Drug Title

Rebetol (Ribavirin)

Pharmacological action

Antiviral agent. It quickly penetrates into cells and acts inside virus-infected cells. Ribavirin is easily phosphorylated intracellularly by adenosine kinase to mono-, di- and triphosphate metabolites. Ribavirin triphosphate is a strong competitive inhibitor of inosine monophosphate dehydrogenase, influenza virus RNA polymerase, and guanylyl RNA information transferase, the latter manifested by inhibition of the informational RNA envelope coating process. These various effects lead to a significant decrease in the amount of intracellular guanosine triphosphate, as well as suppression of viral RNA and protein synthesis. Ribavirin inhibits the replication of new virions, which provides a decrease in viral load, selectively inhibits viral RNA synthesis without inhibiting RNA synthesis in normally functioning cells.

It is most active against DNA viruses - respiratory syncytial virus, Herpes simplex viruses types 1 and 2, adenoviruses, CMV, smallpox viruses, Marek's disease; RNA viruses - influenza A, B, paramyxoviruses (parainfluenza, epidemic parotitis, Newcastle disease), reoviruses, arenaviruses (Lassa fever virus, Bolivian hemorrhagic fever virus), bunyaviruses (Rift Valley fever virus, Crimean-Congo hemorrhagic fever virus), hantaviruses (hemorrhagic fever virus with renal or pulmonary syndrome) paramyxoviruses, oncogenic RNA viruses.

During treatment of hemorrhagic fever with renal syndrome it decreases disease severity, reduces duration of symptoms (fever, oliguria, pains in the lumbar region, abdomen, headache), improves laboratory indexes of renal function, reduces the risk of hemorrhagic complications and unfavorable disease outcome.

DNA viruses - Varicella zoster, pseudo rabies virus, natural cowpox are not sensitive to ribavirin; RNA viruses - enteroviruses, rhinoviruses, Semliki forest encephalitis virus.

Contraindications to use

Chronic heart failure stage IIB-III, myocardial infarction, renal failure (CK less than 50 ml/min), severe anemia, severe hepatic insufficiency, decompensated cirrhosis, autoimmune diseases (incl. autoimmune hepatitis), untreatable thyroid disease, severe depression with suicidal tendencies, children and adolescents under 18 years old, pregnancy, lactation, hypersensitivity to ribavirin.

Administration during pregnancy and lactation

Ribavirin is contraindicated for use during pregnancy and lactation (breast-feeding).

Administration in liver dysfunction

It is contraindicated in severe hepatic insufficiency, decompensated cirrhosis of liver, autoimmune hepatitis.

Administration in patients with kidney dysfunction

It is contraindicated in cases of renal insufficiency (CKR less than 50 ml/min).

Administration in children

Contraindicated in children and adolescents under 18 years of age.

Indications for active substances of Rebetol

Oral: treatment of chronic hepatitis C in adults (in combination with interferon alpha-2b or peginterferon alpha-2b).

Parenteral: hemorrhagic fever with renal syndrome.

Externally as monotherapy or in combination with other medicinal forms of ribavirin for oral administration and parenteral use: Skin and mucous membrane infections caused by Herpes simplex viruses of types 1 and 2, various localizations, including genital area; herpes zoster (as part of complex therapy).

Dosing regimen

 The optimal dosing regimen is determined by the doctor. It should be strictly observed in accordance with the dosage form used for the particular drug indications and the dosing regimen.

Individual, depending on the indication, age, route of administration, and dosage form.