Ribacee
Generic Name
Ribavirin
Manufacturer
Example Pharma Ltd.
Country
Bangladesh
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ribacee 200 mg capsule | ৳ 35.00 | ৳ 350.00 |
Description
Overview of the medicine
Ribavirin is an antiviral medication used in combination with other antiviral agents (e.g., peginterferon alfa, direct-acting antivirals) for the treatment of chronic hepatitis C virus (HCV) infection. It is also used in certain other viral infections.
Uses & Indications
Dosage
Adults
For chronic HCV, usually 1000 mg/day or 1200 mg/day divided into two doses (e.g., <75 kg: 1000 mg/day; ≥75 kg: 1200 mg/day), in combination therapy. This means 5-6 Ribacee 200 mg capsules per day.
Elderly
No specific dose adjustment generally needed based on age alone, but renal function should be monitored.
Renal_impairment
Significant dose reduction required. Contraindicated if creatinine clearance (CrCl) < 50 mL/min.
How to Take
Oral, usually with food. Should be taken twice daily, morning and evening.
Mechanism of Action
Ribavirin is a guanosine analog that interferes with viral RNA synthesis and inhibits viral replication. It is phosphorylated intracellularly to active tri- and monophosphate derivatives. The triphosphate derivative inhibits viral RNA polymerase, and also acts as a competitive inhibitor of inosine monophosphate dehydrogenase, thereby depleting intracellular guanosine triphosphate (GTP) pools.
Pharmacokinetics
Onset
Not directly applicable for acute effects; therapeutic effects for HCV are long-term.
Excretion
Primarily renal (61% excreted unchanged in urine), with a minor fecal elimination (12%).
Half life
Long and variable, terminal half-life is approximately 120-200 hours due to extensive distribution and slow elimination.
Absorption
Rapidly absorbed after oral administration. Bioavailability is variable (45-65%). Food increases bioavailability.
Metabolism
Metabolized by phosphorylation to active forms and by deribosylation and amide hydrolysis to a triazole carboxylic acid metabolite.
Side Effects
Contraindications
- Hypersensitivity to ribavirin
- Pregnancy (Category X) and male partners of pregnant women
- Severe pre-existing cardiac disease, unstable cardiac disease
- Severe anemia, hemoglobinopathies (e.g., thalassemia, sickle cell anemia)
- Severe renal impairment (CrCl < 50 mL/min)
- Autoimmune hepatitis
Drug Interactions
Interferon alfa
Enhanced risk of side effects, especially neuropsychiatric and hematologic effects.
Didanosine (ddI)
Increased risk of pancreatitis, lactic acidosis, and peripheral neuropathy.
Zidovudine / Stavudine
Reduced efficacy of HIV antivirals; avoid co-administration if possible.
Azathioprine / Mercaptopurine
Increased risk of myelosuppression due to inhibition of inosine monophosphate dehydrogenase.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
There is no specific antidote. Treatment is symptomatic and supportive. Hemodialysis is not effective in removing ribavirin.
Pregnancy & Lactation
Pregnancy (Category X): Absolutely contraindicated. Use effective contraception during treatment and for 6 months after for both male and female patients. Two reliable forms of contraception are recommended. Lactation: Contraindicated. Breastfeeding should be discontinued during treatment.
Side Effects
Contraindications
- Hypersensitivity to ribavirin
- Pregnancy (Category X) and male partners of pregnant women
- Severe pre-existing cardiac disease, unstable cardiac disease
- Severe anemia, hemoglobinopathies (e.g., thalassemia, sickle cell anemia)
- Severe renal impairment (CrCl < 50 mL/min)
- Autoimmune hepatitis
Drug Interactions
Interferon alfa
Enhanced risk of side effects, especially neuropsychiatric and hematologic effects.
Didanosine (ddI)
Increased risk of pancreatitis, lactic acidosis, and peripheral neuropathy.
Zidovudine / Stavudine
Reduced efficacy of HIV antivirals; avoid co-administration if possible.
Azathioprine / Mercaptopurine
Increased risk of myelosuppression due to inhibition of inosine monophosphate dehydrogenase.
Storage
Store below 30°C in a dry place, away from light and moisture. Keep out of reach of children.
Overdose
There is no specific antidote. Treatment is symptomatic and supportive. Hemodialysis is not effective in removing ribavirin.
Pregnancy & Lactation
Pregnancy (Category X): Absolutely contraindicated. Use effective contraception during treatment and for 6 months after for both male and female patients. Two reliable forms of contraception are recommended. Lactation: Contraindicated. Breastfeeding should be discontinued during treatment.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24 to 36 months from manufacturing date.
Availability
Pharmacies, hospitals
Approval Status
Approved by major regulatory bodies (e.g., FDA, EMA, DGDA)
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have established the efficacy and safety of ribavirin, primarily in combination with interferon or direct-acting antivirals, for HCV treatment. Studies continue to evaluate its role in new combination therapies.
Lab Monitoring
- Complete Blood Count (CBC) with differential (baseline, 2 weeks, 4 weeks, then monthly)
- Renal function (creatinine, BUN)
- Liver function tests (ALT, AST, bilirubin)
- Thyroid stimulating hormone (TSH)
- Pregnancy tests (for female patients and female partners of male patients)
Doctor Notes
- Ensure strict adherence to contraception guidelines for both male and female patients.
- Monitor Complete Blood Count (CBC), renal, and liver function regularly throughout therapy.
- Educate patients thoroughly on potential for hemolytic anemia, its symptoms, and the importance of reporting them promptly.
- Assess for history of psychiatric conditions or cardiac disease before initiating treatment.
Patient Guidelines
- Take exactly as prescribed, usually with food.
- Do not stop treatment without consulting your doctor.
- Use two reliable forms of birth control during treatment and for 6 months after for both male and female patients.
- Report any severe side effects immediately.
Missed Dose Advice
Take the missed dose as soon as you remember. If it's almost time for the next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.
Driving Precautions
May cause fatigue, dizziness, or vision changes. Exercise caution when driving or operating machinery.
Lifestyle Advice
- Maintain a healthy diet, stay hydrated, and avoid alcohol. Regular medical follow-ups are crucial.
- Avoid exposing yourself to other infections.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.