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Nucleoside antiviral

Ribavirin

Brand names: Copegus, Rebetol

Ribavirin is a broad-spectrum antiviral guanosine analogue used for chronic hepatitis C (in combination regimens) and certain viral haemorrhagic fevers and respiratory infections.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

Clinical monograph

How it works

It interferes with viral nucleic acid synthesis through several mechanisms, including inhibition of viral RNA polymerase and induction of lethal mutagenesis of the viral genome.

Prescribing in practice

  • Ribavirin is teratogenic and embryocidal; effective contraception is essential during and after treatment for both female patients and female partners of male patients.
  • Dose-dependent haemolytic anaemia is common and may precipitate cardiac or respiratory complications.
  • It is contraindicated in pregnancy and requires careful pregnancy-prevention counselling before use.

Monitoring

Monitor full blood count for haemolytic anaemia and confirm a negative pregnancy test before and during treatment.

Counselling the patient

  • Do not become pregnant, and avoid fathering a child, during treatment and for the advised period afterwards.
  • Use reliable contraception throughout and report any planned or suspected pregnancy at once.
  • Tell your clinician about breathlessness, palpitations or unusual tiredness, which may signal anaemia.

Evidence & guidelines

Ribavirin's teratogenicity and use in combination antiviral regimens are well established and reflected in MHRA safety advice.

Reference: NICE TA75; UKHSA; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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