Ribavirin 200 Mg (Ribasure)
Active ingredient: Ribavirin
Product Code: RB0968
Ribavirin 200 mg is indicated for the treatment of chronic hepatitis C virus (HCV) infection.
Ribasure (Ribavirin) 200 mg is manufactured by Aprazer Healthcare Ltd
Ribavirin is found to help with Coronavirus (COVID-19) together with
RIBAVIRIN 200MG (RIBASURE)
What Is This Drug?
Ribasure is a medicine that contains ribavirin as an active ingredient.
Ribavirin is an antiviral medicine that is primarily used in the management of viral hemorrhagic fevers (VHFs) and hepatitis C virus (HCV).[1,2]. Its safe administration has been validated by the United States Food and Drug Administration.
VHFs are commonly used to refer the disorders affecting multiple organ systems of our body. The characteristics of VHFs are:
- A damaged vascular system
- Weakened ability of the body to modulate itself
- Bleeding 
According to research, ribavirin has demonstrated its effectiveness against the early stages of VHFs such as Hantavirus infection, Lassa fever, Crimean–Congo hemorrhagic fever, and Venezuelan hemorrhagic fever.
HCV leads to hepatitis C infection, which can occur frequently or more severely in people with weak immunity such as in HIV. Ribavirin is always prescribed in combination with other drugs for the treatment of chronic hepatitis C.
Severe acute respiratory syndrome (SARS) is also treated with this medication. SARS is a viral infection that causes pneumonia, breathing problems and, even, death.
Classification and Mechanism of Action
Ribavirin is classified as nucleoside antimetabolite analogues, which restrict the action of RNA polymerase and proliferation of genetic material/proteins of viruses.
The enzyme – adenosine kinase – breaks down ribavirin into several products. Among which, ribavirin triphosphate resembles the building blocks of the viral RNA. This inhibits the activity of the viral RNA enzyme (viral mRNA polymerase). The inhibition of the viral enzyme prevents the spread of viral infection inside the body.
Looking After Your Drug
- This medication should be kept far from children.
- This medicine should only be consumed till its expiry date (provided on label) and discarded afterwards.
- The medicine needs to kept at ambient temperature (25°C); however, the storage temperature can be between 15°C and 30°C.[1,5]
- The bottle needs to be tightly locked.
Dosage Form and Strength
This medicine is available either in tablet or capsule form (200 mg).
The dosage of ribavirin is administered for at least 24–48 weeks. It is regularly taken (with food) twice a day: one in morning and other in evening. Do not take in excess or miss the dose.
How to Take the Medication?
The administration of ribavirin depends on the directions provided on the prescription label. The doctor or pharmacist should be consulted if you have any doubts about its usage.
The administration of ribavirin should be accompanied with plenty of fluids.
The occurrence of any side effects of this medicine should be reported immediately to the doctor. He/she may then decrease the dose or stop its administration based on your condition.
Stopping or decreasing the dose of medicines on your own is not recommended.
An overdose of ribavirin can cause adverse events, further leading to the lack of calcium and magnesium in the body. There is no antidote for the overdose of ribavirin. Emergency services should be informed immediately if the person:
- Experiencing troubles in breathing
- Cannot regain consciousness
- Is having seizures 
Warnings and Precautions
Here are some of the warnings and precautions one should follow before administering ribavirin:
- Allergic reaction: The information about your allergy toward ribavirin or any other medicine should be shared with the doctor. The doctor may ask you to stop ribavirin immediately if you develop symptoms such as:
- Difficulty in breathing
- Itching or rashes
- Sudden inflammation of skin or mucous membrane 
- Medications: The entire details of your ongoing medicines should be shared with the doctor. This includes prescribed over-the-counter, vitamins and supplements, and herbal products. Some of the drugs that should be mentioned before taking ribavirin are as follows:
- Medications for anxiety, depression, or other mental illnesses .
- Driving after taking ribavirin: Ribavirin may induce sleep and confusion. Avoid driving if you experience such symptoms after its administration.
- Alcohol and ribavirin: Inform your doctor if you consume alcohol. Avoid drinking alcohol while taking ribavirin as it can severely affect liver.
- Diseases: Your doctor will not prescribe ribavirin if you have any kidney problem, liver failure or autoimmune hepatitis (a condition wherein our immunity affects the liver). Inform your doctor if you underwent organ transplant surgery. Your doctor should be informed if you have any of the following conditions:
- Depression, anxiety, psychosis or suicide ideation
- Gilbert's syndrome
- Gout 
- Oral problems: Ribavirin causes dry mouth that may lead to teeth and gum issues. To avoid this, regularly brush your teeth twice and get a regular dental check-up.
- You must notify your doctor if you are:
- Pregnant or having plans of conceiving 
- A previous/current user of drugs
Possible Side Effects
Some of the side effects of ribavirin are as follows:
- Memory loss
- Difficulty in sleeping
- Painful or irregular menstruation
- Yellowing of the skin or eyes
- Muscle or bone pain
- Vision changes
- Hair loss
- Bloody diarrhea
- Unusual bleeding
- Hoarseness 
When Should the Drug Not Be Used?
You should avoid taking ribavirin if you:
- Are allergic to ribavirin or any other components in its formulation.
- Had any serious condition such as a heart attack in the past six months.
- Are pregnant or breastfeeding.
- Have blood-related disorders such as sickle cell anemia or thalassemia. 
- DrugBank. Ribavirin [Internet] [Updated Feb 12, 2020]. Available at: https://www.drugbank.ca/drugs/DB00811. Accessed on Feb 13, 2020.
- NIH AIDSinfo. Ribavirin [Internet] [Updated Jan 11, 2019]. Available at: https://aidsinfo.nih.gov/drugs/28/ribavirin/0/patient. Accessed on Feb 13, 2020.
- Centers for Disease Control and Prevention. Viral hemorrhagic fevers (VHFs) [Internet] [Updated Jan 29, 2014]. Available at: https://www.cdc.gov/vhf/index.html. Accessed on Feb 13, 2020.
- MedlinePlus. Ribavirin. [Internet] [Updated Jun 15, 2016]. Available at: https://medlineplus.gov/druginfo/meds/a605018.html. Accessed on Feb 13, 2020.
- FDA. COPEGUS® (ribavirin) tablets [Internet] [Updated Aug, 2011]. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/021511s023lbl.pdf. Accessed on Feb 13, 2020.
- FDA. Highlights of prescribing information. REBETOL® (ribavirin USP) capsules, for oral use. REBETOL® (ribavirin USP) oral solution [Internet] [Updated Nov, 2013]. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/020903s052,021546s008lbl.pdf . Accessed on Feb 13, 2020.
- Electronic Medicines Compendium (EMC). Package Leaflet: Information for the patient. Ribavirin 200 mg film-coated tablets. Ribavirin 400 mg film-coated tablets. Ribavirin [Internet] [Updated Aug, 2018]. Available at: https://www.medicines.org.uk/emc/files/pil.7108.pdf. Accessed on Feb 13, 2020.