Ribavirin

Ribavirin, also known as tribavirin, is an antiviral medication used to treat RSV infection, hepatitis C, and viral hemorrhagic fever. For hepatitis C, it is used in combination with other medications such as simeprevir, sofosbuvir, peginterferon alfa-2b or peginterferon alfa-2a. Among the viral hemorrhagic fevers it is used for Lassa fever, Crimean–Congo hemorrhagic fever, and Hantavirus infection but not Ebola or Marburg. Ribavirin is taken by mouth or inhaled. Ribavirin, also known as tribavirin, is an antiviral medication used to treat RSV infection, hepatitis C, and viral hemorrhagic fever. For hepatitis C, it is used in combination with other medications such as simeprevir, sofosbuvir, peginterferon alfa-2b or peginterferon alfa-2a. Among the viral hemorrhagic fevers it is used for Lassa fever, Crimean–Congo hemorrhagic fever, and Hantavirus infection but not Ebola or Marburg. Ribavirin is taken by mouth or inhaled. Common side effects include feeling tired, headache, nausea, fever, muscle pains, and an irritable mood. Serious side effects include red blood cell breakdown, liver problems, and allergic reactions. Use during pregnancy results in harm to the baby. Effective birth control is recommended for both males and females for at least 7 months during and after use. The mechanism of action of ribavirin is not entirely clear. Ribavirin was patented in 1971 and approved for medical use in 1986. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. It is available as a generic medication. In the United States a course of treatment costs more than $USD 200. Ribavirin is used primarily to treat hepatitis C and viral hemorrhagic fevers (which is an orphan indication in most countries). In this former indication the oral (capsule or tablet) form of ribavirin is used in combination with pegylated interferon alfa. Including in people coinfected with hepatitis B, HIV and in the pediatric population. Statins may improve this combination's efficacy in treating hepatitis C. Ribavirin is the only known treatment for a variety of viral hemorrhagic fevers, including Lassa fever, Crimean-Congo hemorrhagic fever, Venezuelan hemorrhagic fever, and Hantavirus infection, although data regarding these infections are scarce and the drug might be effective only in early stages. It is noted by the USAMRIID that 'Ribavirin has poor in vitro and in vivo activity against the filoviruses (Ebola and Marburg) and the flaviviruses (dengue, yellow fever, Omsk hemorrhagic fever, and Kyasanur forest disease)' The aerosol form has been used in the past to treat respiratory syncytial virus-related diseases in children, although the evidence to support this is rather weak. It has been used (in combination with ketamine, midazolam, and amantadine) in treatment of rabies. Experimental data indicate that ribavirin may have useful activity against canine distemper and poxviruses. Ribavirin has also been used as a treatment for herpes simplex virus. One small study found that ribavirin treatment reduced the severity of herpes outbreaks and promoted recovery, as compared with placebo treatment. Another study found that ribavirin potentiated the antiviral effect of acyclovir. Some interest has been seen in its possible use as a treatment for cancers, especially acute myeloid leukemia. The medication has two FDA 'black box' warnings: One raises concerns that use before or during pregnancy by either sex may result in birth defects in the baby, and the other is regarding the risk of red blood cell breakdown. Ribavirin should not be given with zidovudine because of the increased risk of anemia; concurrent use with didanosine should likewise be avoided because of an increased risk of mitochondrial toxicity.