Description

Ribavirin is a broad-spectrum antiviral medicinal product belonging to the group of synthetic nucleoside analogues. It exhibits antiviral activity against a variety of RNA and DNA viruses and is used in the treatment of severe viral infections, particularly those affecting the lower respiratory tract.

In clinical practice, ribavirin may be administered by inhalation (preferred route) or intravenously, strictly under medical supervision. The inhalation route is especially important in pediatric care, as it allows high local concentrations of the active substance to be delivered directly to the respiratory tract while limiting systemic exposure.

Indications

Ribavirin for inhalation is primarily used for the treatment of:

• ✔ Severe pneumonia in infants and young children

• ✔ Infections caused by Respiratory Syncytial Virus (RSV)

• ✔ Severe viral infections of the lower respiratory tract

• ✔ Viral respiratory infections in immunocompromised patients (as determined by a physician)

Treatment is performed exclusively in hospital settings.

Method of Administration

The medication is administered via oral inhalation, meaning the patient inhales the drug as a fine aerosol through the mouth.
For this purpose, a specialized medical nebulizer designed for ribavirin administration is used.

The nebulizer may be connected to:

• an oxygen hood,

• an oxygen tent,

• or a face mask.

This method ensures a constant therapeutic concentration of ribavirin in the lungs, which is essential for effective antiviral action in severe respiratory infections.

Mechanism of Action

Ribavirin interferes with viral replication through multiple mechanisms:

• ✔ inhibition of viral RNA synthesis

• ✔ suppression of RNA-dependent RNA polymerase

• ✔ disruption of viral genome replication

• ✔ induction of lethal mutagenesis in viral RNA

• ✔ reduction in the production of infectious viral particles

When administered by inhalation, ribavirin acts locally in the respiratory epithelium, providing targeted antiviral activity in the lungs.

Special Populations

🔹 Pediatric Use

Clinical studies have not demonstrated specific limitations to the effectiveness of ribavirin in infants and young childrenwhen used according to approved indications.

🔹 Adults and Elderly

Clinical studies evaluating ribavirin use in elderly patients are limited.
Inhaled ribavirin is not recommended for routine use in adults or elderly patients.

🔹 Breastfeeding

There is insufficient data to fully assess the risk to infants when ribavirin is used during breastfeeding. The potential benefits and risks should be carefully evaluated by a healthcare professional.

Contraindications and Precautions

Ribavirin should be used with caution or avoided in patients with:

• ❌ hypersensitivity to ribavirin

• ❌ severe anemia

• ❌ significant cardiac disease

• ❌ severe pulmonary disease (risk of worsened respiratory effects)

Ribavirin is teratogenic. Pregnant women should avoid exposure, including environmental exposure during inhalation therapy.

Drug Interactions

Ribavirin may interact with other medications.

❌ Concomitant use is not recommended with:

• Didanosine

⚠ Use with caution with:

• Abacavir

• Azathioprine

• Levoketoconazole

• Mercaptopurine

• Methotrexate

• Stavudine

• Warfarin

• Zalcitabine

• Zidovudine

✔ Use under medical supervision:

• Interferon alfa-2b

Adverse Reactions

❗ Seek immediate medical attention if the following occur:

• severe or noisy breathing

• marked shortness of breath

• bluish discoloration of lips or skin

• chest pain

• unusual bleeding or bruising

• high fever or chills

• cough producing pink, frothy sputum

• yellowing of the skin or eyes

⚠ Less serious side effects may include:

• eye irritation, dryness, or itching

• tearing

• skin rash

• redness or swelling of the eyelids

Important Safety Information

• The drug is prescription-only

• Administered by trained healthcare professionals

• Used only in hospital settings

• Patients are monitored closely throughout therapy

• Information provided is for reference only and does not replace medical advice

Storage Conditions

• ✔ Store at 15–25 °C

• ✔ Protect from light

• ✔ Do not freeze

• ✔ Keep in original packaging

• ✔ Keep out of reach of children

• ✔ Do not use after the expiration date