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Special warning

1. Ribavirin enters red blood cells, has a large accumulation and slows down, and has a plasma half-life of approximately 300 hours after discontinuation.
The main clinical toxicity of ribavirin is hemolytic anemia. Before treatment, hematology and blood biochemistry should be performed on the 2nd week, 4th week and later.

2. Pregnancy should be avoided during treatment and at least 6 months after discontinuation of treatment for women who use ribavirin, and for men who use ribavirin.
If the spouse of a male patient is pregnant, a condom is needed to reduce vaginal exposure to ribavirin.
Breast-feeding women should stop breast-feeding and milk should be discarded.

3. Ribavirin can cause heart attack and myocardial infarction. Patients with a history of heart disease or obvious heart conditions should not use ribavirin.
Older people over the age of 65 are often accompanied by heart disease, and the liver and kidney function is often reduced, which tends to lead to accumulation. Therefore, it is not recommended for elderly people to use it.

4. When ribavirin is combined with interferon alpha for a long period of time, it can cause growth retardation in children including height and weight loss. Therefore, it is necessary to monitor the growth of children and check thyroid function every 3 months.

5. The maximum amount of ribavirin intravenously administered in a single dose is 0.5 g twice a day for more than 20 minutes.

Ribavirin, because of the “anti-virus” word, thought it worked for any virus and was widely used for respiratory infections including colds. Now let us see exactly what diseases Ribavirin can be used for.

1. Don’t use ribavirin for the common cold!

The use of ribavirin to treat the common cold and influenza is ineffective!

There are more than 200 viruses that cause colds. There are currently no drugs that cover all viruses. The common cold is a self-limiting disease. The common cold does not require systemic treatment with antiviral drugs.

Using Ribavirin can be very serious!

According to data from the monitoring report on adverse drug reactions of the World Health Organization (WHO) from 1987 to 2005, of the 6649 case reports that may have caused adverse reactions due to the use of ribavirin, 52 cases were tumors and 96 cases were fetuses. Abnormalities, including 56 cases of stillbirth, fetal malformation in 21 cases. The remaining 19 cases showed cartilage, sputum, hydrocephalus, congenital spasm, and so on.

2. Hand-foot-mouth disease, early use of ribavirin can have a certain effect

Hand-foot-and-mouth disease is an acute infectious disease caused by enterovirus. It is mainly transmitted through the digestive tract, respiratory tract and close contact. Occurred in preschool children, especially in the 3rd age group, the highest incidence.

The vast majority of patients are mild and do not require special treatment and can heal themselves. A small number of cases, especially those infected by EV71, are in critical condition. Meningitis, encephalitis, encephalomyelitis, neurogenic pulmonary edema, severe circulatory disorders, and even death may occur.

There are no specific anti-enterovirus drugs. Early use of intravenous infusion of ribavirin can have a certain effect. Enteroviruses are small RNA viruses and should not be treated with drugs such as acyclovir, ganciclovir and adenosine.

3. Severe respiratory syncytial virus infection, Ribavirin may be effective

Respiratory syncytial virus (RSV) is an RNA virus. Almost all children are infected before the age of four. In vivo RSV antibodies, although not protective against reinfection, can reduce the severity of the disease.

Treatment of infants and children with mild RSV infections includes supportive therapy such as fever control and adequate hydration. Children with severe lower respiratory illnesses need oxygenation in hospital.

Currently, Ribavirin is the only antiviral drug approved for the treatment of viral pneumonia and bronchitis caused by RSV in infants and children. The treatment of ribavirin should begin early in the course of the disease.

The efficacy of ribavirin in the treatment of patients infected with RSV is uncertain and potentially toxic. The United States is not recommended except for selective cases of serious illness and complications and high-risk infants and children.

Tips: hypertonic saline spray can increase the removal of mucus. Studies have shown that 3% hypertonic saline spray can significantly reduce hospital stay and improve the clinical severity of acute viral bronchiolitis.

4. Hemorrhagic fever, ribavirin reduces mortality

Hemorrhagic fever is a group of viral infectious diseases transmitted by mosquitoes, cockroaches and rodents, and has geographical distribution characteristics. For example, Lassa fever is a disease caused by an arenavirus infection, and Renal hemorrhagic fever syndrome is a disease caused by Hantavirus infection. Significant features of hemorrhagic fever: many with fever, bleeding or prone to hemorrhagic fever, some patients can develop sexual organ failure and death.

Lassa fever, Rift Valley fever, Crimean-Congo hemorrhagic fever, Renal hemorrhagic fever syndrome, Ribavirin first dose 30 mg/kg intravenously, then 16 mg/kg intravenously, Preventive medication This can Oral ribavirin. Studies have reported that ribavirin can reduce the mortality of hemorrhagic fever.

Tips: The treatment of hemorrhagic fever is mainly supportive treatment. Vitamin K1 can be used for bleeding. Aspirin has an effect on platelets and should not be used for fever.

5. Chronic Hepatitis C, Ribavirin and interferon are effective!

Ribavirin monotherapy does not respond to chronic hepatitis C. Oral ribavirin combined with alpha-interferon injection can effectively treat chronic hepatitis C.

Combination Therapy For patients who were first treated, patients who did not respond to monotherapy with interferon, or patients who relapsed after treatment, were better than those who received a single interferon. Ribavirin is orally administered orally twice a day and the dose adjusted according to body weight. The choice of course is influenced by the hepatitis C virus genotype. Infected with virus type 1 type 4, treatment for 48 weeks. Infected with gene type 2 and type 3, the course of treatment is 24 weeks.

Tips: Ribavirin can cross the blood-brain barrier. The most common adverse reactions associated with interferon are psychiatric reactions (such as anxiety, depression, insomnia and irritability) and flu-like symptoms. The life-threatening and fatal adverse reactions include severe depression, suicidal ideation, and bacterial infection.

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