Ribavirin capsules 200mg, No. 60

Inside, without chewing and drinking water, together with food intake, 0.8-1.2 g per day in 2 divided doses (morning and evening). At the same time, interferon alfa-2b is prescribed - subcutaneously, 3 million ME 3 times a week or peginterferon alfa 2b - subcutaneously, 1.5 ?g / kg 1 time per week. When combined with interferon alpha-2b with a body weight of up to 75 kg, the dose of ribavirin is 1 g per day (0.4 g in the morning and 0.6 g in the evening); above 75 kg - 1.2 g per day (0.6 g in the morning and 0.6 g in the evening). When combined with peginterferon alpha-2b with a body weight of less than 65 kg, the dose of ribavirin is 0.8 g per day (0.4 g in the morning and 0.4 g in the evening); 65-85 kg - 1 g per day (0.4 g in the morning and 0.6 g in the evening); more than 85 kg (0.6 g in the morning and 0.6 g in the evening). Duration of treatment - 24 - 48 weeks; while for previously untreated patients - at least 24 weeks, in patients with genotype 1 virus - 48 weeks. In patientsimmune to monotherapy with interferon alpha, as well as in case of relapse - at least 6 months to 1 year (depending on the clinical course of the disease and the response to the therapy).

active substance: ribavirin 200 mg

Chronic heart failure stage IIB-III, myocardial infarction, renal failure (CC less than 50 ml / min), severe anemia, severe hepatic failure, decompensated cirrhosis of the liver, autoimmune diseases (including autoimmune hepatitis), not treatable thyroid disease glands, severe depression with suicidal tendencies, children and adolescents under 18 years of age, pregnancy, lactation, increased sensitivity to ribavirin.

pharmachologic effect

Antiviral agent. It quickly enters cells and acts inside virus-infected cells. Intracellularly, ribavirin is easily phosphorylated by adenosine kinase to mono-, di- and triphosphate metabolites. Ribavirin triphosphate is a strong competitive inhibitor of inosine monophosphate dehydrogenase, influenza virus RNA polymerase and messenger RNA guanylyl transferase; the latter is manifested by inhibition of the messenger RNA coating process. These various effects lead to a significant decrease in the amount of intracellular guanosine triphosphate, as well as suppression of viral RNA and protein synthesis. Ribavirin inhibits the replication of new virions, which reduces the viral load, selectively inhibits the synthesis of viral RNA, without suppressing the synthesis of RNA in normally functioning cells.The most active against DNA viruses - respiratory syncytial virus, Herpes simplex virus types 1 and 2, adenoviruses, CMV, smallpox viruses, Marek's disease; RNA viruses - influenza A, B viruses, paramyxoviruses (parainfluenza, mumps, Newcastle disease), reoviruses, arenaviruses (Lassa fever virus, Bolivian hemorrhagic fever), Bunyaviruses (Rift Valley fever virus, Crimean-Congo haemorrhagic fever virus) (hemorrhagic fever virus with renal or pulmonary syndrome) paramyxoviruses, oncogenic RNA viruses. In the treatment of hemorrhagic fever with renal syndrome, it reduces the severity of the course of the disease, reduces the duration of symptoms (fever, oliguria, pain in the lumbar region, abdomen, headache), improves laboratory parameters of renal function,reduces the risk of developing hemorrhagic complications and an unfavorable outcome of the disease. DNA viruses are not sensitive to ribavirin - Varicella zoster, pseudo-rabies virus, natural cowpox; RNA viruses - enteroviruses, rhinoviruses, Semliki forest encephalitis virus.

Side effect

From the side of the central nervous system and peripheral nervous system: headache, dizziness, general weakness, malaise, insomnia, asthenia, depression, irritability, anxiety, emotional lability, nervousness, agitation, aggressive behavior, confusion; rarely - suicidal tendencies, increased smooth muscle tone, tremor, paresthesia, hyperesthesia, hypesthesia, fainting. From the side of the cardiovascular system: decrease or increase in blood pressure, brady or tachycardia, palpitations, cardiac arrest. From the side of hematopoiesis: hemolytic anemia, leukopenia, neutropenia, granulocytopenia, thrombocytopenia; extremely rare - aplastic anemia. From the respiratory system: dyspnea, cough, pharyngitis, shortness of breath, bronchitis, otitis media, sinusitis, rhinitis. From the digestive system: dry mouth, decreased appetite, nausea, vomiting,diarrhea, abdominal pain, constipation, taste perversion, pancreatitis, flatulence, stomatitis, glossitis, bleeding from the gums, hyperbilirubinemia. From the senses: damage to the lacrimal gland, conjunctivitis, visual impairment, hearing impairment / loss, tinnitus. From the musculoskeletal system: arthralgia, myalgia. From the genitourinary system: hot flashes, decreased libido, dysmenorrhea, amenorrhea, menorrhagia, prostatitis. Allergic reactions: skin rash, erythema, urticaria, hyperthermia, angioedema, bronchospasm, anaphylaxis, photosensitivity, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis;visual impairment, hearing impairment / loss, tinnitus. From the musculoskeletal system: arthralgia, myalgia. From the genitourinary system: hot flashes, decreased libido, dysmenorrhea, amenorrhea, menorrhagia, prostatitis. Allergic reactions: skin rash, erythema, urticaria, hyperthermia, angioedema, bronchospasm, anaphylaxis, photosensitivity, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis;visual impairment, hearing impairment / loss, tinnitus. From the musculoskeletal system: arthralgia, myalgia. From the genitourinary system: hot flashes, decreased libido, dysmenorrhea, amenorrhea, menorrhagia, prostatitis. Allergic reactions: skin rash, erythema, urticaria, hyperthermia, angioedema, bronchospasm, anaphylaxis, photosensitivity, erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis;toxic epidermal necrolysis;toxic epidermal necrolysis;

Others: hair loss, alopecia, hair structure disorder, dry skin, hypothyroidism, chest pain, thirst, fungal infection, viral infection (including herpes), flu-like syndrome, sweating, lymphadenopathy. Medical professionals performing inhalation administration may experience headache, itching, redness of the eyes, or swelling of the eyelids.

Application during pregnancy and lactation

Ribavirin is contraindicated during pregnancy and lactation (breastfeeding).

Application for violations of liver function

Contraindicated in severe liver failure, decompensated liver cirrhosis, autoimmune hepatitis. Application for impaired renal function

Contraindicated in renal failure (CC less than 50 ml / min).

Application in children

Contraindicated in children and adolescents under 18 years of age.

special instructions

Use only in a hospital setting with a specialized intensive care unit. The use of ribavirin in patients who require mechanical ventilation is possible only by specialists with experience in resuscitation measures. Use with caution in women of reproductive age (pregnancy is undesirable), in patients with decompensated diabetes mellitus (with attacks of ketoacidosis), COPD, pulmonary embolism, chronic heart failure, thyroid diseases (including thyrotoxicosis), with blood coagulation disorders, with thrombophlebitis, myelodepression, hemoglobinopathy (including thalassemia, sickle cell anemia), depression, suicidal tendencies (including a history),concomitant HIV infection (against the background of combined highly active antiretroviral therapy - the risk of developing lactic acidosis), in elderly patients. Teratogenicity should be considered by medical personnel using ribavirin.

Drug interactions

The possibility of drug or other type of interaction with ribavirin may persist for up to two months (5 periods T1 / 2 of ribavirin) after discontinuation of its use due to delayed elimination. When used simultaneously with interferons, the therapeutic efficacy increases. With simultaneous use with ribavirin, it is possible to reduce the effectiveness of stavudine and zidovudine.