Copegus
Copegus (Ribavirin)Pharmacological action
Antiviral preparation. Synthetic analogue of nucleosides. It is active in vitro concerning some RNK - and DNA-containing of viruses.
Data of clinical researches have shown, that Ribavirin application as monotherapy at a hepatitis C, including at its chronic form, noneffectively.
However the combined Ribavirin therapy and interferon an alpha-2b at sick of a hepatitis C, having relapse of disease against monotherapy by interferon an alpha-2b, has appeared in 10 times of more effective, than monotherapy by interferon an alpha-2b, and approximately in 3 times of more effective at the patients who earlier were not treated by interferon an alpha-2b.
The mechanism of antiviral Ribavirin action in a combination with interferon an alpha-2b, in particular concerning a virus of a hepatitis C, is unknown.
Indications
As a part of the combined therapy with interferon an alpha-2b:
- Relapse of a chronihepatitis C With at patients is more senior 18 years, before receiving treatment by interferon an alpha with long effect.
- A chronic hepatitis C, earlier not treated, without signs of a decompensation of function of a liver, in the presence of a fibrosis or the expressed inflammatory activity.
Dosage regimen
Preparation accept inside in a dose 1-1 g/24h, parted on 2 receptions (in the morning and in the evening). The dose depends on mass of a body of the patient. At mass of a body of 75 kg and more low a preparation prescribe in a daily dose 1 g in 2 receptions: 2 caps. On 200 mg in the morning and 3 caps. On 200 mg in the evening; at mass of a body above 75 kg the daily dose makes 1.2 g in 2 receptions: 3 caps. On 200 mg in the morning and 3 caps. On 200 mg in the evening.
Duration of treatment depends on a clinical current of disease.
Recommended duration of course of treatment for patients with relapse of disease after previous treatment - 6 months, and for uncured patients - a minimum of 24 weeks. In the latter case treatment should be prolonged for 24 weeks (in total till 48 weeks) to patients with a virus of a genotype 1 at which before the treatment beginning high concentration of the RNK-VIRUS of a hepatitis C in blood was defined, and to the extremity of the first 24 weeks of treatment the RNK-VIRUS of a hepatitis With has ceased to be taped.
Side effect
From hemopoiesis system: reduction of a haemoglobin content owing to a hemolysis; leukopenias, granulocytopenias, thrombocytopenias is possible.
From endocrine system: disturbance of function of a thyroid gland is possible.
Allergic reactions: a dermal eruption, an urticaria, a Quincke's disease, a bronchospasm, an anaphylaxis.
The other: the arterial hypotension, change of laboratory indicators are possible.
Contraindications
- Serious diseases of heart (including forms astable and steady against therapy) during the period to 6 months prior to the beginning of therapy Vero-ribavirinom;
- The diseases of a thyroid gland steady against therapy;
- Hemoglobinopathies (including a thalassemia, a sickemia);
- Chronic renal insufficiency;
- Serious depression, suicidal thoughts or suicide attempts (including in the anamnesis);
- The expressed disturbance of function of a liver;
- Autoimmune diseases (including an autoimmune hepatitis);
- Pregnancy;
- The lactemia period;
- A hypersensibility to Ribavirin and to other components of a preparation.
Pregnancy and lactemia
Application of preparation Copegus is contraindicative at pregnancy and in a lactemia (thoracal feeding).
Copegus treatment should not be begun until the negative result of the test for pregnancy which should be spent directly ahead of the beginning of application of a preparation will be received.
Special indicatings
Safety and efficiency of the combined therapy is studied only at Copegus application with interferon an alpha-2b.
As with the years functionality of kidneys and a liver can decrease, at elderly patients prior to the beginning of application Copegus it is necessary to investigate their function.
The control of laboratory indicators
(The clinical analysis of blood with calculation of the leukocytic formula and number of thrombocytes, the analysis of electrolytes, definition of the maintenance of a creatinine in blood serum, functional assays of a liver) it is necessary to spend laboratory researches before the treatment beginning, then on 2nd and 4th week of treatment, and further it is regular, as required.
At occurrence of the serious undesirable phenomena or deviations in laboratory indicators during preparation application it is necessary to correct a dose or to stop reception of a preparation before the termination of the undesirable phenomena.
Use in pediatrics
Safety and efficiency of a preparation at treatment of children and teenagers is not established. Therefore application for patients is elderly till 18 years it is not recommended.
Influence on ability to driving of motor transport and to management of mechanisms
To the persons testing weariness, drowsiness or disorientation at treatment Copegus, it is necessary to refuse performance of the work demanding special attention and speed of psychomotor reactions (including car driving, management of mechanisms).
Overdosage
Data about cases of an overdosage of preparation Copegus are not present till now.
Medicinal interaction
At simultaneous Copegus reception in a dose of 600 mg with the antiacid preparation containing bonds of magnesium and aluminium, indicator AUC decreased for 14 %.
Conditions and periods of storage
The preparation should be stored in the dry place protected from light at temperature not above 25 C. The Period of validity - 2 years.
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