Generic Name: ribavirin, Oral tablet

Generic Name:

ribavirin, Oral tablet

Copegus,Moderiba,RibaPak,RibaTab,Ribasphere,Ribasphere RibaPak

All Brands

  • Copegus
  • Moderiba
  • RibaPak
  • RibaTab
  • Ribasphere
  • Ribasphere RibaPak
SECTION 1 of 5

Highlights for ribavirin

Oral tablet
1

Ribavirin is used to treat chronic hepatitis C virus infection. It’s available as an oral tablet, oral capsule, and oral solution. An inhalant solution is used to treat children with pneumonia (inhalant is not covered here).

2

This drug should not be used alone. You’ll need to take it with other drugs to treat your infection.

3

The recommended dosage varies. It depends on your age, the condition that’s being treated, other drugs you take to treat your infection, and the form of ribavirin you take.

4

Side effects include flu-like symptoms, mood changes, loss of appetite, nausea, vomiting, and diarrhea.

5

This drug may raise your risk for suicidal thoughts and severe breathing problems. Tell your doctor right away if you have these issues.

IMPORTANT INFORMATION

FDA Warning

This drug has a Black Box Warning. This is the most serious warning from the Food and Drug Administration (FDA). A black box warning alerts doctors and patients to potentially dangerous effects.

Don’t use ribavirin alone. Ribavirin shouldn’t be used alone to treat your hepatitis C virus infection. You’ll need to take it with other drugs.

Heart disease warning. This drug can cause your red blood cells to die early, which can lead to heart attack. Don’t use ribavirin if you have a history of heart disease.

Pregnancy warning. Ribavirin may cause birth defects or the death of an unborn baby. Don’t take ribavirin if you’re pregnant or plan to become pregnant. Men shouldn’t take the drug if their partner is pregnant or plans to become pregnant.

Suicidal thoughts warning

Ribavirin may cause you to have suicidal thoughts or attempt to hurt yourself. The risk may be higher in adolescents. Call your healthcare provider right away or go to the emergency room if you have new or worsening symptoms of depression or thoughts about suicide.

Serious breathing problems

This drug may raise your risk of pneumonia, which can be fatal. If you have trouble breathing, tell your doctor right away.

Growth problems in children

The combination of this drug and PegIntron or INTRON A may cause weight loss or slowed growth in children. Most children will go through a growth spurt and gain weight after treatment stops. However, some children may never reach the height that they were expected to before treatment. Talk to your healthcare provider if you’re concerned about your child's growth during treatment.

Drug Features

Ribavirin is a prescription drug. It’s available in these forms: oral tablet, oral capsule, and oral liquid solution.

Ribavirin is available in its generic form. Generic drugs usually cost less. In some cases they may not be available in every strength or form as the brand. Talk to your healthcare provider to see if the generic will work for you.

This drug must be used as part of a combination therapy. That means you need to take it with other drugs.

Why It's Used

Ribavirin is used to treat hepatitis C virus (HCV) infection.

More Details

How It Works

It isn’t known exactly how ribavirin works to treat hepatitis C. However, it’s thought to interfere with a variety of processes that are important to the hepatitis C virus.

Why It's Used

Ribavirin is used to treat hepatitis C virus (HCV) infection.

The ribavirin tablet is used with another medicine called peginterferon alfa to treat chronic HCV infection. This combination is used in people who don’t have liver disease and who haven’t ever been treated with the drug interferon alpha.

SECTION 2 of 5

ribavirin Side Effects

Oral tablet

Most Common Side Effects

  • Ribavirin is used with interferon or peginterferon alfa. Common side effects of taking the drugs together include:

    • flu-like symptoms, such as:
      • tiredness
      • headache
      • shaking along with having a fever
      • muscle or joint aches
    • mood changes, such as feeling irritable or anxious
    • difficulty sleeping
    • loss of appetite
    • nausea
    • vomiting
    • diarrhea
    • dry mouth
    • eye problems
  • The most common side effects of ribavirin in children include:

    • infections
    • a decrease in appetite
    • stomach pain and vomiting

Serious Side Effects

If you experience any serious side effects, call your doctor right away. If your symptoms are potentially life threatening, or if you’re experiencing a medical emergency, call 9-1-1.

