Drug General Information (ID: DDI701LKWT)
  Drug Name Ribavirin Drug Info Zalcitabine Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antiviral Agents Anti-Hiv Agents
  Structure

 Mechanism of Ribavirin-Zalcitabine Interaction (Severity Level: Moderate)
     Increased risk of metabolic acidosis Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Ribavirin Zalcitabine
      Mechanism Metabolic acidosis Metabolic acidosis
      Key Mechanism Factor 1
Factor Name Metabolic acidosis
Factor Description Metabolic acidosis is a clinical disorder defined as a pH below 7.35 and low HCO3 levels. Metabolic acidosis occurs when the body produces too much acid or the kidneys are unable to remove enough acid from the body. Symptoms vary depending on the underlying cause, but some common symptoms are as follows: shortness of breath, confusion, fatigue, shock, fruity taste of the patient's breath (diabetic ketoacidosis), rapid heartbeat, headache, weakness, and nausea.
      Mechanism Description
  • Increased risk of metabolic acidosis by the combination of Ribavirin and Zalcitabine 

Recommended Action
      Management Coadministration of ribavirin and NRTIs should be undertaken with caution and only if the benefit is anticipated to outweigh the potential risks. Patients should be advised to promptly seek medical attention if they experience symptoms of toxicity such as nausea, vomiting, abdominal pain/distention, fatigue, unexplained weight loss, tachypnea, dyspnea, motor weakness, numbness, tingling, and pain in hands and feet.

References
1 Guyader D, Poinsignon Y, Cano Y, Saout L "Fatal lactic acidosis in a HIV-positive patient treated with interferon and ribavirin for chronic hepatitis C." J Hepatol 37 (2002): 289-91. [PMID: 12127440]
2 Product Information. Copegus (ribavirin). Roche Laboratories, Nutley, NJ.
3 Product Information. Rebetron (interferon-alfa-2b-ribavirin). Schering Laboratories, Kenilworth, NJ.