Riba cough

[Upbeat]

Two months now with Sovaldi and Riba.   Only problem I am having is a nagging cough that won't go away.  I have read that Riba with interferon causes a cough but I don't about Riba and Sovali.  Anyone else have any experience with the Riba cough?

[cheflady]

Hi yes it is quite usual to get the riba couch, my hubby got it really bad and they even gave him an x-ray but that was clear so dont worry to much about it. Good luck with rest of tx. Jules

[WyoSue]

Thanks for the info, guy! I was wondering if it was actually a side effect of the riba or just my usual seasonal allergies kicking in. I've never had a cough last this long, though.

[hrsepwrguy]

"Previous studies have observed that cough occurs more commonly in patients receiving the combination of interferon and ribavirin compared to interferon alone, thus implicating ribavirin as the causal agent. Our data demonstrate that it does so by reversible enhancement of cough reflex sensitivity. Clinicians should be aware of this potential treatment-related effect, so as to avoid unnecessary and costly diagnostic evaluations seeking an alternative aetiology of cough."

http://hepatitiscnewdrugs.blogspot.com/2010/10/chronic-coughpegylated.html

I also had the dry cough through most of tx, use the search this forum button, type in riba cough and it pulls up over 440 previous threads on the subject

Have a great day

[can-do-man]

Hello Upbeat, as a person that treated twice I agree with the others that have treated about the dreaded "Riba cough" as it is pretty common. Of course for those commenting that has never treated they would not know this... Just hang in there as this will soon be over.

[WyoSue]

Hi Upbeat,
I just finished week 6 of Sovaldi + Ribavirin. I've had a nagging dry cough, sinus congestion, and tickly throat the whole 6 weeks.

[pooh55811]

Just to add to my above post:

I did have a dry cough most of my treatment. It went away at some point after I finished treatment.

If the cough is productive or moist, I would be concerned that it could be from some other etiology than Riba. Also, if there is wheezing or shortness of breath I would be concerned. However, if one is anemic from the Riba, one will be short of breath. If you are concerned, you can always have it checked out with your doctor.

Keep in mind that the side effects won't go away immediately. The meds stay in your system for several weeks/months so one has to wait until the meds gradually disappear from the body before all side effects disappear.

You are two thirds done with treatment so you are on the home stretch now. Best of luck.

[flcyclist]

A few years ago I did Int/Riba and had that nagging cough as well.  It didn't keep me awake at night or get worse when I laid down.  Actually, I sleep fairly well during my 48 week tx.  However, the dry cough was annoying since I had to cough often, usually in mid-sentence when talking, and it was hard to ignore.  I don't think many other people really noticed it much, but it bothered me.  I tried to keep a bottle of water handy at all times and drank frequently to keep the throat moist.  That seemed to help.  I never had bad coughing spells that got out of control.  I researched that coughing as well back then and found the same publications.  The coughing went away just a few weeks after EOT, so you have that to look forward to.  Good luck with tx.  

[JimmyMose]

Do you have a prior history of respiratory symptoms? If so you might have to rule out other causes.

The Cough and HCV Therapy; Is it the interferon or the ribavirin?
http://hepatitiscnewdrugs.blogspot.com/2010/10/chronic-coughpegylated.html

Chronic cough associated with interferon/ribavirin therapy for hepatitis C
Four patients without history of respiratory symptoms developed chronic cough temporally related to initiation of therapy with pegylated interferon and ribavirin for chronic hepatitis C infection. Cough resolved within 2-6 weeks after completion of a 48-week course of therapy. To measure cough reflex sensitivity, capsaicin cough challenge testing was performed 1 month prior to cessation of therapy, and 1 and 2 months after completion of treatment. In all patients, cough reflex sensitivity, as measured by C(5) , the concentration of capsaicin inducing 5 or more coughs, was significantly enhanced during treatment compared to 1 month after completion of therapy (P = 0·016).

WHAT IS NEW AND CONCLUSION:
Previous studies have observed that cough occurs more commonly in patients receiving the combination of interferon and ribavirin compared to interferon alone, thus implicating ribavirin as the causal agent. Our data demonstrate that it does so by reversible enhancement of cough reflex sensitivity. Clinicians should be aware of this potential treatment-related effect, so as to avoid unnecessary and costly diagnostic evaluations seeking an alternative aetiology of cough.


Also for those using PEG. Symptoms dry cough, dyspnea, fever, and fine inspiratory crackles where side effects are not related to ribavirin
Pneumonitis is s RARE dangerous side effect linked to peginterferon in comparison with conventional interferon

One remarkable finding is that mortality occurred exclusively in patients with peginterferon-induced pneumonitis in comparison with conventional interferon
Interstitial pneumonitis occurs only rarely as a side-effect of HCV combination treatment and often leads to discontinuation of therapy, which has great implications for patients.
The most common presenting symptom of pneumonitis is any combination of dry cough, dyspnea, fever, and fine inspiratory crackles noted on examination.

[dontworry_behappy1]

As you can see....it's number 1 on the list pooh provided.  I looked it up to and it says ribavirin causes cough.   I would say that's pretty much the cause.

Best to you

[pooh55811]

Link to above information:

http://www.nlm.nih.gov/medlineplus/druginfo/meds/a605018.html

[pooh55811]

From Medline Plus
A service of the U.S. National Library of Medicine
From the National Institutes of HealthNational Institutes of Health:

Ribavirin

What side effects can this medication cause?

Ribavirin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

    cough

    upset stomach

    vomiting

    diarrhea

    constipation

    heartburn

    loss of appetite

    weight loss

    changes in ability to taste food

    dry mouth

    difficulty concentrating

    difficulty falling asleep or staying asleep

    memory loss

    rash

    dry, irritated, or itchy skin

    sweating

    painful or irregular menstruation (period)

    muscle or bone pain

    hair loss

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, or those listed in the IMPORTANT WARNING section, call your doctor immediately:

    hives

    swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

    hoarseness

    difficulty swallowing or breathing

    pain in the stomach or lower back

    bloody diarrhea

    bright red blood in stools

    black, tarry stools

    stomach bloating

    confusion

    dark-colored urine

    yellowing of the skin or eyes

    unusual bleeding or bruising

    vision changes

    fever, chills, and other signs of infection

    depression

    thinking about hurting or killing yourself

    mood changes

    excessive worry

    irritability

    starting to use street drugs or alcohol again if you used these substances in the past

    intolerance to cold

[Upbeat]

Thanks

I have researched the riba cough info,  however it is always part of the interferon combo,   The new orals and Riba is a new ball game.   Since no one takes Riba alone I wonder if its the combo or Riba itself.  I guess the new all oral combos without Riba and its side effects are what the drug companies are shooting for.

[dontworry_behappy1]

Coughing is not listed as a side effect of Sovaldi.   It is listed as a side effect of RIBA.   There has been lots said about the RIBA cough on this forum.  

In the upper left corner of the forum is a magnifying glass.  Click on that glass and you can search the forum for others with the cough.

Best to you