Hepatitis C Treatment: Side Effects You Should Know About

Hepatitis C can be treated and even cured. And treatment is important. Hepatitis C, caused by a virus, can permanently damage your liver if you don't get treatment for it.

Treatment for hepatitis C keeps changing quickly. The standard treatment was typically interferon along with other drugs -- usually ribavirin and either boceprevir (Victrelis) or telaprevir (Incivek). 

But many people have a hard time with interferon’s side effects, which include fatigue, fever, chills, and depression. Treatment now centers around direct acting antiviral drugs (DAAs). These medicines are highly effective for most people with hepatitis C and are interferon-free and often ribavirin-free. This means they typically have fewer side effects. The treatments are often simpler- consisting of fewer pills for a shorter amount of time. DAAs are available as either single drugs or combined with other medicines in one pill.

Glecaprevir and pibrentasvir (Mavyret) is a fixed-dosage combination pill. The recommended dosage is 3 tablets daily. This medication offers a shorter treatment cycle of 8 weeks for adult patients with HCV who don't have cirrhosis and who have not been previously treated. Treatment length is longer for individuals who are in a different disease stage.

Vosevi is a combination of sofosbuvir, velpatasvir and voxilaprevir that has been approved to treat adults with chronic HCV either with no cirrhosis or with compensated cirrhosis who have already had certain treatments.

Elbasvir-grazoprevir (Zepatier), ledipasvir-sofosbuvir (Harvoni), and sofosbuvir-velpatasvir (Epclusa) and are once daily combination pills. Depending on the type of hepatitis C infection, these can often cure the disease in 8 to 12 weeks. Other treatment options include: daclatasvir (Daklinza); ombitasvir-paritaprevir-ritonavir plus dasabuvir, (Viekira Pak); ombitasvir-paritaprevir-ritonavir (Technivie); or some combinations of simeprevir (Olysio); sofosbuvir (Sovaldi); peginterferon or ribavirin.  Ask your doctor what's best for you, based on your medical needs.

What Are the Some of the Most Common Side Effects?
It depends on which drugs you take to treat hepatitis C.

Harvoni
Fatigue
Headache
• Nausea

Mavyret
• Headache
• Fatigue
• Nausea
• Diarrhea

Olysio with interferon and ribavirin
• Rash (sensitivity to sunlight)
Itching
• Nausea
Muscle pain

Peginterferon
• Flu-like (headache, fatigue, fever, chills, muscle ache)
Arthritis-like pain in back, joints
• Gastrointestinal (nausea, abdominal pain, diarrhea)
Insomnia
Depression
• Low blood cell counts

Continued

Ribavirin
Flu-like (fever, headache, chills, muscle ache)
• Gastrointestinal (low appetite, nausea, vomiting, diarrhea)
• Low blood cell counts
Depression
Insomnia

• Hair loss
 

Sovaldi with interferon and ribavirin
• Flu-like symptoms (fatigue, headache)
• Nausea
Insomnia
• Low red blood cell count
• Itching

Solvadi with ribavirin
• Flu-like symptoms (fatigue, headache)
• Nausea
• Insomnia
• Itching
• Low red blood cell count

Viekira Pack with ombitasvir, paritaprevir, dasabuvir and ritonavir

• Fatigue
• Nausea
• Itching
• Skin reactions
• Insomnia
• Weakness
• Severe liver injury if given to one who already has underlying severe liver disease

Zepatier

• Fatigue
• Headache
• Skin reactions
• Low red blood cell count
• Gastrointestinal (nausea,  diarrhea, abdominal pain)
 

How to Make Side Effects Better
There are things you can do to ease many of the side effects from hepatitis C treatment.
• If fever or aches start a few hours after your interferon shot, try getting the shot at bedtime. Take acetaminophen (Tylenol) or  ibuprofen (Advil or Motrin) about 30-60 minutes before your shot. Check with your doctor about which would be best for you.
• If you start to feel depressed, talk to your doctor. He might prescribe an antidepressant. Exercise can also boost your mood. For anxiety or crankiness, exercise regularly, get plenty of sleep, and try relaxation exercises like yoga or tai chi.
• If you have stomach problems, take your medications with food. Eat smaller, healthier meals and skip spicy, acidic foods. Ask your doctor about medications that might help with nausea or diarrhea.
• Use moisturizing soaps and lotions to help with dry skin. Don't take long, hot showers or baths.
• For a dry mouth or sour mouth, brush your teeth often and suck on sugar-free candies. Drink lots of water. 


Remember that these side effects will typically go away once you're cured, so stick with your treatment. Work with your doctor on your treatment plan so that you can manage any problems and try to get the virus out of your body as soon as possible

WebMD Medical Reference Reviewed by Melinda Ratini, DO, MS on September 10, 2017

Sources

SOURCES

Paul Gaglio, MD, medical director of liver transplantation, division of hepatology at Montefiore Medical Center.

Alison Jazwinski, MD, MHS, assistant professor of medicine, division of gastroenterology, hepatology and nutrition, Center for Liver Diseases, University of Pittsburgh.

Medscape: "FDA Panel Backs Sofosbuvir for Hepatitis C," "FDA Panel Recommends Approval of Simeprevir for Hepatitis C."

U.S. Department of Veterans Affairs: "Hepatitis C Treatment Side Effects Management Chart."

UptoDate: "Patient Information: "Hepatitis C (Beyond the Basics)."

FDA. "FDA approves Mavyret for Hepatitis C." "Mavyret Prescribing Information."

Hepatitis C Online. "Elbasvir-Grazoprevir (Zepatier)." "Sofosbuvir-Velpatasvir-Voxilaprevir (Vosevi)."

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