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Copegus by Aprazer (Ribasure-Ribavirin 200/50 mg)

Drug description:
Ribavirin is an anti-viral medication specifically designed and effective against hepatitis C virus. It is used for different genotypes of the virus and different viral load (the initial amount of virus in the body). The drug must be used in combination with peginterferon alfa-2b or interferon alfa-2b for 16-48 weeks depending on the virus type and initial viral load. Read the full guide to find out about the drug’s adverse effects, precautions, and so on.
Brand name:
Copegus by Aprazer
Generic name:
Ribasure-Ribavirin
Manufacturer:
Indications:
Hepatitis C
Benefits:
The medication helps to suppress hepatitis C virus and cure the disease preventing liver damage
Analogs:
Copegus, Rebetol, Ribasphere, Vilona, Virazole
Copegus by  Aprazer (Ribasure-Ribavirin 200/50 mg)
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Order Copegus by Aprazer (Ribasure-Ribavirin 200/50 mg)

Dosage:200/50 mg
Quantity (max. 2) Package Price, USD You save
1 1 bottles $79.90 $86.80 $6.90
1 2 bottles(popular) $155.90 $165.80 $9.90
1 3 bottles $219.90 $240.80 $20.90
1 4 bottles $299.90 $329.80 $29.90
1 5 bottles $353.80 $399.80 $46.00
Price: $168.90

This medication has no bonus!

More facts about Generic Copegus by Aprazer (Ribasure-Ribavirin 200/50 mg):

Generic Copegus by Aprazer (Ribasure-Ribavirin 200/50 mg) guide:

What is Ribavirin and when is it used?

Ribavirin is an unpatented name of the active substance developed to treat hepatitis C, a viral infection that destroys liver. Ribavirin is an antiviral medication that suppresses virus replication and damage to the liver.

The substance is also used to treat human respiratory syncytial virus but different formulations with lower dosage per pill should be used.

Short drug info

Trade names
Copegus, Rebetol, Virazole, other
Pregnancy category

AU: X (High risk)

US: X (Contraindicated)
Routes of administration
by mouth, solution for inhalation
Legal status

AU: S4 (Prescription only)

CA: Rx-only

UK: POM (Prescription only)

US: Rx-only
Bioavailability
64%
Protein binding
0%
Metabolism
liver and intracellularly
Elimination half-life
298 hours (multiple dose); 43.6 hours (single dose)
Excretion
Urine (61%), faeces (12%)

The substance is available under different commercial names depending on the manufacturer. It can be found under the names Copegus, Rebetol, Ribasphere, Vilona, Virazole, and others. The price for the branded medication pill is around $22 which makes $3,700 for the complete course of 168 tablets. Alternatively, you can buy generic Ribavirin and get a pill for around $1.66 which makes $279 for the whole course of treatment. Generic drugs based on Ribavirin are identical to the branded ones but cost less money because their manufacturers didn’t invent the formula but use existing formula. The spread and use of generic is promoted to allow people with lower incomes enjoy the advances of modern medicine.

The primary indication when you should buy Ribavirin in the dosage available at this webpage is chronic hepatitis C.

Ribavirin is a synthetic analog of naturally produced in the body substances called nucleosides that are effective against certain viruses DNA and RNA responsible for their survivability and replication. The mechanism of the medication’s effect on the hepatitis C is unknown. Besides, when the formulation is used alone, this doesn’t ensure the elimination of the virus. You should keep in mind that a specialist must appoint the therapy with the use of peginterferon alfa-2b or interferon alfa-2b. These drugs alone can treat the viral infection but only the combination with Ribavirin ensures maximal responsiveness to the therapy.

However, not everyone can use Ribavirin. Verify with your healthcare provider whether you can or cannot use the drug based on the contraindications for its use.

Who must not use Ribavirin?

You should not buy generic Copegus and use it in:

- Increased sensitivity or intolerance of the main substance or additional components of the tablets.

- Severe heart diseases including unstable and uncontrolled forms.

- Weakening due to a serious disease.

- Chronic kidney failure with creatinine clearance below 50 ml per minute or other conditions that require hemodialysis.

- Severe liver function impairment (grade B or C according to the Child-Pugh classification) or decompensated liver cirrhosis.

- When the use of peginterferon alfa-2b or interferon alfa-2b is contraindicated due to HIV and hepatitis C with liver function impairment ≥ 6 points according to the Child-Pugh classification.

- Confirmed severe mental disorder including sever major depressive disorder, suicidal tendencies or attempts.

- Inability to use peginterferon alfa-2b or interferon alfa-2b in autoimmune hepatitis or history of other autoimmune diseases.