  • low red blood cells (anemia). Symptoms may include:

    • a general feeling of weakness
    • tiredness
    • dizziness
    • fast heart rate
    • trouble sleeping
    • pale skin
  • swelling and irritation of your pancreas (pancreatitis). Symptoms may include:

    • stomach pain
    • nausea
    • vomiting
    • diarrhea
  • pneumonia. Symptoms may include:

    • trouble breathing
  • severe depression

  • liver problems. Symptoms may include:

    • stomach bloating
    • confusion
    • brown-colored urine
    • yellowing of the whites of your eyes
  • heart attack. Symptoms may include:

    • pain in your chest, left arm, jaw, or between your shoulders
    • shortness of breath
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Ribavirin may cause drowsiness.

Mild side effects may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 5

ribavirin May Interact with Other Medications

Oral tablet

Ribavirin can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions

Food Interactions

Don’t take ribavirin with a high fat meal. This can increase the amount of the drug in your blood. Take your medication with a low-fat meal.

Medications That Might Interact with This Drug

Immunosuppressant drug
  • azathioprine

Taking ribavirin with azathioprine can increase the amount of azathioprine in your body. This may increase your risk for toxic side effects due to azathioprine.

Live flu vaccine

Taking ribavirin with the live flu vaccine may decrease the effect of the flu vaccine. Don’t take ribavirin 48 hours before or 2 weeks after receiving a live flu vaccine.

Interferons (alfa)

Taking ribavirin with interferons (alfa) might increase the risk for side effects, including low red blood cells (anemia), due to ribavirin treatment.

HIV medications
  • reverse transcriptase inhibitors. Taking ribavirin with reverse transcriptase inhibitors may increase the risk for toxic effects on your liver. Taking these medications together should be avoided if possible.
  • zidovudine. Taking ribavirin with zidovudine may increase your risk of adverse effects, including low red blood cells (anemia). Taking these two medications together should be avoided if possible.
  • didanosine. Taking ribavirin with didanosine may increase your risk of adverse effects. Didanosine should not be taken with ribavirin.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.

Pregnant women

Ribavirin is a category X pregnancy drug. Category X drugs should never be used during pregnancy.

Don’t use ribavirin if you’re pregnant. Don’t use it if you or your female partner plans to become pregnant. Ribavirin can cause birth defects or death of an unborn baby. This can happen if either the mother or father uses ribavirin during conception, or if the mother takes the drug during pregnancy. You or your female partner should not become pregnant while taking ribavirin and for 6 months after treatment ends.

You must use two effective forms of birth control during and for 6 months after treatment if you’re a man or a woman being treated with ribavirin. Talk to your healthcare provider about forms of birth control that you can use.

Women must have a negative pregnancy test before starting treatment, every month while being treated, and for 6 months after treatment ends.

If you or your female partner becomes pregnant during or within 6 months after treatment with ribavirin, tell your healthcare provider right away. You or your healthcare provider should contact the Ribavirin Pregnancy Registry by calling 1-800-593-2214. The Ribavirin Pregnancy Registry collects information about what happens to mothers and their babies if the mother takes ribavirin while pregnant.

Women who are nursing

It isn’t known if ribavirin passes through breastmilk. If it does, it can cause serious effects in a nursing child.

You and your doctor may need to decide if you’ll take ribavirin or breastfeed.

For Children

The safety and effectiveness of the ribavirin tablet haven’t been established in children under the age of 5 years.

When to call the doctor

  • Tell your doctor right away if you or your female partner becomes pregnant during your treatment with ribavirin. Ribavirin can cause birth defects or death of an unborn baby.
  • Talk to your doctor before starting any new prescription or over-the-counter medications, vitamins, and herbal supplements. Certain medications may affect how ribavirin works.

Allergies

Don’t take this drug again if you’ve ever had an allergic reaction to it. Taking it again could be fatal.

SECTION 4 of 5

How to Take ribavirin (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?

