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    Ribavirin

    Drug Information

    Common brand names:

    Copegus, Rebetol, Ribasphere, RibaPak, Ribatab

    Summary of Interactions with Vitamins, Herbs, & Foods

    Types of interactions: Beneficial Adverse Check

    Replenish Depleted Nutrients

    • Vitamin B12

      Neomycin can decrease absorption or increase elimination of many nutrients, including calcium , carbohydrates, beta-carotene , fats, folic acid , iron , magnesium , potassium , sodium, and vitamin A , vitamin B12 , vitamin D , and vitamin K . Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

    • Vitamin K

      Several cases of excessive bleeding have been reported in people who take antibiotics. This side effect may be the result of reduced vitamin K activity and/or reduced vitamin K production by bacteria in the colon. One study showed that people who had taken broad-spectrum antibiotics had lower liver concentrations of vitamin K2 (menaquinone), though vitamin K1 (phylloquinone) levels remained normal. Several antibiotics appear to exert a strong effect on vitamin K activity, while others may not have any effect. Therefore, one should refer to a specific antibiotic for information on whether it interacts with vitamin K. Doctors of natural medicine sometimes recommend vitamin K supplementation to people taking antibiotics. Additional research is needed to determine whether the amount of vitamin K1 found in some multivitamins is sufficient to prevent antibiotic-induced bleeding. Moreover, most multivitamins do not contain vitamin K.

    Reduce Side Effects

    • Fish Oil
      Anemia is one of the side effects of ribavirin therapy. In a preliminary trial, supplementing with EPA partially prevented the decline in hemoglobin levels in patients with hepatitis C who were being treated with the combination of ribavirin and pegylated interferon alpha-2b.
    • L-Carnitine
      In a randomized trial, patients with chronic hepatitis C who were being treated with Peg-interferon-alpha 2b and ribavirin were randomly assigned to receive L-carnitine (2 grams twice a day) or no L-carnitine (control group). Compared with the control group, fewer patients in the L-carnitine group had to reduce the medication dosage or discontinue treatment because of side effects such as anemia or a decline in the white blood cell count.
    • Probiotics

      A common side effect of antibiotics is diarrhea , which may be caused by the elimination of beneficial bacteria normally found in the colon. Controlled studies have shown that taking probiotic microorganisms-such as Lactobacillus casei, Lactobacillus acidophilus, Bifidobacterium longum, or Saccharomyces boulardii-helps prevent antibiotic-induced diarrhea.

      The diarrhea experienced by some people who take antibiotics also might be due to an overgrowth of the bacterium Clostridium difficile, which causes a disease known as pseudomembranous colitis. Controlled studies have shown that supplementation with harmless yeast-such as Saccharomyces boulardii or Saccharomyces cerevisiae (baker's or brewer's yeast)-helps prevent recurrence of this infection.

      Treatment with antibiotics also commonly leads to an overgrowth of yeast (Candida albicans) in the vagina ( candida vaginitis ) and the intestines (sometimes referred to as "dysbiosis"). Controlled studies have shown that Lactobacillus acidophilus might prevent candida vaginitis.

    Support Medicine

    • Probiotics
      In one study, taking 500 mg of Saccharomyces boulardii twice daily enhanced the effectiveness of the antibiotic vancomycin in preventing recurrent clostridium infection. Therefore, people taking antibiotics who later develop diarrhea might benefit from supplementing with saccharomyces organisms.

    Reduces Effectiveness

    • Khat

      Khat (Catha edulis) is an herb found in East Africa and Yemen that has recently been imported into the United States. Studies have shown that chewing khat significantly reduces the absorption of ampicillin, which might reduce the effectiveness of the antibiotic. Therefore, people taking ampicillin should avoid herbal products that contain khat.

    Potential Negative Interaction

    • none

    Explanation Required 

    • none

    The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers' package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

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