Ribavirin is a powerful antiviral drug that helps treat hepatitis Cinfection. It's not completely understood how it fights the hepatitis C virus, but in general, it interferes with the virus' ability to replicate.

In the United States, ribavirin is approved by the Food and Drug Administration (FDA) to only treat severe respiratory syncytial virus infection. In 1998, however, the FDA approved ribavirin for the treatment of hepatitis C when taken in combination with interferon alpha.

Ribavirin is the generic name of the drug. It's also sold under the brand names of Copegus, Rebetol,Ribasphere, RibaPak and Virazole (this ribavirin is in the form of a nebulizer solution and is only used to treat the syncytial virus).

Ribavirin can't fight hepatitis C by itself. It must be taken with interferon to be effective against hepatitis C. Currently, the standard treatment for hepatitis C is a combination of ribavirin and pegylated interferon.

With this therapy, about one-half of the people infected with genotype 1 reach sustained virologic response (SVR) and up to 80% of the people infected with genotype 2 or 3 will reach SVR. In addition to genotype, successful treatment will depend on your age, race, HIV status, whether you have diabetes and if you are within 6 months of acute infection (among other factors).

Doctors determine how much ribavirin to prescribe based on the genotype of the hepatitis C virus you're infected with, your weight and which type of peginterferon you'll take.

Standard amounts range from 800 mg to 1,400 mg each day, which is split into two doses that you take 12 hours apart.

Side effects exist with any medication but are very common with the combination of peginterferon and ribavirin. Here is a list of the common side effects.

Unfortunately for some people, the side effects can become so severe that they will limit treatment. Since ribavirin can't be used alone, the side effects are actually from the combination of ribavirin and interferon.

Ribavirin is safe for most people (if they take it as prescribed by their doctors), but some people shouldn't take it. Here is a list of reasons you shouldn't take ribavirin:

• If you are pregnant. Ribavirin can cause birth defects. You must have a negative pregnancy test before you start treatment and will need to take birth control during treatment and continue taking it until 6 months after treatment ends.
  
  
• If you are breastfeeding.
  
  
• If you have advanced kidney disease, unstable heart disease or advanced liver disease.
  
  
• If you have autoimmune hepatitis.

Sources:

Copegus Prescribing Information and Medical Guide.http://www.rocheusa.com/products/copegus/pi.pdf

Dienstag, JL. Chronic Hepatitis. In: AS Fauci, E Braunwald, DL Kasper, SL Hauser, DL Longo, JL Jameson, J Loscaizo (eds), Harrison’s Principles of Internal Medicine, 17e. New York, McGraw-Hill, 2008.

Friedman, LS. Liver, Biliary Tract, & Pancreas: Chronic Viral Hepatitis. In: LM Tierney, SJ McPhee, MA Papadakis (eds), 2007 Current Medical Diagnosis and Treatment, 46e. New York, McGraw-Hill, 2007.

Katzung, BG. Basic and Clinical Pharmacology, 10e. New York, McGraw-Hill, 2007.

Rebetol Product Information.http://www.fda.gov/medwatch/SAFETY/2003/03May_PI/Rebetol_PI.pdf.