section name header

Pronunciation

rye-ba-VYE-rin

Classifications

Therapeutic Classification: antivirals

Pharmacologic Classification: nucleoside analogues

Indications

REMS

Action

Therapeutic Effects:

Pharmacokinetics

Absorption: Systemic absorption occurs following nasal and oral inhalation. Rapidly and extensively absorbed following oral administration, but undergoes first-pass hepatic metabolism (64% bioavailability).

Distribution: 70% of inhaled drug is deposited in the respiratory tract. Appears to concentrate in the respiratory tract and red blood cells. Enters breast milk.

Metabolism/Excretion: Eliminated from the respiratory tract by distribution across membranes, macrophages, and ciliary motion. Metabolized primarily by the liver; metabolites are renally excreted.

Half-life: Inhaln — 9.5 hr (40 days in RBCs); oral — 43.6 hr (single dose); 12 days (multiple dose).

Time/Action Profile

(blood levels)

ROUTEONSETPEAKDURATION
Inhalnunknownend of inhalnunknown
POunknown1.7–3 hr12 hr

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

Inhalation

CV: CARDIAC ARREST, hypotension.

Derm: rash.

EENT: blurred vision, conjunctivitis, erythema of the eyelids, ocular irritation, photosensitivity.

Hemat: hemolytic anemia, reticulocytosis.

Oral

CNS: HOMICIDAL IDEATION, SUICIDAL IDEATION/ATTEMPTS, depression, aggressive behavior, emotional lability ( in children), fatigue ( in children), impaired concentration ( in children), insomnia ( in children), irritability ( in children).

Derm: pruritus ( in children).

EENT: dry mouth, optic neuritis, papilledema, retinal artery/vein thrombosis, retinal detachment, retinal hemorrhage, retinopathy (with macular edema), visual abnormalities.

GI: anorexia ( in children), dyspepsia ( in children), vomiting ( in children).

GU: fertility (males).

Hemat: hemolytic anemia.

MS: arthralgia ( in children).

Neuro: dizziness, faintness.

Resp: dyspnea ( in children).
Misc: fever ( in children).

Interactions

Drug-Drug:

Route/Dosage

RSV Infection

Chronic Hepatitis C

Viral Genotype 1 or 4

Renal Impairment

Renal Impairment

Availability

(Generic available)

Assessment

Lab Test Considerations:

Implementation

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Copegus, Rebetol, Virazole

Canadian Brand Names

Ibavyr

Pot. Nursing Diagnoses