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Rivarus has the main ingredient Ribavirin, which belongs to the group of antiviral drugs. Rivarus is indicated in the following cases: Patients with hepatitis A, B, C caused by viruses, herpes zoster, herpes simplex, viral diseases in children such as measles, mumps, chickenpox, respiratory syncytial.
1. What is Rivarus?
Rivarus medicine has the main ingredient Ribavirin, which belongs to the group of antiviral drugs. Rivarus is a synthetic nucleotide with a guanosin-like structure that inhibits viral replication by inhibiting RNA and DNA synthesis, thereby inhibiting protein synthesis and viral replication. The antiviral effect of Rivarus is mainly located in susceptible virus-infected cells.
2. Indications of the drug Rivarus
Indications for use of Rivarus drug in the following cases:
Respiratory syncytial virus (RSV) infection of the lower respiratory tract (including bronchiolitis and pneumonia) in high-risk children (newborns) prematurity, congenital malformations in the heart, lungs, immunodeficiency, malnutrition,... hospitalization). Although it is possible to start Rivarus treatment before a patient has a diagnosis, Rivarus should only be continued when the patient is certain to have RSV infection. Therefore, it is necessary to diagnose quickly and get early results of the disease. Viral hemorrhagic fevers include Lassa fever, hemorrhagic fever with pulmonary syndrome, renal syndrome (due to Hantavirus infection), Crimean-Congo hemorrhagic fever. Influenza A or B virus infection. Chronic hepatitis C virus infection in people with compensated liver disease who have not been treated with interferon or have relapsed after interferon alpha-2b therapy: In combination with Interferon alpha-2b or Peginterferon alpha-2b to treatment because Rivarus alone has no effect. This regimen is effective even in cases of hepatitis C with HIV co-infection.
3. Contraindications of Rivarus
The use of Rivarus is contraindicated in the following cases:
Patients with a history of allergy or hypersensitivity to Ribavirin or to any component of Rivarus. Patients with severe heart disease, uncontrolled or unstable heart disease within 6 months, patients with myocardial ischemia. Severe kidney disease, including those with chronic renal failure or creatinine clearance (ClCr) < 50 ml/min or patients on dialysis. Thalassemia , thalassemia , sickle cell anemia . Concomitant administration of Rivarus and Peginterferon alfa or Interferon alpha is contraindicated in subjects with psychiatric disorders, autoimmune hepatitis, decompensated cirrhosis, cirrhosis with chronic HCV infection, decompensated cirrhosis with pre-existing HIV and during treatment, severe liver failure.
4. Dosage and usage of Rivarus
4.1. Dosage of the drug Rivarus Adults
Chronic hepatitis B, C:
The average oral dose is 400mg/time x 2 times/day. The dose can be adjusted according to weight, the dose can be increased to 1200mg/day for people weighing more than 85 kg. Use combination drug Rivarus with Interferon (3-5 million international units/time, injected 3 times/week), or Peginterferon dose 1.5 microgram/kg/time (injection once/week). The duration of treatment depends on the genotype (genotype) of the hepatitis C virus and on whether the patient has been previously treated with Interferon. Hepatitis C virus infection (mono) genotypes 1, 4, treatment for 48 weeks, types 2 and 3 for 24 weeks, and types 5 and 6, there is no clinical experience. In case of HIV co-infection, treatment should be given within 48 weeks, regardless of genetic virus infection. Recurrence of Interferon-treated cases: Continuation of Rivarus combination therapy for 24 weeks, and at week 24, patients should be checked for response to treatment by measuring HCV RNA levels. serous. If there is no response to treatment, the drug should be discontinued because it is unlikely to be effective with further treatment. Dengue fever (including Lassa fever, viral fever):
Oral use of Rivarus for prophylaxis when patients are at high risk of exposure: Take 500-600mg/time x 4 times/day, lasting for 7-10 days. Hepatitis A: Oral dose of 800mg/day, divided into several times a day, lasting for 10-14 days.
Herpes zoster / simplex : Oral dose 800 - 1200mg / day, divided 3-4 times a day, treatment lasts from 7 to 10 days.
Prophylaxis of genital herpes recurrence: Oral dose of 400mg/day, divided into 1-2 times a day, treatment lasts for 6 months.
Children:
Treatment with Rivarus is not recommended for use in children and adolescents (< 18 years of age) due to insufficient data on safety and efficacy when combined with other medicinal products to treat treatment of hepatitis C.
