: swelling, loss of appetite, stomatitis, constipation, dry oral mucous or metallic taste, diarrhea and glossitis, as well as nausea, pancreatitis, abdominal pain, change in taste, vomiting, hyperbilirubinemia and gum bleeding;
• problems with the function of the sense organs: visual or auditory disorders, lesions in the lacrimal glands and ear noise;
• lesions of the musculoskeletal structure: myalgia or arthralgia;
• disorders associated with the urogenital system: dysmenorrhea, prostatitis, hot flashes, and also weakening of libido or menorrhagia;
• other manifestations: pain in the injection area, violation of the hair structure or their loss, viral infection (for example, herpes), fungus, hypothyroidism, hyperhidrosis, and in addition, a feeling of intense thirst, flu-like syndrome, pain in the sternum and lymphadenopathy.

During inhalations, the physicians may develop the following negative symptoms: ocular hyperemia, eyelid edema, headaches, and epidermal itching.

[18], [19]

Overdose

Drug intoxication can cause potentiation of the negative manifestations of Ribavirin.

In such cases, a mandatory cancellation of the medication is required. Symptomatic therapeutic measures are also performed.

[23]

Interactions with other drugs

Combination with interferons increases the effectiveness of the drug.

The bioavailability level of the drug is reduced when combined with aluminum or magnesium substances, as well as with simethicone.

The interaction of drugs with zidovudine or stavudine can cause a weakening of the activity of these drugs.

It is necessary to take into account the low rate of excretion of Ribavirin - because of this, it can affect the use of other drugs for another 2-month period after the end of therapy.

[24], [25]

Storage conditions

Ribavirin is required to be stored in a dark and protected from moisture place. The temperature level is within 25 ° C.

[26], [27], [28], [29]

Shelf life

Ribavirin is allowed to apply for a 36-month term from the time the therapeutic substance is realized.

[30], [31], [32]

Application for children

The drug is not used in pediatrics.

[33], [34], [35], [36], [37], [38],

Analogs

Analogues of the medication are Arviron, Ribapeg, Trivorin, Virazole with Ribamidil, Vero-Ribavirin, Rebetol, Ribavin and Devirs.

[39], [40], [41], [42], [43], [44],

Reviews

Ribavirin usually receives positive reviews from patients. But sometimes in the comments it is reported that the drug only eliminates the symptoms of the disease, not eliminating the cause of their occurrence, and therefore it is recommended to use its analogues. At the same time, in the responses, the appearance of various negative symptoms is often mentioned, which were sometimes resolved by transferring from tablets to capsule form of the drug.

There is also evidence that in people with recurrent pathology and those who have not previously used interferon α-2β, the effectiveness of treatment increases with the combined use of Ribavirin with Altevir.

[45], [46], [47]