Drug interactions
Ribavirin + Zidovudine
Severity: Major
Ribavirin and Zidovudine: 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 the intracellular phosphorylation of zidovudine to its active form, potentially lowering antiretroviral activity. Both drugs also cause hematologic toxicity, so anemia and neutropenia may be worsened.
What this interaction means in plain words
Ribavirin and Zidovudine 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; Zidovudine belongs to Anti Virals.
Why it happens
Competition for intracellular phosphorylation reduces zidovudine activation, with additive bone marrow suppression.
What to do
Avoid zidovudine in patients receiving ribavirin and use another nucleoside backbone; if unavoidable, monitor HIV viral load and complete blood counts closely.
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 + Stavudine Major
- Abacavir + Ribavirin Moderate
- Emtricitabine + Ribavirin Minor
- Lamivudine + Ribavirin Minor
- Ribavirin + Tobramycin inhaled Minor
Other interactions of Zidovudine
- Elvitegravir / cobicistat / emtricitabine / tenofovir df + Zidovudine Contraindicated
- Stavudine + Zidovudine Contraindicated
- Atidarsagene autotemcel + Zidovudine Major
- Betibeglogene autotemcel + Zidovudine Major
- Carboplatin + Zidovudine Major
- Cisplatin + Zidovudine Major
Frequently asked questions
Can I take Ribavirin with Zidovudine?
MediHelp rates the interaction as major. Ribavirin and Zidovudine 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 the intracellular phosphorylation of zidovudine to its active form, potentially lowering antiretroviral activity. Both drugs also cause hematologic toxicity, so anemia and neutropenia may be worsened.
How serious is the interaction between Ribavirin and Zidovudine?
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 zidovudine in patients receiving ribavirin and use another nucleoside backbone; if unavoidable, monitor HIV viral load and complete blood counts closely.
What other medicines interact with Ribavirin?
MediHelp also lists interactions of Ribavirin with, for example, Didanosine, Stavudine, Abacavir. The full list is on the Ribavirin page.
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