- Hereditary and congenital change or violation of the structure of the hemoglobin protein (e.g. thalasemia, sickle cell anemia).

- Pregnancy and lactation. The treatment in fertile women is started only after a negative pregnancy test made right before the therapy start.

- Men who was a pregnant partner.

The use of Ribavirin is possible at a doctor’s discretion in:

- Severe lung diseases, for instance, COPD.

- Diabetes with ketoacidosis.

- Blood coagulation disorders.

- Depressed blood formation function of the bone marrow.

How is Ribavirin taken?

Therapy should be carried out by a doctor with experience in the treatment of chronic hepatitis C. Ribavirin should be taken twice times a day (in the morning and in the afternoon) while eating. Due to the teratogenic potential (ability to influence fetus development), capsules should not be broken not to expose pregnant women to the drug’s negative effect.

The medication should be always used with peginterferon alfa-2b or interferon alfa-2b. Their precise dosages and duration of use depends on the chosen drug and can be found in the user guides for them.

Therapy with the use of peginterferon alfa-2b

The recommended dosages of peginterferon alfa-2b solution for injections depend on the patient’s body weight and virus genotype. The duration of therapy with Ribavirin and peginterferon alfa-2b depends on the virus genotype. In patients with genotype 1 in who after four weeks of the treatment RNA of the virus is found should continue the therapy for 48 weeks.

The duration of the treatment can be reviewed in patients:

- With virus genotype 1 and initial low viral load (≤ 800,000 IU/ml);

- With virus genotype 4 in whom on the fourth week of treatment the test for detection of viral RNA is negative and remains negative on the 24th week.

In general, the treatment course for 24 weeks can be associated with a higher risk of relapse compared to the course of 48 weeks.

When deciding on the shortening of the treatment course, doctors should consider tolerance of the medication and additional factors that can help make prognosis, in particular, the degree of fibrosis.

Careful consideration is needed when considering shortening of the treatment course in patients with genotype 1 and initial high viral load (> 800, 000 IU/ml) and in 4 weeks the test for viral RNA is negative and remains negative on the 24th week. There are some clinical data that suggest that the shortening of the therapy can negatively affect the resistance of the virologic response.

In patients with hepatitis C with genotype 2 and 3 in whom after 4 weeks of treatment is found viral RNA, regardless of the initial viral load should receive the therapy for 24 weeks.

The treatment can be shortened to 16 weeks in certain groups of patients with genotype 2 and 3 with low viral load (≤ 800,000 IU/ml) in whom after 4 weeks of therapy the test for viral RNA is negative and remains negative after 16 weeks. However, there is a risk of relapses and inferior response to the therapy in the 16-week course.

When deciding on the shortening of the treatment course, doctors should consider tolerance of the medication and additional factors that can help make prognosis, in particular, the degree of fibrosis.

Careful consideration is needed when considering shortening of the treatment course in patients with genotype 1 and initial high viral load (> 800, 000 IU/ml) and in 4 weeks the test for viral RNA is negative and remains negative on the 24th week. There are some clinical data that suggest that the shortening of the therapy can negatively affect the resistance of the virologic response.

There are few clinical data on the treatment of genotypes 5 and 6. The recommended course is 48 weeks.

Dosage regimen for Ribavirin plus peginterferon alfa-2b

Genotype
Daily dosage of Ribavirin/number of capsules
Treatment course duration
1 with low viral load and no virus RNA found in 4 and 24 weeks of treatment
Body weight < 75 kg = 1000 mg (5 capsules a day, 2 in the morning; 3 in the evening) Body weight ≥75 kg = 1200 mg (6 capsules a day, 3 in the morning; 3 in the evening)
24 or 48 weeks
1 with high viral load and no virus RNA found in 4 and 24 weeks of treatment
Body weight < 75 kg = 1000 mg (5 capsules a day, 2 in the morning; 3 in the evening) Body weight ≥75 kg = 1200 mg (6 capsules a day, 3 in the morning; 3 in the evening)
48 weeks
1 or 4 without with positive viral RNA test in 4 and 24 weeks
Body weight < 75 kg = 1000 mg (5 capsules a day, 2 in the morning; 3 in the evening) Body weight ≥75 kg = 1200 mg (6 capsules a day, 3 in the morning; 3 in the evening)
48 weeks
2 or 3 with low viral load and no virus RNA found in 4 weeks of treatment
800 mg (4 capsules, 2 in the morning, 2 in the evening)
16 or 24 weeks
2 or 3 with high viral load and no virus RNA found in 4 weeks of treatment
800 mg (4 capsules, 2 in the morning, 2 in the evening)
24 weeks
2 or 3 with positive viral RNA test in 4 and 24 weeks
800 mg (4 capsules, 2 in the morning, 2 in the evening)
24 weeks

