The maximum concentration anavar steroidin plasma: about 5 micromoles per liter at the end of 1 week of receiving 200 mg every 8 hours and about 11 micromoles per liter at the end of 1 week of receiving 400 mg every 8 hours.
Biotransformation: ribavirin phosphorylated in liver cells in active metabolites as mono-, di -, and triphosphate, which is then metabolized into 1,2,4 – triazolkarboksamid (amide hydrolysis trikarboksilovuyu deribozilirovanie and acid to form a triazole carboxylic metabolite).
Excretion: ribavirin is excreted from the body slowly. Half after receiving a single 200 mg dose of from 1 to 2 hours due to the plasma and erythrocytes of 40 days. Upon termination of a course of reception T (1/2 is about 300 hours of ribavirin and its metabolites are primarily excreted in the urine only about 10% is excreted in the feces in unchanged form for about 7% of ribavirin is displayed for 24 hours and about 10%… – 48 hours.
In special clinical conditions: while taking the drug in patients with renal insufficiency AUC and Cmax increased ribavirin, due to a decrease in the true clearance. Patients with liver failure anavar steroid pharmacokinetics ribavirin does not change. After receiving a single dose with food containing fat varies significantly ribavirin pharmacokinetics (AUC and Cmax increased by 70%).
Chronic hepatitis C (primary patients not previously treated with interferon alpha, with aggravation after a course of monotherapy with interferon alpha, in patients refractory to monotherapy with interferon alpha), treatment is carried out in combination with interferon alpha.
Hypersensitivity, pregnancy, lactation, chronic heart failure IIb-III century, myocardial infarction, renal insufficiency (creatinine clearance – less than 50 ml / min), severe anemia, liver failure, decompensated cirrhosis, autoimmune diseases (including autoimmune hepatitis), not treatable thyroid disease, severe depression with suicidal intentions, children and Youth age (up to 18 years).
Women of childbearing age (pregnancy is not desirable), decompensated diabetes (with bouts of ketoacidosis); chronic obstructive pulmonary disease, pulmonary embolism, chronic heart failure, thyroid disease (including hyperthyroidism), bleeding disorders, thrombophlebitis, mielodeprescia, hemoglobinopathies (including thalassemia, sickle-cell anemia), depression, anavar steroid suicidal (including history).
Dosing and Administration
The drug is taken by mouth without chewing and drinking water, along with the food intake.
Duration ribavirin combination therapy with alpha – interferon is typically 24 – 48 weeks. In addition, for treatment-naïve patients with duration of the course is at least 24 weeks and patients with genotype 1, the course duration is 48 weeks. In patients refractory to monotherapy with alpha – interferon, and for relapsed disease course duration is at least 6 months.
From the nervous system: headache, insomnia, asthenic syndrome, depression.
Cardio-vascular system: decrease in blood pressure, bradycardia, cardiac arrest.
From the side of hematopoiesis: hemolytic anemia, leukopenia, neutropenia, granulocytopenia, thrombocytopenia.
From the digestive system: loss of appetite, nausea, hyperbilirubinemia.
Allergic reactions: urticaria, angioedema, bronchoconstriction, anaphylaxis skin rash.
Other: hair loss.
Perhaps the increased severity of side effects.
Treatment: removal of the drug, symptomatic therapy.
Interaction with other drugs
When combined ribavirin and alpha – interferon indicated synergy of their action.
In clinical use of different drugs at therapeutic doses in combination with ribavirin showed no significant interactions.
Purpose ribavirin anavar steroid zidovudine treatment during and / or simultaneously with stavudine existing HIV infection accompanied by a decrease in phosphorylation of these drugs, resulting in HIV viremia and treatment regimen requires a change. Ribavirin interaction is detected and a non-nucleoside reverse transcriptase inhibitors or protease inhibitors. It is therefore possible joint use of these drugs and ribavirin for the treatment of patients co-infected with HIV and hepatitis C.
Medicaments containing compounds of magnesium and aluminum, simethicone reduces the bioavailability of the drug.
Keep in mind teratogenicity of the drug, the men and women of reproductive age during treatment and for 7 months after the end of treatment should use effective contraception.
Laboratory tests (complete blood count with leukocyte and platelet count, determination of electrolytes, creatinine, liver function tests) should be carried out before the start of therapy, at 2 and 4 weeks, and then on a regular basis.
During treatment with ribavirin maximum decrease in hemoglobin in the majority of cases it occurs after 4-8 weeks of starting treatment. By reducing the hemoglobin is less than 110 mg / mL should be temporarily reduce the dose of ribavirin at 400 mg per day, with a decrease in hemoglobin of less than 100 mg / ml dose should be reduced to 50% of the original. In most cases, the recommended dose modifications provide restoration of hemoglobin levels. By reducing the hemoglobin is less than 85 mg / ml should stop taking the drug.
In acute manifestations of hypersensitivity (urticaria, angioedema, bronchoconstriction, anaphylaxis) use of the drug should be discontinued immediately. Transient rashes do not serve as grounds for interruption of treatment.
During treatment, those experiencing fatigue, drowsiness or disorientation, should refrain from driving motor vehicles and activities potentially hazardous activities that require high concentration and psychomotor speed reactions.
In connection with a possible anavar steroid worsening of renal function in elderly patients prior to use of the drug is necessary to determine kidney function, in particular creatinine clearance. oxydrolone