Ribavirin
2 medicines
Ribavirin is an antiviral used with other medicines for hepatitis C and for severe RSV infection. It is a severe teratogen, so both partners must avoid pregnancy during treatment and for 6 months afterward.
Key facts
- Ribavirin (found in Copegus and combination hepatitis C regimens) is an antiviral that disrupts how a virus copies its genetic material.
- It is combined with other antivirals for chronic hepatitis C, and an inhaled form is used for severe respiratory syncytial virus (RSV) infection in infants and high-risk patients.
- Ribavirin causes severe birth defects. Anyone who could become pregnant, or whose partner could become pregnant, must use effective contraception during treatment and for 6 months after the last dose.
- Seek urgent care for extreme fatigue, breathlessness, or a fast heartbeat, which can signal severe anaemia.
What Ribavirin treats
Ribavirin treats chronic hepatitis C infection, always combined with other direct-acting antivirals, never alone. An inhaled form treats severe RSV bronchiolitis or pneumonia, mainly in infants and people with weakened immune systems or serious heart or lung disease. It is occasionally used for certain viral haemorrhagic fevers under specialist care.
How Ribavirin works
Ribavirin resembles the natural building blocks a virus needs to copy its genetic material. It is incorporated into new viral RNA and introduces errors, and it disrupts an enzyme step in RNA synthesis, together slowing the virus's ability to multiply.
Before you take it
- Never take ribavirin during pregnancy. It is a proven teratogen, and both partners must use two reliable forms of contraception during treatment and for 6 months after finishing.
- Do not take it if you have a blood disorder such as sickle cell disease or thalassaemia, severe heart disease, or significant kidney impairment.
- Ribavirin lowers red blood cell counts. Tell your prescriber about anaemia or a low blood count before starting.
- Blood tests are required before treatment and at intervals during it, to catch anaemia early.
Side effects
Common effects include fatigue, headache, nausea, and irritability.
Seek urgent care for:
- Breathlessness, chest pain, or a racing heart, which can signal severe anaemia.
- Yellowing of the skin or eyes.
- Signs of a serious allergic reaction: facial swelling, rash, or difficulty breathing.
Safety essentials
- Pregnancy prevention is absolute: ribavirin causes major birth defects, and this risk extends to a male patient's partner. Both partners need contraception during treatment and for a full 6 months after the last dose.
- Ribavirin breaks down red blood cells in a dose-dependent way (haemolytic anaemia). Regular blood counts are mandatory, and the dose may need to be lowered if anaemia develops.
- Never take ribavirin alone for hepatitis C. It works only in combination with other antivirals as prescribed.
This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.