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What Are the Side Effects of Ribavirin Treatment?

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Updated June 10, 2014

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Question: What Are the Side Effects of Ribavirin Treatment?
Answer: Ribavirin (also known as Copegus or Rebetol) is an antiviral drug that treats hepatitis C and is always prescribed with an interferon (usually peginterferon). Side effects from the combination of ribavirin and interferon (or peginterferon) are common and some people can have them so severe that they interfere with treatment. Since ribavirin can't be used alone as a hepatitis C treatment, the side effects are actually from the combination of ribavirin and an interferon. Here is a list of the most common side effects:
  • Anemia, a blood disorder where there aren't enough red blood cells to carry oxygen. The result is that you're tired. After about two weeks of ribavirin treatment, about 10% of people develop a severe form of anemia.
  • Headache
  • Irritability and anxiety
  • Depression. Sometimes people taking ribavirin develop severe depression and can even have suicidal thoughts. These side effects, along with general irritability, are unofficially known as Riba Rage, even though they're really caused by the interferon. For most people, these side effects can be controlled with antidepressants or other medicines. It's important to look for signs of behavioral change during treatment so your doctor can help control any developing depression as quickly as possible. For people with known psychiatric problems, it's possible your doctor will want to start you on a preventative therapy before you start treatment. Some people with severe depression or a history of suicidality may not be able to start treatment of hepatitis C.
  • Alopecia (hair loss)
  • Itchiness
  • Insomnia (having trouble sleeping)
  • Arthralgia (joint pain)
  • Myalgia (muscle pain)
  • Anorexia (loss of appetite)
  • Neutropenia. Neutropenia is a blood disorder caused by a loss of neutrophils, a type of white blood cell that destroys bacteria. Neutropenia is probably the result of decreased bone marrow function, which the combination therapy suppresses, and may mean your body will have trouble fighting off bacterial infections.
  • Nausea and vomiting
  • Fever
  • Chills
  • Fatigue (tiredness)

Some people may experience many more side effects. Here is an extensive list of the possible side effects from treating hepatitis C with ribavirin and peginterferon.

Sources:

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

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.

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