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Ribasphere (ribavirin) Disease Interactions

There are 3 disease interactions with Ribasphere (ribavirin):

Major

Ribavirin (Includes Ribasphere) ↔ Anemia

Severe Potential Hazard, High plausibility

Applies to: Anemia, Arrhythmias, Heart Block, Congestive Heart Failure, Ischemic Heart Disease

Oral ribavirin may cause anemia. The decrease in hemoglobin generally occurs within 1 to 2 weeks after initiation of therapy and stabilizes by week 4. Because significant anemia may adversely affect cardiac function, oral ribavirin should not be used in patients with severe anemia of any etiology or a history of serious or unstable heart disease. It should also be avoided in patients with hemoglobinopathies such as thalassemia or sickle-cell anemia. Therapy with oral ribavirin may be administered cautiously in patients with stable heart conditions. Both the hemoglobin level and cardiovascular status must be closely monitored. A permanent dosage reduction is required in these patients if the hemoglobin decreases by >= 2 g/dL during any 4-week period. If, after 4 weeks on the reduced dosage, the hemoglobin remains < 12 g/dL, therapy should be discontinued. The drug should also be withdrawn if cardiovascular status deteriorates. For all patients, a dosage reduction is recommended when hemoglobin is < 10 g/dL. If hemoglobin falls below 8.5 g/dL, oral ribavirin should be permanently discontinued. In clinical trials, hemoglobin values generally returned to baseline 4 to 8 weeks after cessation of therapy.

References

  1. "Product Information. Virazole (ribavirin)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  2. "Product Information. Rebetron (interferon-alfa-2b-ribavirin)." Schering Laboratories, Kenilworth, NJ.
Major

Ribavirin (Includes Ribasphere) ↔ Pulmonary Deterioration

Severe Potential Hazard, Moderate plausibility

Applies to: Pulmonary Impairment

The use of aerosolized ribavirin has been associated with deterioration in pulmonary function, most significantly in patients with chronic obstructive pulmonary disease or asthma. Respiratory status should be monitored in all patients receiving aerosolized ribavirin, but in particular, patients with underlying respiratory disorders. Therapy should be stopped if sudden deterioration occurs, and reinstituted only with extreme caution and consideration of concomitant bronchodilator therapy.

References

  1. Hebert MF "Ribavirin." Bulletin of the Hospital Pharmacy and The Drug Information Analysis Service University of California 36 (1988): 1-4
  2. "Product Information. Virazole (ribavirin)." ICN Pharmaceuticals Inc, Cost Mesa, CA.
  3. Janai HK, Marks MI, Zaleska M, Stutman HR "Ribavirin: adverse drug reactions, 1986 to 1988." Pediatr Infect Dis J 9 (1990): 209-11
Major

Ribavirin (Includes Ribasphere) ↔ Renal Dysfunction

Severe Potential Hazard, High plausibility

Applies to: Renal Dysfunction

Orally administered ribavirin is metabolized by the liver, and both parent drug and metabolites are eliminated by the kidney. In patients with creatinine clearance between 10 and 30 mL/min, the mean area under the concentration-time curve has been shown to be three times greater than that in patients with normal renal function, presumably due to decreased clearance of the drug. Therapy with oral ribavirin should be administered cautiously in patients with creatinine clearance below 50 mL/min. Dosage adjustments may be necessary. The drug is not recommended for use in patients with severe renal impairment.

References

  1. "Product Information. Rebetron (interferon-alfa-2b-ribavirin)." Schering Laboratories, Kenilworth, NJ.
  2. Paroni R, Del Puppo M, Borghi C, et al "Pharmacokinetics of ribavirin and urinary excretion of the major metabolite 1,2,4-triazole-3-carboxamide in normal volunteers." Int J Clin Pharmacol Ther Toxicol 27 (1989): 302-7

Ribasphere (ribavirin) drug Interactions

There are 24 drug interactions with Ribasphere (ribavirin)

Ribasphere (ribavirin) alcohol/food Interactions

There is 1 alcohol/food interaction with Ribasphere (ribavirin)

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.

Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2016 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

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