Chronic hepatitis C
Form: Oral tablet
Strengths:
  • 200 mg
  • Moderiba 1,200 Dose Pack tablet 600 mg
  • Moderiba 800 mg Dose Pack tablet 400 mg
Adult Dosage (ages 18 years and older)

Tablets (used with peginterferon alfa):

  • genotype 1: If you weigh:
    • less than 75 kg: 500 mg taken every morning and 500 mg taken each evening for 48 weeks
    • more than 75 kg: 600 mg taken each morning and 600 mg taken each evening for 48 weeks
  • genotypes 2 and 3: 400 mg taken each morning and 400 mg taken each evening for 24 weeks
Child Dosage (ages 5-17 years)
  • 23–33 kg: 200 mg taken each morning and 200 mg taken each evening
  • 34–46 kg: 200 mg taken each morning and 400 mg taken each evening
  • 47–59 kg: 400 mg taken each morning and 400 mg taken each evening
  • 60–74 kg: 400 mg taken each morning and 600 mg taken each evening
  • More than 75 kg: 600 mg taken each morning and 600 mg taken each evening

People who reach their eighteenth birthday during treatment should stay on the child dosage until the end of treatment.

The duration of treatment for people who have never been treated with interferon depends on what genotype of the virus you have:

  • genotypes 2 and 3: 24 weeks
  • other genotypes: 48 weeks

The duration of treatment for people who have been treated with interferon is 24 weeks.

Child Dosage (ages 0-4 years)

A safe and effective dose hasn’t been determined for this age group.

Senior Dosage (ages 65 years and older)

Seniors may have decreased kidney function and may not be able to process the drug well. This increases risk of side effects.

Special Considerations

Kidney Disease:

  • Don’t use Rebetol or Ribasphere if your kidney function has a creatinine clearance less than 50 mL/min.
  • Your Moderiba or Copegus dose should be reduced if you have a creatinine clearance less than or equal to 50 mL/min.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Healthline Pharmacist Editorial Team

Ribavirin comes with serious risks if you don't take it as prescribed.

If You Don't Take It At All

Ribavirin won’t work to treat your hepatitis C virus infection. The infection will continue to progress and cause more damage to your liver. This infection may be deadly if not treated properly.

If You Don't Take It On Schedule

You may become resistant to this drug and it will no longer work for you. The infection will continue to progress and cause more damage to your liver. Be sure to take your medication every day as directed. 

If You Take Too Much

You may have higher levels of calcium and magnesium in your blood. This can lead to heart problems. Get medical help right away if you think you’ve taken too much of this drug.

If You Miss a Dose

If you miss a dose of ribavirin, take the missed dose as soon as possible during the same day. Don’t double the next dose to try to catch up. If you have questions about what to do, call your healthcare provider.

How to Tell If the Drug Is Working

Your doctor will do blood tests to check the amount of the virus in your body. If ribavirin is working, this amount should decrease. These blood tests may be done before you start treatment, at weeks 2 and 4 of treatment, and at other times to see how well the medications are working.

Ribavirin is a long-term drug treatment.

Important Considerations for Taking Ribavirin
take with food Take this medication with food
do not crush Don’t cut or crush this medication
storage Store in temperatures from 59–86°F (15–30°C)
refillable Prescription is refillable
clinical monitoring Clinical Monitoring See Details
not usually stocked Not every pharmacy stocks this drug, so call ahead
prior authorization required Insurance See Details

Clinical Monitoring

During treatment with ribavirin, your doctor may do blood tests to check your:

  • levels of hepatitis C virus infection in your body. These blood tests may be done before, during, and after treatment to make sure that the virus is no longer causing infection or inflammation.
  • liver function
  • red and white blood cells and platelets
  • thyroid function

You may also need these tests:

  • pregnancy test. Ribavirin may cause birth defects or the death of an unborn baby. Your doctor will do pregnancy tests each month during and for 6 months after stopping treatment.
  • dental exam. This drug can cause dental issues because of dry mouth caused by the medication.
  • eye exam: Ribavirin can cause serious eye issues. Your doctor will do a baseline eye exam and possibly more if you have eye problems.

Insurance

Many insurance companies will require a prior authorization before they approve the prescription and pay for ribavirin.

Are There Any Alternatives?

There are other drugs available to treat your condition. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

What does the pill look like?

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SECTION 5 of 5

How Much Does ribavirin Cost?

Oral tablet
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Lowest price for ribavirin

Walmart $153.00
Sams Club $153.00
Kroger Pharmacy $212.70
These represent the lowest cash prices for ribavirin and may be lower than your insurance.

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Content developed in collaboration with University of Illinois-Chicago, Drug Information Group

Medically reviewed by Creighton University, Center for Drug Information and Evidence-Based Practice on June 6, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

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