Details About Generic Salt ::  Ribaviri

Main Medicine Class:: Anti-infective, Antiviral   

(rye-buh-VIE-rin)
Virazole
Lyophilized powder for aerosol reconstitution: 6 g ribavirin/100 mL vial. Contains 20 mg/mL when reconstituted with 300 mL sterile water.
Class: Anti-infective, Antiviral

 

Drugs Class ::

 Action Has antiviral inhibitory activity against respiratory syncytial virus (RSV), influenza virus, and herpes simplex virus. Exact mechanism is unknown.

Indications for Drugs ::

 Indications

Aerosol

Treatment of carefully selected hospitalized infants and young children with severe lower respiratory tract infections caused by RSV.

Capsule

In combination with recombinant interferon alfa-2b injection for the treatment of chronic hepatitis C in patients with compensated liver disease previously untreated with alpha interferon or who have relapsed following alpha interferon therapy.

Drug Dose ::

 Route/Dosage

RSV

INFANTS & CHILDREN: Inhalation 6 g reconstituted with 300 mL Sterile Water aerosolized and administered over 12 to 18 hr/day for 3 to 7 days.

Capsules

ADULTS: PO Patients £ 75 kg: two 200 mg capsules in the morning and three 200 mg capsules in the evening. Patients > 75 kg: three 200 mg capsules in the morning and evening. In patients whose hemoglobin levels fall < 10 g/dL, reduce the ribavirin dose to 600 mg/day (one 200 mg capsule in the morning and two 200 mg capsules in the evening). Permanently discontinue ribavirin in patients whose hemoglobin levels fall < 8.5 g/dL. In patients with a history of stable cardiovascular disease, a permanent dose reduction of ribavirin to 600 mg/day is required if the hemoglobin decreased by ³ 2 g/dL during any 4-wk treatment period. Permanently discontinue ribavirin therapy in patients with cardiac history if the hemoglobin remains < 12 g/dL after 4 wk on a reduced ribavirin dose.

Contraindication ::

 Contraindications Infants requiring assisted ventilation because drug may precipitate in the equipment, interfering with safe and effective ventilation; women who are or may become pregnant.

Drug Precautions ::

 Precautions

Pregnancy: Category X. Lactation: Undetermined. Children: Safety and efficacy of ribavirin capsules not established. Elderly: Administer ribavirin capsules with caution, reflecting greater frequency of decreased hepatic, renal, or cardiac function and comorbidity. Monotherapy: Ribavirin monotherapy is not effective for treatment of chronic hepatitis C virus infection. Renal Function Impairment: Do not use in patients with Ccr < 50 mL/min.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CARDIOVASCULAR: Cardiac arrest, hypotension, digitalis toxicity (aerosol). CNS: Headache, dizziness, insomnia, irritability, depression, emotional lability, impaired concentration, nervousness, fatigue (capsules). DERMATOLOGIC: Rash; alopecia, pruritus, injection site inflammation and reaction (capsules). EENT: Conjunctivitis (aerosol); sinusitis, taste perversion, hearing disorders, vertigo (capsules). GI: Nausea, anorexia, dyspepsia, vomiting (capsules). HEMATOLOGIC: Anemia (aerosol); hemolytic anemia, changes in hemoglobin, WBC, neutrophil, and platelet values (capsules). RESPIRATORY: Worsening of respiratory status, bacterial pneumonia, pneumothorax, apnea, ventilator dependence (aerosol); dyspnea (capsules). OTHER: Myalgia, arthralgia, musculo-skeletal pain, rigors, fever, flu-like symptoms, asthenia, chest pain (capsules).

Drug Mode of Action ::  

 Action Has antiviral inhibitory activity against respiratory syncytial virus (RSV), influenza virus, and herpes simplex virus. Exact mechanism is unknown.

Drug Interactions ::

 Interactions None well documented.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies.
  • Obtain baseline reticulocyte count and monitor daily.
  • Monitor I&O.
  • Obtain baseline vital signs and monitor at regular intervals during administration.
  • Assess respiratory status prior to starting drug and monitor closely during treatment.
  • If respiratory status deteriorates rapidly, discontinue treatment and notify health care provider.
  • Obtain baseline digoxin levels on patients who are concomitantly receiving digoxin and monitor for digoxin toxicity.
  • Assess skin prior to starting drug and observe for changes.

Drug Storage/Management ::

 Administration/Storage

  • Administer by aerosol using only Small Particle Aerosol Generator (SPAG-2). Refer to manufacturer instructions for use of device.
  • Reconstitute with 100 mL of preservative-free Sterile Water for Injection, then transfer solution to reservoir.
  • Dilute to final volume of 300 mL with Sterile Water for Injection. Concentration should be 20 mg/mL.
  • Do not administer with other aerosol medications.
  • Discard solutions placed in SPAG-2 unit ³ q 24 hr and when liquid level is low before adding newly reconstituted solution.
  • Store reconstituted solution at room temperature and discard after 24 hr.
  • Store powder form of drug at room temperature.
  • Minimize environmental exposure to ribavirin by use of an aerosol delivery hood or other shielding techniques. Do not allow pregnant women near patient when aerosol is being delivered.

Drug Notes ::

 Patient/Family Education

  • Caution patient that this medication must not be taken during pregnancy or when pregnancy is possible.
  • Tell family to notify health care provider if change in respiratory status or rash occurs.

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Disclaimer ::

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