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Blood ribavirin concentration in high‐dose ribavirin for adenovirus‐induced haemorrhagic cystitis – a case report
Author(s) -
Homma M.,
Inoue Y.,
Hasegawa Y.,
Kojima H.,
Kohda Y.
Publication year - 2008
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/j.1365-2710.2008.00874.x
Subject(s) - ribavirin , medicine , pharmacology , gastroenterology , virology , virus , hepatitis c virus
Summary Blood ribavirin concentration was monitored after the administration of high‐dose oral ribavirin in a case of adenovirus‐induced haemorrhagic cystitis post‐stem‐cell transplantation. Combination use of intravenous gamma immunoglobulin (15 g/3 days) and high‐dose ribavirin (RBV; 9000 mg/4 days) provided plasma ribavirin concentration of 24·3 μ m and achieved virus eradication. High level of erythrocyte ribavirin (1085 μ m ; mostly as phosphorylated metabolites) with long half‐life (15 days) caused severe anaemia, which required several blood transfusions for 2 weeks after the cessation of the ribavirin treatment. It was suggested that blood transfusion and intensive haemoglobin level monitoring is necessary for at least 4 weeks after the RBV, because of the high accumulation of phosphorylated ribavirin in erythrocytes even after stopping ribavirin administration.