A female patient who has hepatitis C is being treated with pegylated interferon alfa and ribavirin [Ribasphere]. It will be important for the nurse to teach this patient that:
a. if she gets pregnant, she should use the inhaled form of ribavirin [Virazole].
b. if she is taking oral contraceptives, she should also take a protease inhibitor.
c. she should use a hormonal contraceptive to avoid pregnancy.
d. she will need a monthly pregnancy test during her treatment.
D
Ribavirin causes severe fetal injury and is contraindicated during pregnancy. Women taking ri-bavirin must rule out pregnancy before starting the drug, monthly during treatment, and monthly for 6 months after stopping treatment. Inhaled ribavirin is also embryo lethal and teratogenic. Adding a protease inhibitor will reduce the efficacy of oral contraceptives. Women using ribavi-rin should use two reliable forms of birth control.
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