Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Austria: Copegus, Rebetol, Ribavirin; Belgium: Copegus, Rebetol, Virazole; Bulgaria: Copegus, Rebetol, Ribavirin; Cyprus: Copegus; Czech Republic: Copegus, Rebetol, Ribavirin; Denmark: Copegus, Rebetol; Estonia: Copegus, Rebetol, Ribavirin; Finland: Copegus, Rebetol; France: Copegus, Rebetol; Germany: Copegus, Rebetol, Ribavirin, Virazole; Greece: Copegus, Rebetol, Virazole; Hungary: Copegus, Rebetol; Ireland: Copegus, Rebetol, Ribavirin; Italy: Copegus, Rebetol, Virazole; Latvia: Copegus, Rebetol, Ribavirin; Lithuania: Copegus, Rebetol, Ribavirin; Luxembourg: Copegus, Rebetol, Ribavirin, Virazole; Malta: Rebetol, Ribavirin; Netherlands: Copegus, Rebetol, Ribavirin, Virazole; Poland: Copegus, Rebetol, Ribavirin; Portugal: Copegus, Rebetol, Ribavirina; Romania: Copegus, Rebetol, Ribavirin; Slovakia: Copegus, Rebetol, Ribavirin; Slovenia: Copegus, Rebetol, Ribavirin; Spain: Copegus, Rebetol, Virazole; Sweden: Copegus, Rebetol, Ribavirin, Virazole; UK: Copegus, Rebetol, Virazole.

North America

Canada: Virazole; USA: Copegus, Rebetol, Ribasphere, Virazole.

Latin America

Argentina: Copegus, Ribavirina, Vibuzol; Brazil: Ribav, Ribavirin-Ribavirina, Viramid; Mexico: Desiken, Trivorin, Varinar, Vilona, Virazide.


Japan: Copegus, Rebetol.

Drug combinations

Ribavirin and Peginterferon Alpha-2a

Ribavirin and Peginterferon Alpha-2b


Ribavirin: C~8~H~12~N~4~O~5~. Mw: 244.20. 1H-1,2,4-Triazole-3-carboxamide, 1-β-D-ribofuranosyl-. CAS-36791-04-5 (1974).

Pharmacologic Category

Antivirals; Nucleosides and Nucleotides. (ATC-Code: J05AB04).

Mechanism of action

Inhibits replication of RNA and DNA viruses; inhibits influenza virus RNA polymerase activity and inhibits initiation and elongation of RNA fragments resulting in inhibition of viral protein synthesis.

Therapeutic use

Treatment of respiratory syncytial virus (RSV) infections. Specially indicated for treatment of severe lower respiratory tract RSV infections in underlying compromising condition (prematurity, bronchopulmonary dysplasia and other chronic lung conditions, congenital heart disease, immunodeficiency, immunosuppression), and recent transplant recipients. In combination with interferon alpha-2b injection for treatment of chronic hepatitis C in compensated liver disease patients previously untreated with alpha-interferons, or patients who have relapsed after alpha-interferon therapy.

Pregnancy and lactiation implications

Significant teratogenic effects observed in all animal studies. Contraindicated in pregnancy. Not recommended in nursing women.

Unlabeled use

Used in other viral infections including influenza A and B and adenovirus.


Hypersensitivity to ribavirin or any component of the formulation. Women of childbearing age who will not use contraception reliably. Pregnancy. Male partners of pregnant women. Hemoglobinopathies (e.g. thalassemia major, sickle cell anemia). Patients with autoimmune hepatitis. Ribavirin tablets contraindicated in hepatic decompensation.

Warnings and precautions

Hemolytic anemia is primary toxicity of oral therapy, usually occurring within 1-2 weeks of therapy initiation. Anemia associated with ribavirin may worsen underlying cardiac disease. Avoid use in significant/unstable cardiac disease. Ribavirin monotherapy not effective for chronic hepatitis C infection. Use with caution in renal impairment (avoid use in CrCl <50 mL/minute). Autoimmune/infectious disorders occurred with combination therapy (use with caution in autoimmune disease or severe infection). Bone marrow suppression occurred with combination therapy (discontinue if this occurs). Dental and periodontal disorders reported with combination therapy. Xerostomia may contribute to and/or exacerbate dental disorders. Severe cutaneous reactions, including Stevens-Johnson syndrome and exfoliative dermatitis reported (rarely) with combination therapy. Discontinue with signs or symptoms of severe skin reactions. Diabetes occurred with combination therapy. Acute hypersensitivity reactions (e.g. anaphylaxis, angioedema, bronchoconstriction, and urticaria) observed (rarely) with combination therapy. Pancreatitis occurred with combination therapy. Discontinue therapy in suspected/confirmed pancreatitis. Severe psychiatric events occurred including depression and suicidal behavior during combination therapy. Avoid use in psychiatric history (discontinue if severe psychiatric symptoms occur). Pulmonary symptoms associated with combination therapy; use with caution in pulmonary disease, including sarcoidosis. Use with caution in patients requiring assisted ventilation as precipitation of drug in respiratory equipment may interfere with safe and effective patient ventilation. Ribavirin is potentially mutagenic, tumor-promoting, and gonadotoxic.



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