Ribavirin (Copegus, Rebetol)

Reviewed by: HU Medical Review Board | Last reviewed: May 2023

Ribavirin is a prescription drug used in combination with other medicines to treat chronic hepatitis C virus (HCV) infection. Ribavirin is known by several brand names, including:1,2

  • Copegus
  • Moderiba
  • Rebetol
  • Ribasphere
  • RibaTab

There are also generic forms of ribavirin available. Ribavirin should not be used alone to treat chronic HCV infection.1,2

What are the ingredients in ribavirin?

Ribavirin is the active ingredient in the name brands listed above.1,2

How does ribavirin work?

Ribavirin is a type of drug called a nucleoside analog. The exact way ribavirin works is not fully understood. Scientists believe it stops the hepatitis C virus from replicating and spreading in the body.1,2

What are the possible side effects of ribavirin?

The most common side effects of ribavirin in adults include:1,2

  • Redness, soreness, or other reactions at the site of injection (peginterferon, which is taken with ribavirin, is an injected drug)
  • Fatigue or tiredness
  • Headache
  • Fever or chills
  • Nausea
  • Muscle aches
  • Anxiety or emotional irritability

In children treated with ribavirin, the most common side effects include:1,2

  • Fever
  • Headache
  • Low white blood cell counts
  • Fatigue or tiredness
  • Loss of appetite
  • Redness at the injection site
  • Vomiting

Ribavirin may also cause serious side effects, including:1,2

  • Pancreatitis
  • Lung problems
  • New or worsening eye problems
  • Liver problems
  • Dental problems
  • Weight loss and delayed growth in children

Ribavirin has a boxed warning, the strictest warning from the U.S. Food and Drug Administration (FDA). This is because it may cause severe side effects, including:1,2

  • Reduction in red blood cell count (anemia). Anemia can worsen heart disease and may cause a heart attack. People who have a history of heart disease should not be treated with ribavirin.
  • Birth defects in unborn babies. If you or your partner can become pregnant, you should use birth control during treatment and for some time after the last dose of ribavirin. Talk to your doctor about your options for birth control while taking ribavirin.

These are not all the possible side effects of ribavirin. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with ribavirin.

Things to know about ribavirin

Do not take ribavirin if you have:1,2

  • Autoimmune hepatitis
  • Blood disorders like thalassemia major or sickle cell disease
  • Take didanosine (Videx or Videx EC)

Before starting ribavirin, tell your doctor if you have or had:1,2

  • Prior hepatitis C treatment that did not work
  • Breathing problems
  • Eye problems
  • Anemia
  • Thyroid problems
  • Diabetes
  • Liver problems
  • HIV or other immune system problems
  • A history of mental health issues
  • Kidney problems
  • An organ transplant
  • Infection with hepatitis B

There is not enough data to know if ribavirin is safe to take while breastfeeding. Before taking ribavirin, tell your doctor if you are breastfeeding or plan to breastfeed.1,2

Ribavirin may interact with other drugs. Before beginning treatment for HCV, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

For more information, read the full prescribing information of Copegus and Rebetol.

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