Drug Profile: Ribavirin

Ribavirin is an antiviral used to treat severe viral pneumonia in infants and young children, hepatitis C, RSV and it seems to reduce mortality in patients having Hemmorrhagic Fever with Renal Syndrome (HFRS). It has also been shown to have in vitro activity against HSV and influenza A and B but the clinical significance of these findings has not been determined.

Brand Names:

• Virazole
• Copegus
• Rebetol
• Tribavirin

Mechanism of Action:

Ribavirin is a synthetic guanine analogue that acts on messenger RNA and nucleotide metabolism. The exact mechanism of action is unknown.

Dosage:

Ribavirin can be given orally, through inhalation, or intravenously.

Typical adult dosage: Administer as aerosol; or 4 g i.v. or p.o daily

Typical pediatric dosage:
For RSV: Administer as aerosol (1.1 g/day).
For systemic (i.v.) use:
30 mg/kg as single dose
Then 16 mg/kg Q6h X 4 days
Then 8 mg/kg Q8h X 6 days

Side Effects:

• Flu-like illness is common during treatment
• pulmonary deterioration (especially in asthmatics and people with obstructive lung disease)
• cardiovascular complications such as hypotension, bradycardia, tachycardia, digitalis toxicity, and cardiac arrest.
• anemia
• rash
• conjunctivitis
• toxic effects such as:
  Abdominal pain
  Allergy
  Anemia
  Arthralgia or arthritis
  Breast feeding - contraindication
  Diarrhea
  Fever
  Headache
  Insomnia
  Lactic acidosis
  Leukopenia / neutropenia
  Myalgia or myopathy
  Nausea / vomiting
  Paresthesia
  Rash

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