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3093770 tn?1389742726

When to take Ribavirin?

So I just came fro my pre tx appointment
I have been told that I can take the Riba at same time with morning and evening Telaprevir. That is 6am and 10pm

Does that sound right?

At the same time I have been told that some people had tx side effects but not many (Really?) and I did not get any preventive anti nausea or itch cream. Hmmmm! We are only a phone call away and if gets really bad there is always emergency services. Hmmmm As if I will start to explain my whole history to someone at emergency who will have no clue on the specificity of this tx

And for the headaches I have been told that Paracetamol is the best
13 Responses
Avatar universal
Good idea to take your first dose of ribavirin with Telaprevir.  The extra fat grams will help with absorbency.  Taking the second dose at 10 pm may cause you to experience insomnia as that is a known side effect from ribavirin.  It is not necessary to take ribavirin at the same time or at a specific time as it is with Incivek due to ribavirin's long half life.  The rule of thumb for dosing ribavirin is usually 12 hrs apart but taking it with your evening meal is fine plus the fat grams will help with absorbency.  If you choose to take it at 10 pm and it does not interfere with your sleep than stick with it because that's what works for you.  
3159077 tn?1356034731
I take my Incivek and Ribavirin at 7:00 a.m.; 2nd dose of Incivek at 3:00 p.m.; 2nd dose of Ribavirin at 7:00 p.m.; and last dose of Incivek at 11:00 p.m. I eat the 20 grams of fat 30 minutes before the three Incivek doses and a small snack before the 7:00 p.m. Ribavirin. I read that it's important to keep a steady supply of Incivek in my system so I try to take the doses right on time. I'm following the recommended dosing schedule of every eight and 12 hours for both meds.

I hear you about the "We'll deal with it when it comes up" attitude. I would have felt more comfortable getting the itch/rash cream prescribed ahead of time just in case. I had to ask for it and drag myself down to the hospital to  pick it up.

I am on week four and my side effects have been manageable so far. I've had nausea, fatigue, and the rash is just starting. Food tastes bad and I generally don't feel like doing anything because it seems like too much effort is required.
3093770 tn?1389742726
I have a terrible sleep for years now so that would not be a problem :)

I was just concerned that it will not be at exact 12 hours. So 16 hours and then 8 hours between the doses
1747881 tn?1546179478
As you can see the half life for riba is very long, for me personally, I couln't take the riba and telaprevir at the same time due to severe nausea so for the first 12 wks I took tela at 5:30 am then every 8 hrs, I took riba at 7:00 and 7:00 to keep them seperated, after I finished tela I took the riba at 7:00 am then again when I ate diner, I was in a ribavirin study and the study docs were ok with that schedule

Multiple dose Ribavirin pharmacokinetic data are available for HCV patients who received Ribavirin in combination with peginterferon alfa-2a. Following administration of 1200 mg/day with food for 12 weeks mean ± SD (n = 39; body weight > 75 kg) AUC0-12hr was 25,361 ± 7110 ng•hr/mL and Cmax was 2748 ± 818 ng/mL. The average time to reach Cmax was 2 hours. Trough Ribavirin plasma concentrations following 12 weeks of dosing with food were 1662 ± 545 ng/mL in HCV infected patients who received 800 mg/day (n = 89), and 2112 ± 810 ng/mL in patients who received 1200 mg/day (n = 75; body weight > 75 kg).

The terminal half-life of Ribavirin following administration of a single oral dose of Ribavirin is about 120 to 170 hours. The total apparent clearance following administration of a single oral dose of Ribavirin is about 26 L/h. There is extensive accumulation of Ribavirin after multiple dosing (twice daily) such that the Cmax at steady state was four-fold higher than that of a single dose.


179856 tn?1333550962
Once you build up to your serum level it wont matter if you take it day or night it will always been about the same level inside of you.....I took mine earlier just because it made me feel better psycholocially somehow.

OrphanHawks doctor told her it doens't even matter anymore if you take it all in the morning, as long as you take it. No more 12 hour caveat to it.
Avatar universal
I agree it doesn't matter as long as you take your total dose for the day. I was in the last boceprevir trial and the dosing just said twice daily, my doctor was fine with me taking it 6 to 8 hours apart... Good luck
163305 tn?1333672171
I didn't do the triple tx. Since the riba kept me awake, I was told I could take it with breakfast and lunch. It's important to take it with a substantial meal or it can cause nausea.

As hspwr pointed out, it has a long half life. Some doctors go on the old protocol of telling you to take it 12 hours apart but that simply isn't necessary.
What is important is to make it a routine and do what you must do to remember. Set alarms, write it down on your calendar, make it a habit.

Good luck
1853014 tn?1340042175
thanks this is very helpful..  I will start taking my riba earlier to see if it helps me also with sleep..
206807 tn?1331939784

Once you build up to your serum level it wont matter if you take it day or night it will always been about the same level inside of you.....I took mine earlier just because it made me feel better psycholocially somehow.”

I was finally going to make a post but you beat me to it, Thanks a lot LOL
163305 tn?1333672171
Yes. I couldn't sleep until I changed the timing of my second dose of riba.
Hope that helps.
3093770 tn?1389742726
I think I mastered the perfect method to sleep fast as my sleep is crap right now

I have couple of books which are quite challenging. I kid you not, is taking me around a page and a half to fall asleep :)

So the positive if the Riba will create any problem is that I will manage to finish the book, lol
206807 tn?1331939784
Seeing how I would forget and read the same sentence over and over, I comic book would have probably lasted me all the way through tx.
Avatar universal
  I was always able to go to sleep, right after I popped the Riba, my insomnia tends to be more like, waking up at 4 am, 5 am, 6 am, etc.
  The meds made my mouth dry, so I would have to drink water thru-out the night, so it had to do with that, I think.
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