Ribavirin

Snapshot

• A 3-month old girl is brought to the emergency room with difficulty breathing. She was a preterm baby, born at 36 weeks, and has been tracking along the 50% percentile for height and weight. There were no other complications associated with her birth or development. She is up to date on all vaccines. On physical exam, there is audible wheezing, coughing, and rhinorrhea, suspicious for an RSV infection. She is given an antiviral medication. (Bronchiolitis)

Introduction

• Drugs
  • ribavirin
• Mechanism of action
  • inhibits inosine monophosphate dehydrogenase which disrupts the synthesis of guanine nucleotides
• Clinical use
  • chronic hepatitis C
    • used with other anti-hepatitis C agents
  • respiratory syncytial virus (RSV) infections
    • marginal benefit in those with severe disease 
• Adverse effects
  • hemolytic anemia
  • myocardial infarction
  • teratogenic
    • avoid in pregnancy
    • effects may persist up to 6 months after completion of medication