Chronic hepatitis C:
Use oral Rivarus in combination with interferon. Children over 3 years old: 15 mg/kg body weight/day, divided into 2 times. Dengue fever (Lassa fever, viral fever): Oral use of Rivarus for prophylaxis when patients are at high risk of exposure:
Children 6-9 years old: 400mg/time x 4 times/day, last for 7-10 days. Children under 6 years of age: The dose of Rivarus has not been determined. Other subjects
Renal impairment: The dose of Rivarus should be reduced for patients with creatinine clearance (CrCl) ≤ 50ml/min.
ClCr 30 - 50ml/min: Alternate daily dose of 200mg and 400mg. ClCr < 30ml/min and/or on hemodialysis: 200mg/day oral dose. Elderly: Renal function should be assessed before using Rivarus.
4.2. How to take Rivarus Rivarus is made in the form of capsules. Before taking, patients should carefully read the instructions for use on the drug leaflet and consult a doctor, specialist pharmacist. When swallowed, swallow the tablet whole with a full glass of water. Should be taken at a fixed time of the day to avoid forgetting the dose.
5. Undesirable effects of Rivarus
Patients using Rivarus may experience unwanted side effects as follows:
Common side effects are as follows:
Nervous system: Headache, fatigue, tremor, fever, flu-like symptoms, myasthenia gravis, weight loss, dysesthesia, hot flashes, confusion, hyperesthesia, dizziness, depression, excitability, insomnia, anxiety, decreased concentration, emotional lability. Blood and lymphatic system: Decreased hemoglobin, anemia, neutropenia, thrombocytopenia, swollen lymph nodes. Digestive system: Nausea, anorexia, diarrhea, abdominal pain, vomiting, dry mouth, constipation, abdominal distension, bleeding gums, mouth ulcers, pancreatitis. Cardiovascular system: Tachycardia, increased or decreased blood pressure. Musculoskeletal system: Myalgia, arthralgia, rhabdomyolysis. On the skin: Hair loss, itching, dry skin, rash, rash, increased sweating. Respiratory system: Pharyngitis, rhinitis, sinusitis, cough, shortness of breath, chest pain. Five senses: Taste and vision disturbances, tinnitus, hearing loss. Endocrine-genital system: Menstrual disorders, hypothyroidism or hyperthyroidism, decreased libido. Other: Increased risk of superinfection, other fungal and viral infections. Uncommon side effects are as follows: Depression, suicidal ideation.
Rare adverse effects are as follows:
Blood and lymphatic system: Hemolytic anemia. Respiratory system: Bronchospasm (in people with a history of asthma, with obstructive ventilation syndrome), severe progressive interstitial pneumonia.
6. Precautions while using Rivarus
Patients using Rivarus should note the following information:
Use caution when using the drug for people under 18 years of age, especially when combined with Interferon alpha-2b because the effects and safety of the drug are unknown in this age group. this age. Some psychotic symptoms have been observed in patients receiving Rivarus in combination with Interferon alpha-2b such as insomnia, irritability, depression, suicidal ideation, regardless of history or no history of the disease. mental. Therefore, it is necessary to monitor and be cautious when using oral Rivarus in combination with Interferon alpha-2b, especially in people with a history of mental disorders, depression. Women of childbearing age: Be sure not to become pregnant or not to become pregnant during and for several months after treatment, because of the potential for teratogenicity. Rivarus should not be used by people who are taking injectable drugs (high risk of reinfection) and heavy drinkers (risk of increasing liver damage). Rivarus causes blood disorders, so patients must have blood tests (erythrocytes, white blood cells, white blood cell count, platelets, blood clotting time) before taking Rivarus. At the same time, monitor and test blood in the 2nd, 4th and periodically thereafter depending on the clinical condition so that anemia can be detected in time. Note to pregnant women: Rivarus is fetotoxic and teratogenic. Not for use by pregnant women. Before giving Rivarus to women, they need to have a test to confirm that they are not pregnant. Women of childbearing age should use effective contraception during treatment and for 6 months after stopping the drug. If pregnancy occurs during this time, the physician should inform the patient of the teratogenic potential of Rivarus. Men treated with Rivarus also need to use contraception during treatment and for at least 6-7 months after stopping the drug. Note to nursing women: It is not known whether Rivarus is excreted in human milk. To avoid adverse effects of the drug on a nursing infant, do not administer to a nursing woman or stop breastfeeding before starting the drug. Precautions while driving and using machines: Rivarus has no or negligible influence on the ability to drive and use machines. However, other drugs when combined with Rivarus may be affected. Therefore, patients who are fatigued, drowsy or confused during treatment should be cautious to avoid driving or operating machinery. Above is information about Rivarus drug for patients to refer to. However, Rivarus is only used when prescribed by a doctor, patients need to be careful when using it to achieve the best effect and limit unwanted side effects.
