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1116669 tn?1269146866

Has anyone tried to or had to split ribavarin tabs when their dose was reduced?

The form is the Ribasphere RiboPak 600 mg tabs which are not split and have a film coating: My dilemma: Triple (Incivek) tx times 7 weeks today with a a worsening hgb each week (from pre-tx 13 to 9.5 this week) The trajectory of progressive dropping forecasts a definite continuing lowering. 2 alterations have been made: My Ribo has been reduced from 600 twice a day+ 1200 mg to 400 twice a day+800 and Procrit ordered. However! Since I just received a monthly supply of  600 mg Ribo tablets 2 days ago the pharmacy is having a hard time with my insurance company approving the new 400 mg prescription plus I am being asked by the pharmacy (a large NYC pharmacy) to wait until monday (for both availability and insurance approval) reasons. As I cannot become more anemic because of my unambiguous need to work m-f and the weekend making it difficult regarding a dialogue with my hematologist: Has anyone carefully (I'm in healthcare so not entirely naive) split their existing coated non-scored tabs when their Ribo was reduced secondary to anemia?
15 Responses
1116669 tn?1269146866
I meant to report my Ribo was reduced from 2 600 mg tabs each day for a total of 1200 mg to 2 400 mg tabs each day for a total of 800 mg each day. p.s. I was undetectable at 4 weeks
1815939 tn?1377995399
I would NOT split the tabs. They are coated for a reason. I am sure in this case it is so they absorb at the appropriate time, for the appropriate amount of time, in the appropriate part of the GI tract.

Here is a link:


"How should this medicine be used?"
"Ribavirin comes as a tablet, a capsule and an oral solution (liquid) to take by mouth. It is usually taken with food twice a day, in the morning and the evening, for 24 to 48 weeks or longer. Take ribavirin at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ribavirin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor."

"Swallow the capsules whole; do not split, chew, or crush them."

1815939 tn?1377995399
The hematologist should either be on call or have some other doctor covering for him/her. I would try to give him/her a call and state it is urgent that you speak with the doctor or whomever is on call for the doctor.
Avatar universal
A toll-free telephone number to talk to nurses—24 hours a day, 7 days a week—who will provide guidance throughout your treatment with PEGASYS alone or in combination with COPEGUS. Call 1-877-PEGASYS (1-877-734-2797; Prompt #2)
Avatar universal
I don't think they should be split without a doctor's or the pharmacy's direction, but for future reference for other medications, they have pill splitters that work perfectly.  You can find one at any supermarket or pharmacy.  
1768199 tn?1323621536
I have a phone number from the pharmacy that provides my meds where I can reach a pharmacist.  Does your pharmacy have a customer service rep or pharmacist you could call.  When I signed up for treatment, this pharmacy offered to have a nurse call and check on me once a month.  I declined but it was nice to be offered this.

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