Many people who start treatment for chronic hepatitis C don't make it through the entire course of therapy because of side effects. New antiviral drugs are replacing hard-to-tolerate medications — peginterferon alfa and ribavirin — that were, until recently, the backbone of hepatitis C treatment. Even so, peginterferon alfa and ribavirin are likely to remain in use in parts of the world with limited medical resources.
The new anti-hepatitis C drugs also have unpleasant side effects, including flu-like symptoms similar to those affecting most people on peginterferon alfa and ribavirin. These side effects typically aren't severe enough to lead to stopping treatment, but they may erode quality of life. Fortunately, you can take steps to reduce the impact of hepatitis C treatment side effects. Here are some tips for managing the most common ones.
Feeling tired and run-down is the most common side effect of both interferon-based and interferon-free treatments. To avoid fatigue or limit its impact, try:
Headache and muscle aches — typically accompanied by fatigue — are common side effects of hepatitis C medications. You can cope with these signs and symptoms by:
Cough is a common respiratory side effect of hepatitis C treatment. Shortness of breath also may develop, as may airway and lung infections. See your doctor if you often feel out of breath or if you have a fever and a deep cough that produces thick sputum. To manage a cough:
Hepatitis C treatment, particularly with peginterferon alfa, can cause depression, mood swings and irritability. These side effects aren't trivial, particularly for people who have a history of mental health problems. Strategies for coping with depression include:
The older hepatitis C drugs sometimes cause dry skin, itching and a rash triggered by sunlight. Hair loss also may occur, but the hair usually grows back after treatment. Protect your skin and hair by:
Difficulty falling or staying asleep (insomnia) may be a result of mood problems caused by peginterferon alfa, potentially worsening depression and anxiety. Insomnia is also a side effect of ribavirin, as well as of the new combination treatment of ledipasvir-sofosbuvir (Harvoni). To get enough sleep:
New antivirals as well as peginterferon alfa and ribavirin can cause nausea, vomiting, diarrhea, appetite loss or a combination of these side effects in some people. Many also complain of a bad taste in the mouth. Sometimes, these side effects can lead to weight loss. Coping strategies include:
Some peginterferon alfa and ribavirin side effects are serious enough to require close monitoring by your doctor. If necessary, you may have to reduce your medication dosage or stop treatment completely. These serious side effects include:
Exposure to ribavirin during pregnancy can cause abnormalities in the developing baby. Women should have pregnancy tests before and periodically during ribavirin treatment. Similarly, men considering ribavirin treatment should take precautions to avoid exposing their female partners' unborn children to the drug by: