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Ribavirin (By mouth)
Treats hepatitis C. Used together with an interferon medicine, such as Intron® A, Peg-Intron®, or Pegasys®.
There may be other brand names for this medicine.
Rebetol, Ribasphere, Copegus, Ribasphere RibaPak, Ribasphere Ribapak, RibaTab
When This Medicine Should Not Be Used
You should not use this medicine if you have had an allergic reaction to ribavirin, or if you have serious kidney disease or liver problems that are getting worse (such as autoimmune hepatitis or cirrhosis). Do not use this medicine if you are pregnant or breastfeeding, if your female sexual partner is pregnant, or if you have a blood disorder (such as sickle-cell anemia or thalassemia major). Do not use this medicine together with didanosine (Videx®, Videx® EC).
How to Use This Medicine
Capsule, Liquid, Tablet
- Your doctor will tell you how much of this medicine to use and how often. Your dose may need to be changed several times in order to find out what works best for you. Do not use more medicine or use it more often than your doctor tells you to.
- This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor or pharmacist if you have any questions. Ask your pharmacist for the Medication Guide if you do not have one. Your doctor might ask you to sign some forms to show that you understand this information.
- Ribavirin is used with other medicines to treat hepatitis C infection. Use all of the medicines your doctor has prescribed as part of your combination treatment. Ribavirin by itself will not treat hepatitis C.
- Take this medicine one time in the morning and one time at night, unless your doctor tells you otherwise. It is best to take this medicine with food at the same time every day.
- Swallow the capsule whole. Do not crush, break, or open it.
- Drink extra fluids so you will pass more urine while you are using this medicine. This will keep your kidneys working well and help prevent kidney problems.
- Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
If a dose is missed:
- If you miss a dose or forget to use your medicine, use it as soon as you can. If it is almost time for your next dose, wait until then to use the medicine and skip the missed dose. Do not use extra medicine to make up for a missed dose. Ask your doctor what to do if you miss taking your medicine for more than 24 hours.
How to Store and Dispose of This Medicine
- Store the capsules and tablets at room temperature, away from heat, moisture, and direct light. Store the oral liquid in the refrigerator or at room temperature, away from heat and direct light.
- Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any leftover medicine after you have finished your treatment. You will also need to throw away old medicine after the expiration date has passed.
- Keep all medicine away from children and never share your medicine with anyone.
Drugs and Foods to Avoid
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.
- Make sure your doctor knows if you are also using azathioprine (Azasan®, Imuran®) or medicine to treat HIV or AIDS (such as abacavir, lamivudine, stavudine, zidovudine, Trizivir®, or Ziagen®).
- Do not drink alcohol while you are using this medicine.
Warnings While Using This Medicine
- Using this medicine while you are pregnant can harm your unborn baby. The medicine may also cause birth defects if the father is using it when his sexual partner becomes pregnant. If a pregnancy occurs while you are using this medicine, tell your doctor right away.
- To make sure you are not pregnant, your doctor may ask you to have a pregnancy test before you start using this medicine. You must have a negative pregnancy test before you will be allowed to take this medicine. You should test for pregnancy every month while you are using this medicine, and for 6 months after your treatment ends.
- Use two forms of birth control to keep from getting pregnant while you are using this medicine (even if the medicine is temporarily stopped). Keep using two forms for at least 6 months after your treatment ends. This is very important for both men and women. Men using ribavirin might need to use a condom with a spermicide such as nonoxynol-9 as one form of birth control.
- Make sure your doctor knows if you have kidney disease, liver disease (including hepatitis B), blood circulation problems, a blood disorder (such as anemia), breathing problems, lung disease, heart or blood vessel disease, high blood pressure, a history of heart attack, mental problems (such as depression or anxiety), or an addiction to drugs or alcohol.
- Make sure your doctor knows if you have HIV or AIDS, cancer, diabetes, eye or vision problems, Gilbert's disease, pancreas problems, thyroid problems, any infection (such as flu), or an autoimmune disorder (such as psoriasis, lupus, or arthritis). Tell your doctor if you have lung disease such as sarcoidosis, or if you have had an organ transplant.
- This medicine lowers the number of some types of blood cells in your body. Because of this, you may bleed or get infections more easily. To help with these problems, avoid being near people who are sick or have infections. Wash your hands often. Stay away from rough sports or other situations where you could be bruised, cut, or injured. Brush and floss your teeth gently. Be careful when using sharp objects, including razors and fingernail clippers.
- Your doctor will need to check your blood at regular visits while you are using this medicine. Be sure to keep all appointments.
- Check with your doctor right away if you have back, leg, or stomach pains; bleeding gums; chills; dark urine; difficulty breathing; fever; general body swelling; headache; loss of appetite; nausea or vomiting; nosebleeds; pale skin; sore throat; or yellowing of the eyes or skin. These could be symptoms of a blood disorder called anemia.
- This medicine may cause a serious type of allergic reaction called anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you have a rash; itching; hoarseness; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth while you are using this medicine.
- Serious allergic reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin; fever or chills; hives or welts; red skin lesions; a severe skin rash or acne; or sores or ulcers on the skin while you are using this medicine.
- Pancreatitis may occur while you are using this medicine. Stop using this medicine and check with your doctor right away if you have sudden and severe stomach pain, chills, constipation, nausea, vomiting, fever, or lightheadedness.
- Check with your doctor if blurred vision, decreased vision, or any other change in vision occurs while you are using this medicine. Your doctor may want you to have your eyes checked by an ophthalmologist (eye doctor).
- This medicine will not keep you from giving hepatitis C to other people. Follow your doctor's instructions about how to prevent the spread of this infection.
- This medicine may make you dizzy or drowsy. Avoid driving, using machines, or doing anything else that could be dangerous if you are not alert.
- For some children and teenagers, this medicine can increase thoughts of suicide. All of the warnings in this leaflet are true for a child or teenager who is using this medicine. Tell your doctor right away if you start to feel more depressed. Also tell your doctor right away if you have thoughts about hurting yourself. Report any unusual thoughts or behaviors that trouble you, especially if they are new or get worse quickly. Make sure your caregiver knows if you have trouble sleeping, get upset easily, have a big increase in energy, or start to act reckless. Also tell your doctor if you have sudden or strong feelings, such as feeling nervous, angry, restless, violent, or scared. Let your doctor know if you or anyone in your family has bipolar disorder (manic-depressive) or has tried to commit suicide.
- This medicine may cause teeth and gum problems. A dry mouth may also damage your teeth and gums if you take this medicine for a long time. To help prevent this condition, carefully brush your teeth at least two times a day and have regular visits with your dentist.
- Some patients who have used this medicine may experience vomiting. If you vomit during your treatment, rinse your mouth out with water. This may also help prevent damage to your teeth and gums.
Possible Side Effects While Using This Medicine
Call your doctor right away if you notice any of these side effects:
- Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
- Blistering, peeling, or red skin rash.
- Bloody or black, tarry stools.
- Chest pain or uneven heartbeats.
- Dark-colored urine or pale stools.
- Depressed mood or thoughts of hurting yourself or others.
- Diarrhea that may contain blood.
- Feeling unusually cold or shivering.
- Fever, chills, sore throat, sweating, and body aches.
- High fever (temperature greater than 100 degrees F).
- Problems with vision.
- Shortness of breath or trouble with breathing.
- Sudden and severe stomach pain, lower back pain, nausea, vomiting, or lightheadedness.
- Unusual bleeding, bruising, pale skin, or weakness.
- Worsening of psoriasis.
- Yellowing of your skin or the whites of your eyes.
If you notice these less serious side effects, talk with your doctor:
- Changes in taste.
- Cough, runny or stuffy nose.
- Dry mouth or skin.
- Hair loss.
- Headache, irritability, or trouble with sleeping.
- Memory problems.
- Mild diarrhea, nausea, vomiting, stomach pain or upset, or loss of appetite.
- Mild skin rash or itching.
- Muscle or joint pain.
- Tired feeling.
- Weight loss.
If you notice other side effects that you think are caused by this medicine, tell your doctor