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(rye ba vye' rin)Ribavirin will not treat hepatitis C (a virus that infects the liver and may cause severe liver damage or liver cancer) unless it is taken with another medication. Your doctor will prescribe another medication to take with ribavirin if you have hepatitis C. Take both medications exactly as directed. Ribavirin may cause anemia (condition in which there is a decrease in the number of red blood cells) that can worsen any heart problems you have and can cause you to have a heart attack that can be life-threatening. Tell your doctor if you have ever had a heart attack and if you have or have ever had high blood pressure, breathing problems, any condition that affects your blood such as sickle cell anemia (inherited condition in which the red blood cells are abnormally shaped and cannot bring oxygen to all parts of the body) or thalassemia (Mediterranean anemia; a condition in which the red blood cells do not contain enough of the substance needed to carry oxygen), bleeding in the stomach or intestines, or heart disease. If you experience any of the following symptoms, call your doctor immediately: excessive tiredness, pale skin, headache, dizziness, confusion, fast heartbeat, weakness, shortness of breath, or chest pain. Keep all appointments with your doctor and the laboratory. Your doctor will order blood tests before you start taking ribavirin and often during your treatment. Talk to your doctor about the risks of taking ribavirin. For female patients: Do not take ribavirin if you are pregnant or plan to become pregnant. You should not start taking ribavirin until a pregnancy test has shown that you are not pregnant. You must use two forms of birth control and be tested for pregnancy every month during your treatment and for 6 months afterward. Call your doctor immediately if you become pregnant during this time. Ribavirin may cause harm or death to the fetus. For male patients: Do not take ribavirin if your partner is pregnant or plans to become pregnant. If you have a partner who can become pregnant, you should not start taking ribavirin until a pregnancy test shows that she is not pregnant. You must use two forms of birth control, including a condom with spermicide during your treatment and for 6 months afterward. Your partner must be tested for pregnancy every month during this time. Call your doctor immediately if your partner becomes pregnant. Ribavirin may cause harm or death to the fetus.
Before taking ribavirin,
- tell your doctor and pharmacist if you are allergic to ribavirin, any other medications, or any of the ingredients in ribavirin tablets, capsules, or oral solution. Ask your pharmacist or check the Medication Guide for a list of the ingredients.
- tell your doctor if you are taking didanosine (Videx). Your doctor will probably tell you not to take ribavirin if you are taking this medication.
- tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Be sure to mention any of the following: azathioprine (Azasan, Imuran); medications for anxiety, depression, or other mental illness; nucleoside reverse transcriptase inhibitors (NRTIs) for human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) such as abacavir (Ziagen, in Atripla, in Trizivir), emtricitabine (Emtriva, in Atripla, in Truvada), lamivudine (Epivir, in Combivir, in Epzicom), stavudine (Zerit), tenofovir (Viread, in Atripla, in Truvada), and zidovudine (Retrovir, in Combivir, in Trizivir); and medications that suppress the immune system such as cancer chemotherapy, cyclosporine (Neoral, Sandimmune), sirolimus (Rapamune), and tacrolimus (Prograf). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have kidney disease, liver failure, or autoimmune hepatitis (swelling of the liver that occurs when the immune system attacks the liver). Your doctor may tell you not to take ribavirin.
- tell your doctor if you drink or have ever drunk large amounts of alcohol, if you use or have ever used street drugs, if you have ever thought about killing yourself or planned or tried to do so, and if you have ever had a liver transplant or other organ transplant. Also tell your doctor if you have or have ever had a mental illness such as depression, anxiety, or psychosis (loss of contact with reality); cancer; HIV or AIDS; diabetes; sarcoidosis (a condition in which abnormal tissue grows in parts of the body such as the lungs); Gilbert's syndrome (a mild liver condition that may cause yellowing of the skin or eyes); gout (a type of arthritis caused by crystals deposited in the joints); any type of liver disease other than hepatitis C;or thyroid, pancreas, eye, or lung disease.
- tell your doctor if you are breast-feeding.
- you should know that ribavirin may make you drowsy, dizzy, or confused. Do not drive a car or operate machinery until you know how this medication affects you.
- do not drink alcoholic beverages while you are taking ribavirin. Alcohol can make your liver disease worse.
- you should know that your mouth may be very dry when you take this medication, which can lead to problems with your teeth and gums. Be sure to brush your teeth twice a day and have regular dental exams. If vomiting occurs, rinse your mouth out thoroughly.
- upset stomach
- loss of appetite
- weight loss
- changes in ability to taste food
- dry mouth
- difficulty concentrating
- difficulty falling asleep or staying asleep
- memory loss
- dry, irritated, or itchy skin
- painful or irregular menstruation (period)
- muscle or bone pain
- hair loss
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- difficulty swallowing or breathing
- pain in the stomach or lower back
- bloody diarrhea
- bright red blood in stools
- black, tarry stools
- stomach bloating
- dark-colored urine
- yellowing of the skin or eyes
- unusual bleeding or bruising
- vision changes
- fever, chills, and other signs of infection
- thinking about hurting or killing yourself
- mood changes
- excessive worry
- starting to use street drugs or alcohol again if you used these substances in the past
- intolerance to cold