Dosage regimen for Ribavirin plus interferon alfa-2b

Body weight
Daily dosage
Treatment course duration
<75 kg
1000 mg (5 capsules a day, 2 in the morning, 3 in the evening)
24 or 48 weeks
>75 kg
1200 mg (6 capsules a day, 3 in the morning, 3 in the evening)
24 or 48 weeks

Treatment of hepatitis C of patients who had already received treatment

The recommended dosage of the drug used along with peginterferon alfa-2b is once a week in the dosage of 1000 mg for the body weight below 75 kg and 1200 in the body weight above 75 kg without regard to genotype.

If the virus is found in the blood after 12 weeks of treatment, the course is discontinued. The recommended total duration of the course is 48 weeks. For patients with genotype 1 who didn’t respond to the previous treatment with peginterferon alfa-2b and Ribavirin, the recommended treatment duration is 72 weeks.

If during the therapy severe adverse effects develop or laboratory indicators significantly deviate, the dosage should be adjusted by the doctor.

What adverse effects can Ribavirin cause?

When you buy Copegus or a generic version of the medication, you should know that it can cause adverse reactions:

- The medication’s use during the first week can cause hemolytic anemia. In severe form, it can cause worsening of the heart function and/or aggravation of the existing heart problems.

- In some patients develop the level of blood urea and indirect bilirubin.

Other possible adverse reactions are:

- Nervous system: headache, dizziness, general weakness, insomnia, asthenia, depression, irritability, anxiety, aggressive behavior, and others.

- Cardiovascular system and blood formation: drop or elevation of arterial tension, irregular heartbeat, slow or rapid heartbeat, and others.

- Respiratory system: wheezing, shortness of breath, pharyngitis, bronchitis, otitis media, rhinitis, and others.

- Digestive system: dry mouth, low appetite, nausea, vomiting, diarrhea, pain in the abdomen, bloating, and others.

- Metabolism: changes in the level of thyroid hormones.

- Muscles, joints, bones: muscle pain, joint pain.

- Genitourinary system: flushes, low sex drive, dysmenorrhea, prostatitis.

- Allergic reactions: skin rash, urticaria, swelling, anaphylaxis, and others.

- Other: sensitivity to light, hair loss, dry skin, thirst, fungal or viral infections, flu-like syndrome, sweating, etc.

Can Ribavirin be taken with other drugs?

Before you order Ribavirin and take it with other medications, please read the complete list of interactions with other medicines in the user’s guide. Here you can find the most notable interactions. - Antacids (heartburn medications) lower the amount of active Ribavirin in the blood but they can be taken while undergoing the therapy, preferably, at least one hour before Ribavirin.

- Ribavirin can lower the concentration of anti HIV medications so their level in the blood should be monitored.

- Ribavirin enhances the toxicity of Didanosine and Azathioprine so their combined use is contraindicated. The possibility of a drug or other type of interaction with Ribavirin may persist for up to 2 months after discontinuation of use due to its delayed excretion.

Special recommendations

- The medication must not be used alone but only in combination with peginterferon alfa-2b or interferon alfa-2b.

- Before the therapy initiation, a patient must undergo all general medical tests.

- Women of fertile age must do pregnancy test right before the start of the therapy as Ribavirin has a potent fetus damaging effect and in case of use in pregnancy severe mutations of the baby are possible.

- In the occurrence of immediate allergic reaction (anaphylaxis, swelling) the therapy must be immediately discontinued and respective treatment made.

- In decompensation of liver cirrhosis or other liver dysfunctions, the therapy must be discontinued.

- Ribavirin washing out of the body is substantially reduced in kidney failure so creatinine clearance must be controlled and if it is less than 50 ml per minute, dosages must be lowered.

- During the therapy of hepatitis C in patients with HIV the risk of severe adverse reactions and even death are increased so the patients must be closely monitored.

Where can you buy Ribavirin?

The best way to get the qualitative medication cheap is to order generic Ribavirin online from our drugstore. We sell the medication without Rx and ship it worldwide.

Free prescription

Our doctor prescribes Ribasure-Ribavirin online for free, and there is no doctor’s consultation fee.

Discrete packaging

All orders of Ribasure-Ribavirin arrive in discrete unmarked parcels. We leave the shipment description blank.

For more answers see the FAQ section

Copegus by Aprazer (Ribasure-Ribavirin) Reviews:

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