Drug interactions
Ribavirin + Stavudine
Severity: Major
Ribavirin and Stavudine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Ribavirin may reduce intracellular phosphorylation of stavudine, lowering its antiviral activity. Both drugs can also cause mitochondrial toxicity, with lactic acidosis and pancreatitis reported.
What this interaction means in plain words
Ribavirin and Stavudine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Ribavirin belongs to Anti Virals; Stavudine belongs to Anti Virals.
Why it happens
Competition for phosphorylation reduces stavudine activation, and additive mitochondrial toxicity may occur.
What to do
Avoid the combination and use an alternative NRTI. If unavoidable, monitor HIV viral load and for lactic acidosis and pancreatitis.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Ribavirin
- Didanosine + Ribavirin Contraindicated
- Ribavirin + Zidovudine Major
- Abacavir + Ribavirin Moderate
- Emtricitabine + Ribavirin Minor
- Lamivudine + Ribavirin Minor
- Ribavirin + Tobramycin inhaled Minor
Other interactions of Stavudine
- Didanosine + Stavudine Contraindicated
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Stavudine Contraindicated
- Hydroxycarbamide + Stavudine Contraindicated
- Stavudine + Zidovudine Contraindicated
- Atidarsagene autotemcel + Stavudine Major
- Betibeglogene autotemcel + Stavudine Major
Frequently asked questions
Can I take Ribavirin with Stavudine?
MediHelp rates the interaction as major. Ribavirin and Stavudine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Ribavirin may reduce intracellular phosphorylation of stavudine, lowering its antiviral activity. Both drugs can also cause mitochondrial toxicity, with lactic acidosis and pancreatitis reported.
How serious is the interaction between Ribavirin and Stavudine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and use an alternative NRTI. If unavoidable, monitor HIV viral load and for lactic acidosis and pancreatitis.
What other medicines interact with Ribavirin?
MediHelp also lists interactions of Ribavirin with, for example, Didanosine, Zidovudine, Abacavir. The full list is on the Ribavirin page.
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