Ribavirin is an antiviral medication that is used to treat chronic hepatitis C.

Ribavirin is not effective when used alone. ribavirin must be used in combination with interferon alfa or peginterferon alfa.

Ribavirin is sometimes given to people taking other antiviral medications to treat hepatitis C.

Ribavirin may also be used for purposes not listed in this medication guide.

You should not use ribavirin if you have autoimmune hepatitis, moderate to severe kidney disease, a hemoglobin blood cell disorder, or if you take didanosine.

Ribavirin can harm an unborn baby if the mother or the father is using ribavirin. Do not use if you are pregnant, or if you are a man whose sex partner is pregnant. Both men and women should use effective birth control while taking ribavirin and for at least 6 months after the last dose.

Ribavirin is not effective when used alone and must be used in combination with an interferon.

In rare cases, ribavirin can cause fatal heart problems. Get emergency medical attention if you have chest pain.

Ribavirin comes as a tablet, a capsule and an oral solution (liquid) to take by mouth. It is usually taken with food twice a day, in the morning and the evening, for 24 to 48 weeks or longer. Take ribavirin at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ribavirin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the capsules whole; do not split, chew, or crush them.

Shake the liquid well before each use to mix the medication evenly. Be sure to wash the measuring spoon or cup after use each time you measure the liquid.

Your doctor may decrease your dose or tell you to stop taking ribavirin if you develop side effects of the medication or if certain laboratory tests show that your condition has not improved. Call your doctor if you are bothered by side effects of ribavirin. Do not decrease your dose or stop taking ribavirin unless your doctor tells you that you should.

Ribavirin is not effective when used alone and must be used in combination with other medications to treat hepatitis C.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Take ribavirin with food.

Swallow the capsule whole and do not crush, chew, break, or open it. Tell your doctor if you have trouble swallowing the capsule.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

Drink extra fluids while you are taking ribavirin to keep from getting dehydrated.

Ribavirin can cause dry mouth, which could lead to tooth decay or gum disease. If you vomit while taking ribavirin, rinse your mouth out with water to prevent damage to your teeth or gums. Be sure to have regular dental exams while you are taking this medication.

You will need frequent medical tests.

Store ribavirin tablets or capsules at room temperature away from moisture, heat, and light.

Store ribavirin liquid (oral solution) at room temperature or in the refrigerator.

You should not take ribavirin if you are allergic to it, or if you have:

• a hemoglobin blood cell disorder such as sickle-cell anemia or thalassemia;

• autoimmune hepatitis;

• moderate to severe kidney disease;

• if you are also taking didanosine; or

• if you are pregnant, or if you are a man whose sex partner is pregnant.

When you take ribavirin in combination with other medications: There may be other reasons you should not take the combination treatment. Tell your doctor about all your medical conditions.

Tell your doctor if you have ever had:

• a blood cell disorder such as anemia (low red blood cells);

• heart problems, high blood pressure, or heart attack;

• breathing problems;

• vision problems (you may need an eye exam before taking ribavirin);

• diabetes;

• human immunodeficiency virus (HIV or AIDS) or a weak immune system;

• depression, mental illness, thoughts of hurting yourself or others;

• a thyroid disorder;

• kidney disease;

• an organ transplant;

• liver problems other than hepatitis C; or

• treatment for hepatitis C that did not work well.

Both men and women taking ribavirin should use effective birth control to prevent pregnancy. Ribavirin can cause birth defects, miscarriage, or death to an unborn baby if the mother or father is using this medicine.

• If you are a woman, do not take ribavirin if you are pregnant. You will need to have a negative pregnancy test before taking ribavirin. You will also need pregnancy tests during treatment and for 6 months after your last dose.

• If you are a man, do not take ribavirin if your sex partner is pregnant.

• Both men and women should keep using effective birth control for at least 6 months after the last dose of ribavirin.

• Tell your doctor right away if a pregnancy occurs while either the mother or the father is taking ribavirin. Your name may be listed on a pregnancy registry to track the effects of ribavirin on the baby.

It may not be safe to breastfeed while using this medicine. Ask your doctor about any risk.

Ribavirin is not approved for use by anyone younger than 3 years old. Ribavirin tablets are not approved for use by anyone younger than 5 years old.

Take the missed dose on the same day you remember it. Skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Get your prescription refilled before you run out of medicine completely.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store ribavirin tablets and capsules at room temperature and away from excess heat and moisture (not in the bathroom). Store ribavirin oral solution in the refrigerator or at room temperature.

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Be sure to drink plenty of fluids while you are taking ribavirin.

Avoid drinking alcohol. It can make your liver problems worse.

Using ribavirin will not prevent you from passing hepatitis to other people. Follow your doctor's instructions about how to prevent passing the disease to another person.

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Ribavirin can cause anemia. In rare cases, this can lead to fatal heart problems. Get emergency medical attention if you have chest pain.

Ribavirin may cause serious side effects. Call your doctor at once if you have:

• problems with your vision;

• severe pain in your upper stomach spreading to your back, nausea, vomiting, diarrhea;

• new or worsening cough, fever, stabbing chest pain, wheezing, feeling short of breath;

• severe depression, thoughts about suicide, or thoughts about hurting someone else;

• signs of serious anemia--pale or yellowed skin, dark colored urine, confusion or weakness; or

• other signs of low blood cell counts--fever, chills, flu-like symptoms, swollen gums, mouth sores, skin sores, easy bruising, unusual bleeding, feeling light-headed.

Ribavirin can affect growth in children. Tell your doctor if your child is not growing at a normal rate while using this medicine.

Common side effects of ribavirin may include:

• nausea, vomiting, loss of appetite;

• fever, chills or shaking;

• low blood cell counts, anemia;

• feeling weak or tired;

• headache, muscle pain; or

• mood changes, feeling anxious or irritable.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your other medicines, especially:

• azathioprine; or

• medicines to treat HIV or AIDS.

This list is not complete. Other drugs may affect ribavirin, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.