Ribavirin, commonly known as “virazole”. It is because of the word “virazole” that you will be blinded. Whether it is a grassroots community hospital or a tertiary hospital, whether it is a general hospital or a children’s specialist hospital, even a top children’s specialist hospital like Beijing Children’s Hospital, whether it is a common cold or rotavirus enteritis, or a common type of hand, foot and mouth disease, all may be prescribed ribavirin. As we all know, more than 90% of upper respiratory infections in children are caused by viral infections, and ribavirin is a broad-spectrum antiviral drug, which seems logically justified for its treatment. However, science is not just such a simple literal logical relationship, especially in medicine, because it is a matter of life and health, any treatment needs to be tested by rigorous evidence-based medicine, clinical studies to prove its effectiveness and safety. In China, ribavirin is available in 15 dosage forms, with nearly 700 manufacturers. WHO Essential Medicines List: The most basic use of ribavirin is oral or intravenous for hepatitis C and viral hemorrhagic fever. It also needs to be used in combination with pegylated interferon-a to be effective for hepatitis C. It cannot be used alone to treat hepatitis C. It is not recommended for use in children under 3 years of age. However, the intravenous form is not licensed by the FDA in the U.S. The only licensed forms of ribavirin in the U.S. are the nebulized form for respiratory syncytial virus infection only and the oral form of ribavirin in combination with alpha-interferon for the treatment of hepatitis C. The nebulized form was only considered for severe respiratory syncytial virus-induced lower respiratory tract infections in the presence of immunodeficiency (e.g., in children with concomitant chronic lung disease or congenital heart disease). Subsequent studies have failed to demonstrate a clear clinical benefit of ribavirin for respiratory syncytial virus pneumonia. Therefore, ribavirin is no longer used as a routine treatment for respiratory syncytial virus. The FDA specifically warns that: Ribavirin has significant teratogenic and embryocidal toxicity and is contraindicated in women during pregnancy and in male spouses of women during pregnancy; Ribavirin can cause hemolytic anemia, which can lead to fatal heart disease and nonfatal myocardial infarction; Sudden deterioration of respiratory function can occur in infants initiated on ribavirin inhalation; Ribavirin monotherapy is not effective for chronic hepatitis C virus infection. The drug is cardiotoxic, hepatotoxic and hematotoxic and can have fatal side effects when used in overdose. 1. This drug should not be used in patients with respiratory RSV infection without laboratory confirmation; it is not used in lactating women with respiratory RSV infection (because respiratory RSV infection in lactating women is self-limiting). 2, This drug eye drops should not be used for viral eye diseases other than herpes simplex virus keratitis. 3. This drug is not recommended for patients with thalassemia, sickle cell anemia, or creatinine clearance less than 50 ml/min. 4. Patients with active tuberculosis should not use this drug; patients with pancreatitis or those with symptoms of pancreatitis should not use this drug. Ribavirin can enter the red blood cells, accumulate in large amounts and can accumulate for several weeks. Therefore, the spouse of a woman or man taking this drug should use at least two or more effective contraceptive measures before the start of treatment, during treatment, and for at least 6 months after stopping the drug. For many self-limiting diseases like colds that get better on their own as long as there are no complications, there is no need to use ribavirin at all. Antiviral therapy is of no clinical benefit for the treatment of the common cold (oseltamivir can be used early in infections caused by influenza viruses to be able to shorten the course of the disease) and should be avoided to reduce possible side effects. Ribavirin should be used with caution in pediatrics, the risks are too high.