For your hepatitis C treatment to work, you must take your medications exactly as prescribed. And that means finding ways to ease any side effects.
Hepatitis C Treatment: The Spectrum of Side EffectsThe good news: The latest drugs to be approved for hepatitis C, direct-acting antivirals (DAAs), have far fewer side effects than earlier oral drugs and injectables and are even more effective.
In fact, Anthony Michaels, MD, a hepatologist at Ohio State University's Wexner Medical Center, says that none of his hepatitis C patients on the newest DAAs have had to stop the treatment because of side effects. “Most of these side effects are livable and manageable,” he says.
Side effects from the older regimen of peginterferon and ribavirin can be severe. People who are taking those drugs need to find ways to manage the effects so they're able and willing to stick with the treatment.
8 Hepatitis C Treatment Side Effects and How to Cope
Whether you're experiencing mild or severe side effects, here are steps you can take to ease them:
Fever and chills. Fever, chills, and flu-like symptoms may follow peginterferon injections within a few hours. Some experts recommend taking the injection before going to bed so that you'll be asleep when they start. Also, Dr. Michaels suggests taking acetaminophen 30 to 60 minutes before your injection and as needed. A cool sponge bath may relieve a fever. Cover yourself with extra blankets or wear a sweatshirt if you get the chills.
Fatigue. Almost everyone with hepatitis C has some fatigue, if not from the treatment, then from the disease itself. Some people on the newer treatments also report feeling fatigued, says Robert Gish, MD, medical director of the Hepatitis B Foundation and a professor of medicine at the University of Nevada, Las Vegas.
As counterintuitive as it might seem, light exercise can actually combat fatigue, give you more energy, and even boost your mood. Try exercising in brief spurts of 10 to 15 minutes.
Also be sure to get plenty of rest during the day. Take short naps of 20 minutes when possible — just not too close to bedtime. Ask for help with chores when you need it. Eat smaller, nutritious meals throughout the day and stay well hydrated to keep up your energy levels.
To combat this common side effect, cut caffeine — found in coffee, tea, soda, and chocolate — from your diet, especially later in the day. Keep your bedroom cool, dark, and quiet, and try to go to bed and wake up at the same times every day. Although people on hepatitis C treatment may not want to take any more pills than absolutely necessary, if nothing else helps, talk to your doctor about sleep medication, Michaels says.
Depression and irritability.
These common symptoms can come from both living with hepatitis C and treating it. To combat negative emotions, try exercise — it releases feel-good hormones and can be a mood-lifter. Joining a support group can help, too. Talk to your doctor if you have suicidal thoughts; you may need prescription medication for depression.
Nausea and vomiting.
Taking ribavirin with food may help ease nausea, but avoid greasy or spicy foods, which may upset your stomach. If you wake up with nausea, munch on dry white toast or plain crackers. And ginger, found in tea and gingersnaps as well as in supplements, has been used for centuries to calm queasiness. Talk to your doctor about the right amount for you.
About one-third of those taking interferon and ribavirin report skin rashes, as do a small number of people on the newer treatments, Dr. Gish says. Keep your showers or baths short, use cooler water, and follow your shower by applying a thick moisturizer. Gently rub rather than scratch itchy patches. For the itchiness, antihistamines can help, or talk to your doctor about steroid creams.
Thinning hair or hair loss.
Hair loss is common with aging, but it can also be accelerated with hepatitis C treatment. Avoid shampooing every day and skip harsh processing chemicals and dyes. For women, consider keeping your hair cut short and layered to make it appear fuller. And a hat will protect your scalp and hair from the sun’s damaging rays.
Older hepatitis C treatments can lead to mouth sores or ulcers. Try using a soft toothbrush. Stay hydrated, but avoid piping hot drinks that can burn and citrusy drinks that can sting. Acetaminophen may help ease the pain of mouth sores.
Living With Hepatitis C
Newer treatments come with fewer side effects, and more treatment options are expected to be approved by the end of 2015 or early in 2016. Your doctor will help you determine the best course of treatment for you, as well as help you find ways to manage any side effects you experience.