Ribavirin Prescribing Practices Among HCPs and the Future of Ribavirin in the Treatment of Chronic Hepatitis C

Off-label use of medication occurs frequently among health-care practitioners (HCPs). The off-label use of ribavirin (RBV) in the treatment of hepatitis C (HCV) is not well described in the literature, but often occurs in clinical practice. The package insert of RBV, which was based on the results of large, multicenter clinical trials, recommends twice daily (BID) dosing. However, the rationale for this dosing regimen remains unclear, as the pharmacokinetics of RBV supports once daily (QD) dosing. This article discusses the history, the proposed mechanism of action (MOA), the pharmacokinetics and the hemolytic anemia associated with RBV. In addition, the RBV prescribing practices among HCPs who treat a high-volume of HCV patients will be revealed. Finally, this article will address the possible role of RBV in the treatment of HCV in the upcoming era of all-oral, interferon-free therapies.