Imuran and Ribasphere Ribapak

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Talk to your doctor before using ribavirin together with azaTHIOprine. Combining these medications can increase the risk of side effects that affect your bone marrow function, resulting in low numbers of different types of blood cells. This can make you more likely to develop anemia, bleeding problems, or infections. Contact your doctor if you experience potential signs and symptoms of these conditions such as paleness of skin, fatigue, dizziness, fainting, unusual bleeding or bruising, fever, chills, sore throat, body aches, or other flu-like symptoms. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

GENERALLY AVOID: Published case reports suggest that ribavirin may potentiate the myelotoxic effects of 6-mercaptopurine and its prodrug, azathioprine. The proposed mechanism is inhibition of inosine monophosphate dehydrogenase by ribavirin, which interferes with one of the metabolic pathways of 6-mercaptopurine and leads to accumulation of the myelotoxic metabolite 6-methylthioinosine monophosphate (6-MTIMP). Pancytopenia and bone marrow suppression have been reported in the literature to occur within 3 to 7 weeks after the concomitant administration of pegylated interferon/ribavirin and azathioprine. Myelotoxicity was reversible within 4 to 6 weeks upon withdrawal of both the hepatitis C antiviral and azathioprine treatments, and did not recur upon reintroduction of either treatment alone. Theoretically, inhibition of inosine monophosphate dehydrogenase may also reduce the pharmacologic effects of 6-mercaptopurine and azathioprine by inhibiting conversion to the active metabolite; however, this was not observed in the case reports.

MANAGEMENT: The use of ribavirin in combination with 6-mercaptopurine or azathioprine should generally be avoided if possible. Patients receiving the combination should have complete blood counts, including platelet counts, monitored weekly for the first month, twice monthly for the second and third months, then monthly or more frequently if dosage or other therapy changes are necessary. Treatment with these medications should be discontinued promptly if pancytopenia develops, and the combination should not be reintroduced following recovery.

Imuran

Generic Name: azathioprine

Brand name: Azasan, Imuran

Synonyms: n.a.

What is Imuran?

Ribasphere Ribapak

Generic Name: ribavirin

Brand name: Rebetol, RibaPak, Ribasphere, RibaTab, Virazole, Copegus, RibaPak 600, Moderiba, Moderiba 800 Dose Pack, Moderiba 1200 Dose Pack, Moderiba 1000 Dose Pack, Moderiba 600 Dose Pack

Synonyms: Ribavirin, Ribavirin (Oral Inhalation)

What is Ribasphere Ribapak?