Ribavirin, a commonly used drug in the whistler department, deserves our attention. Ribavirin is a synthetic nucleoside antiviral drug, which was marketed abroad in the 1970s, and the ribavirin developed in China was marketed in the 1980s. At present, ribavirin is mainly used in the clinic for the treatment of viral diseases such as viral pneumonia and bronchitis caused by the rosacea syncytial virus, and cutaneous herpes virus infection. The Medical Whistleblower Channel reported that in 2006, the CFDA’s Adverse Drug Reaction Information Circular had addressed the safety of ribavirin. According to CFDA, in view of the wide clinical application of ribavirin and the large amount of use, relevant professionals are hereby reminded to pay attention to its safety issues such as reproductive toxicity and hemolytic anemia. Ribavirin in clinical application also has a lot of controversy is highly concerned, many experts have their own views on this. The medical community whistle channel pointed out: First, women of childbearing age, do not recommend the use of ribavirin For women of childbearing age, this drug is really a serious disadvantage outweighs the benefits. If you use ribavirin, a drug with a high risk of teratogenicity, without knowing that you are pregnant, the result is likely to be regret. Teratogenic effects – very clear Well-documented animal studies have confirmed that ribavirin is significantly mutagenic and embryotoxic, and can occur at less than 1/20th of the human dosage. The World Health Organization’s Adverse Drug Reaction Monitoring Report database search results from 1987 to 2005 showed that of the 6649 case reports of adverse reactions that may have been caused by the use of ribavirin, a total of 96 cases of fetal anomalies were reported, of which 56 cases were stillbirths, 21 cases of fetal malformations (see the table below), and the remaining 19 cases were manifested in cartilage, nevus, hydrocephalus, congenital hernia, etc. The results of this study show that ribavirin has been shown to be associated with a number of adverse reactions in children. Ribavirin should be used with caution for children with colds Most common colds are caused by viruses, including rhinoviruses, coronaviruses, parainfluenza viruses, and respiratory syncytial viruses, among which rhinoviruses are the most common pathogens. Ribavirin, an antiviral, is “indicated for viral pneumonia and bronchitis caused by the respiratory syncytial virus” and is “contraindicated for use in patients without laboratory confirmation of respiratory syncytial virus infection”. –Ribavirin Tablets and Injections drug insert. “Ribavirin does not cure colds! Does not cure colds! Does not cure colds! Say the important thing three times.” If the doctor uses “ribavirin tablets”, “ribavirin injection”, to treat “patients without laboratory confirmation of rosary syncytial virus infection”, it is an overdose. Third, hand, foot and mouth disease, can use ribavirin? In China, ribavirin is used for the treatment of hepatitis C virus (HCV) and respiratory syncytial virus (RSV) infections in addition to other antiviral therapy is also used in large quantities. Some studies have shown that the use of ribavirin in pediatric hand, foot and mouth disease is about 20%. In addition, some hospitals use up to 12% of the medication “over-the-counter”, including newborns and infants, which means that the actual scope of use is much larger than the instructions. Ribavirin can be used to treat HFMD, but should be limited to severe cases. HFMD is a self-limiting disease and generally does not require specific treatment. Mildly symptomatic hand, foot and mouth disease only requires attention to isolation to avoid cross-infection. Appropriate rest, light diet, good oral and skin care, and symptomatic treatment (such as fever and other symptoms using a combination of traditional Chinese and Western medicine) can be, the prognosis is good. more than 95% of the pediatric patients are ordinary cases of manifestations of such patients do not need to be treated with ribavirin, but only need to carry out the conventional treatment can be self-cured, and most of them are cured within 1 week, the prognosis is good. Severe manifestations have been reported in approximately 5% of cases, especially in children younger than 3 years of age. The disease progresses rapidly, with symptoms of persistent high fever, depression, vomiting, generalized weakness, abnormal breathing, circulatory dysfunction, meningitis, encephalitis (with brainstem encephalitis being the most dangerous), cerebrospinal myelitis, pulmonary edema, etc., and a very small number of cases are in critical condition, which may even lead to death, and surviving cases may also have after-effects. These patients should be treated for neurologic involvement, respiratory and circulatory failure, and recovery without delay. Ribavirin is not indicated for routine colds, flu, or common cases of HFMD. However, for severe hand-foot-mouth disease, ribavirin is still a good choice of drugs, for now there is no specific anti-EV71 virus drugs, ribavirin as a broad-spectrum antiviral drugs can fully play its advantages, to help improve the child’s critical illnesses, as soon as possible out of danger. Fourth, men should also take contraceptive measures Ribavirin has a strong teratogenic effect, prohibited for pregnant women and women who are likely to become pregnant, patients who have used ribavirin need to avoid pregnancy for at least 6 months after stopping the drug. The U.S. drug insert also requires that it be contraindicated in the male spouses of women who are pregnant. Data on the reproductive toxicity of ribavirin in men are mainly derived from animal studies: in male mice given doses ranging from 35 to 150 mg/kg, it resulted in significant vasovaginal atrophy, decreased sperm concentration and increased number of morphologically abnormal spermatozoa. Spermatogenesis was partially restored 3 to 6 months after discontinuation of the drug. Several other toxicity tests also suggest that testicular damage can be induced in adult rats given orally at doses as low as 16 mg/kg. V. Certain patients should refuse ribavirin In addition to pregnant and lactating women, and male spouses of pregnant women, ribavirin should also be avoided in the following patients: 1, patients with severe anemia or a history of heart disease: there are reports of fatal or non-fatal myocardial damage in anemic patients with the drug. 2.Ribavirin should not be used in patients with symptoms of pancreatitis or definite pancreatitis. 3.Ribavirin should not be used in patients with active tuberculosis. 4.Elderly people over 65 years old: the possibility of anemia in elderly people using ribavirin is greater than that of young patients, because of the decline in renal function in the elderly, which can easily lead to accumulation.