Why is Ribavac (Ribavirin) prescribed?

Ribavac (Ribavirin) is used with an interferon medication in the treatment hepatitis C. It is used for people who have not been treated with an interferon before. Ribavirin is what is a nucleoside analogue. Nucleoside analogues work by stopping the virus that causes hepatitis C from spreading inside the body. It is not known if treatment that includes ribavirin and another medication cures hepatitis C infection, prevents liver damage that may be caused by hepatitis C, or prevents the spread of hepatitis C to other people.

How should this medicine be used?

Ribavirin comes as a tablet. It is usually taken with food twice a day, in the morning and the evening, for 24 to 48 weeks or longer. Take ribavirin at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ribavirin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Your doctor may decrease your dose or tell you to stop taking ribavirin if you develop side effects of the medication or if certain laboratory tests show that your condition has not improved. Call your doctor if you are bothered by side effects of ribavirin. Do not decrease your dose or stop taking ribavirin unless your doctor tells you that you should.

Other uses for this medicine

Ribavirin is also sometimes used to treat viral hemorrhagic fevers (viruses that can cause bleeding inside and outside of the body, problems with many organs, and death). In the event of biological warfare, ribavirin may be used to treat viral hemorrhagic fever that has been spread deliberately. Ribavirin is also sometimes used to treat severe acute respiratory syndrome (SARS; a virus that may cause breathing problems, pneumonia, and death). Talk to your doctor about the possible risks of using this drug for your condition.

Ribavac (Ribavirin) may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking ribavirin,

• tell your doctor and pharmacist if you are allergic to ribavirin, any other medications, or any of the ingredients in ribavirin tablets, capsules, or oral solution. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
• tell your doctor if you are taking didanosine (Videx). Your doctor will probably tell you not to take ribavirin if you are taking Ribavac (Ribavirin).
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: azathioprine (Azasan, Imuran); medications for anxiety, depression, or other mental illness; nucleoside reverse transcriptase inhibitors (NRTIs) for human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) such as abacavir (Ziagen, in Atripla, in Trizivir), emtricitabine (Emtriva, in Atripla, in Truvada), lamivudine (Epivir, in Combivir, in Epzicom), stavudine (Zerit), tenofovir (Viread, in Atripla, in Truvada), and zidovudine (Retrovir, in Combivir, in Trizivir); and medications that suppress the immune system such as cancer chemotherapy, cyclosporine (Neoral, Sandimmune), sirolimus (Rapamune), and tacrolimus (Prograf). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have kidney disease, liver failure, or autoimmune hepatitis (swelling of the liver that occurs when the immune system attacks the liver). Your doctor may tell you not to take ribavirin.
• tell your doctor if you drink or have ever drunk large amounts of alcohol, if you use or have ever used street drugs, if you have ever thought about killing yourself or planned or tried to do so, and if you have ever had a liver transplant or other organ transplant. Also tell your doctor if you have or have ever had a mental illness such as depression, anxiety, or psychosis (loss of contact with reality); cancer; HIV or AIDS; diabetes; sarcoidosis (a condition in which abnormal tissue grows in parts of the body such as the lungs); Gilbert's syndrome (a mild liver condition that may cause yellowing of the skin or eyes); gout (a type of arthritis caused by crystals deposited in the joints); any type of liver disease other than hepatitis C;or thyroid, pancreas, eye, or lung disease.
• tell your doctor if you are breast-feeding.
• you should know that ribavirin may make you drowsy, dizzy, or confused. Do not drive a car or operate machinery until you know how Ribavac (Ribavirin) affects you.
• do not drink alcoholic beverages while you are taking ribavirin. Alcohol can make your liver disease worse.
• you should know that your mouth may be very dry when you take Ribavac (Ribavirin), which can lead to problems with your teeth and gums. Be sure to brush your teeth twice a day and have regular dental exams. If vomiting occurs, rinse your mouth out thoroughly.

What special dietary instructions should I follow?

Be sure to drink plenty of fluids while you are taking ribavirin.

What should I do if I forget a dose?

If you remember the missed dose that same day, take the medication right away. However, if you do not remember the missed dose until the next day, call your doctor to find out what to do. Do not take a double dose to make up for a missed one.

What side effects can Ribavac (Ribavirin) cause?

Ribavirin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• cough
• upset stomach
• vomiting
• diarrhea
• constipation
• heartburn
• loss of appetite
• weight loss
• changes in ability to taste food
• dry mouth
• difficulty concentrating
• difficulty falling asleep or staying asleep
• memory loss
• rash
• dry, irritated, or itchy skin
• sweating
• painful or irregular menstruation (period)
• muscle or bone pain
• hair loss

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, or those listed in the IMPORTANT WARNING section, call your doctor immediately:

• hives
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• hoarseness
• difficulty swallowing or breathing
• pain in the stomach or lower back
• bloody diarrhea
• bright red blood in stools
• black, tarry stools
• stomach bloating
• confusion
• dark-colored urine
• yellowing of the skin or eyes
• unusual bleeding or bruising
• vision changes
• fever, chills, and other signs of infection
• depression
• thinking about hurting or killing yourself
• mood changes
• excessive worry
• irritability
• starting to use street drugs or alcohol again if you used these substances in the past
• intolerance to cold

Ribavirin may slow growth and weight gain in children. Talk to your child's doctor about the risks of giving Ribavac (Ribavirin) to your child.

Ribavirin may cause other side effects. Call your doctor if you have any unusual problems while taking Ribavac (Ribavirin).