Ribavirin (trade name Rebetol®) is used in the US and other countries to treat hepatitis C in conjunction with interferon. When used alone, ribavirin has only a temporary effect on hepatitis C viral levels and liver disease. Therefore it is only useful in people who can tolerate interferon.

Ribavirin comes as 200-mg capsules. The usual dose for treating hepatitis C is either 4 to 6 capsules per day, in addition to interferon injections. Side effects result in a reduction in dosage in a fair number of persons.

Ribavirin accumulates in the red blood cells and damages them, shortening their life in the body. The body compensates by making more red blood cells, but many people cannot keep pace with the accelerated loss of red cells caused by ribavirin. Red blood cells carry oxygen from the lungs to the rest of the body, and if the red blood cell count drops too much, a person will feel easily tired. Most people have only a small reduction in red blood cells, but for some people the drop is severe. For some people, even a minor drop in red blood cells can be dangerous. For example, someone with heart disease might develop a heart attack if the red cell count were to drop, or someone who is already anemic from another cause could become severely anemic on ribavirin. Therefore it is important to monitor the red blood cell count while on ribavirin, and to be doubly careful with persons with heart disease or pre-exisiting anemia.
The anemia caused by ribavirin resolves when ribavirin is stopped, usually within one to two months.

Ribavirin is known to cause severe birth defects in animals. Anyone taking ribavirin, whether male or female, should use effective contraception, and should understand that any accidental pregnancy could well give rise to a severely deformed fetus. Since ribavirin accumulates in the body with treatment, contraception is advised for a full 6 months after completing a course of ribavirin. If you have religious or other scruples against contraception or abortion, then you should definitely think twice before taking ribavirin. You should let your doctor know your feelings about family planning, and your sexual partner also needs to know about the ribavirin treatment. If you are contemplating having a child, then you may decide to go through with the pregnancy first and be treated for hepatitis afterwards. These are all issues you should discuss with your physician and your spouse or other sexual partner.

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