ribavirin (Inhalation route)

Pronunciation

rye-ba-VYE-rin

Inhalation, oral/nebulization route(Powder for Solution)

Use caution when administering aerosolized ribavirin to patients requiring mechanical ventilator assistance. Sudden deterioration of respiratory function has been associated with initiation of aerosolized ribavirin in infants. Monitor respiratory function during treatment. Ribavirin is not indicated for use in adults. Ribavirin has been shown to produce testicular lesions in rodents and to be teratogenic in all animal species in which adequate studies have been conducted (rodents and rabbits) .

Commonly used brand name(s)

In the U.S.

  • Virazole

Available Dosage Forms:

  • Powder for Solution

Therapeutic Class: Antiviral

Pharmacologic Class: Viral RNA Polymerase Inhibitor

Chemical Class: Guanosine Nucleoside Analog

Uses For ribavirin

Ribavirin for inhalation is used to treat severe pneumonia in infants and young children that is caused by the respiratory syncytial virus (RSV). It is given by oral inhalation, which means breathing the medicine as a fine mist through the mouth. Your child will use a special nebulizer (sprayer) that is attached to an oxygen hood, oxygen tent, or face mask .

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ribavirin is available only with your doctor's prescription .

Before Using ribavirin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ribavirin, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to ribavirin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatrics-specific problems that would limit the usefulness of ribavirin in infants and young children .

Geriatric

Appropriate studies on the relationship of age to the effects of ribavirin have not been performed in the geriatric population. ribavirin is not recommended for use in adults and the elderly .

Pregnancy

Pregnancy Category Explanation
All Trimesters X Studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities. This drug should not be used in women who are or may become pregnant because the risk clearly outweighs any possible benefit.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving ribavirin, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using ribavirin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Didanosine

Using ribavirin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Abacavir
  • Azathioprine
  • Lamivudine
  • Stavudine
  • Zalcitabine
  • Zidovudine

Using ribavirin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Interferon Alfa-2b

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of ribavirin. Make sure you tell your doctor if you have any other medical problems, especially:

  • Anemia or
  • Heart disease or
  • Lung disease—May cause side effects to become worse .

Proper Use of ribavirin

ribavirin will be given by a nurse or other trained health professional, and only while your child is in the hospital .

To help clear up your child's infection completely, ribavirin must be given for the full time of treatment, even if your child begins to feel better after a few days. Also, ribavirin for inhalation works best when there is a constant amount in the lungs. To help keep the amount constant, ribavirin must be given on a regular or continuous schedule .

Precautions While Using ribavirin

It is very important that your doctor check your child's progress to make sure ribavirin is working properly and to check for unwanted effects. Your child will be monitored very closely while ribavirin is given .

If a woman is pregnant, being exposed to ribavirin can harm the unborn baby. It is very important that all pregnant women who will be with your child in the hospital contact the doctor immediately .

ribavirin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Incidence not known
  • Back, leg, or stomach pains
  • bleeding gums
  • bluish color of fingernails, lips, skin, palms, or nail beds
  • blurred vision
  • chest pain or discomfort
  • confusion
  • cough
  • coughing that sometimes produces a pink frothy sputum
  • dark urine
  • difficult, fast, noisy breathing, sometimes with wheezing
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • extremely shallow or slow breathing
  • fast, slow, pounding, or irregular heartbeat or pulse
  • fatigue
  • fever or chills
  • general body swelling
  • headache
  • increased sweating
  • lightheadedness, dizziness, or fainting
  • loss of appetite
  • low blood pressure or pulse
  • nausea or vomiting
  • nosebleeds
  • not breathing
  • pale skin
  • severe pain in chest
  • shortness of breath
  • sneezing
  • sore throat
  • stopping of heart
  • sudden onset of severe breathing problems
  • sweating
  • swelling in the legs and ankles
  • tightness in the chest
  • trouble with breathing when moving or walking
  • unconsciousness
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • yellow eyes or skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known
  • Burning, dry, or itching eyes
  • eye discharge or excessive tearing
  • rash
  • redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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