Ribavirin, as well as its generic form Copegus, is a strong synthetic remedy that has direct effect on some deadly viruses, including (and primarily) hepatitis C. Due to the severity of the condition and a good ability of the virus to resist anti-virus chemicals, the course of intake of Rivabirin is usually quite long (up to a half a year and longer). In order to maximize the results of intervention and cause maximum damage to the virus cells, it is crucial to follow medical instruction on the intake of the pills. These instructions include the major copegus contraindications.
While Copegus ought to be taken together with food to enhance the action of the remedy, it is absolutely NOT permitted to consume it with alcohol. There are several reasons for this warning. Firstly, hep C primarily damages liver cells, undermining their ability to perform their function. Alcohol is metabolized through liver, and if it is not done properly, it can cause major toxicity and alcohol poisoning – vomiting, fever, muscle ache, headaches and, in some cases, comatose states. Secondly, both alcohol and hep C damage liver tissue to the point of causing cirrhosis. Alcohol consumption during treatment will only halt the beneficial effect of Ribavirin and accelerate the cirrhotic processes in the liver, holding your cure back. All this should be an indicator that ribavirin and alcohol are absolutely not combinable.
Apart from the fact that copegus with alcohol are a detrimental combination, there are other important contraindications on substances that you absolutely should not combine with Ribavirin:
Antacids: the bioavailability of 600 mg of Ribavirin is reduced by simultaneous administration of antacids containing magnesium, aluminum and methicone: the total concentration is reduced by 14%. This interaction has no clinical significance.
Nucleoside analogs: Ribavirin inhibits the phosphorylation of zidovudine and stavudine. The clinical significance of these results is unknown, but it can be assumed that the simultaneous administration of Copegus with zidovudine or stavudine may lead to an increase in the concentration of HIV in the blood plasma. Therefore, it is recommended to monitor the level of HIV RNA in individuals taking Copegus simultaneously with one of the two above drugs. If the level of HIV RNA increases, the joint use of Ribavirin with preparations of nucleoside reverse transcriptase inhibitors should be reviewed.
Didanosine (ddI.): The combined use of didanosine and ribavirin is not recommended. With their joint intake, the concentration of didanosine and its metabolites increases. There have been reported cases of severe hepatic insufficiency, peripheral neuropathy, pancreatitis, symptomatic hyperlactacidemia/laсtoaсidosis with the simultaneous use of these drugs.
Azathioprine: Ribavirin, having an inhibitory effect on inosine monophosphate dehydrogenase, can affect the metabolism of azathioprine, leading to the accumulation of 6-methylthioinosine monophosphate, which in turn causes the development of myelotoxicity.
In individual cases, when the benefits of combined use of ribavirin and azathioprine are greater than potential risk, blood tests should be carefully monitored, and in the presence of the signs of myelotoxicity, the intake should be discontinued.