Blood ribavirin concentration in high-dose ribavirin for adenovirus-induced haemorrhagic cystitis - a case report

Journal of Clinical Pharmacy and Therapeutics
Masato HommaYukinao Kohda

Abstract

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 microM and achieved virus eradication. High level of erythrocyte ribavirin (1085 microM; 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.

References

Apr 7, 2004·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Masato HommaYukinao Kohda
Sep 25, 2004·Antimicrobial Agents and Chemotherapy·Yoichi InoueYukinao Kohda
Dec 6, 2005·Hepatology Research : the Official Journal of the Japan Society of Hepatology·Yoichi InoueYukinao Kohda

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Citations

Oct 4, 2011·Archivum Immunologiae Et Therapiae Experimentalis·Ewa Elżbieta UlrychGrażyna Młynarczyk
Jul 26, 2008·Reviews in Medical Virology·Liesbeth LenaertsLieve Naesens
May 15, 2015·The Journal of Antimicrobial Chemotherapy·Joseph E RowerJennifer J Kiser
Sep 15, 2010·Blood·Caroline A LindemansJaap Jan Boelens
Jul 2, 2014·Clinical Microbiology Reviews·Thomas Lion

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