Treating Hepatitis C: Managing the Side Effects of Interferon and Ribavirin

If you have hepatitis C, your doctor may have recommended treatment. Treatment can't cure hepatitis C, but it can help clear the virus from your body and may stop or slow the damage to your liver.

Treatment for hepatitis C usually includes a combination of:

• A long-acting (pegylated) interferon shot
• Ribavirin, an oral drug that fights viruses

If your doctor has prescribed treatment, it's important to keep taking the medicines for as long as they are recommended. Side effects are common, but there are things you can do to help you feel better.

What are the side effects of treatment?
The more common side effects of interferon may include:

• Flu-like symptoms (fever, body aches)
• Headache
• Skin irritation
• Fatigue
• Problems sleeping
• Nausea
• Loss of appetite
• Irritability
• Hair loss

Other serious side effects can also occur. These include depression, blood problems, infection or trouble with your lungs, liver, eyes, thyroid, heart or immune system. Discuss all the possible side effects with your doctor before you start treatment so you know what to watch out for.

Side effects of ribavirin may include:

• Anemia (low red blood cell count)
• Problems with your liver
• Extreme tiredness
• Skin irritation
• Nausea
• Decreased appetite
• Lung problems
• Birth defects

Managing the side effects
If you're having side effects, talk to your doctor. Some side effects can be very serious. For the less serious but bothersome side effects, he or she can suggest ways to relieve some of the discomfort. You can also try these tips to manage some of these common side effects.

Fatigue

• Be active every day. Check with your doctor before you start an exercise program.
• Balance your activity with rest, and plan activity for times when you feel best. Get as much sleep as you can.
• Eat a balanced diet with lots of fruits and vegetables.
• Drink plenty of water, especially during and after exercise.
• Time interferon injections for weekends or other times you're not as busy.

Sleep problems

• Try to get to bed and wake up at the same time every day.
• Try taking ribavirin in the early evenings instead of right before bed.
• Keep naps short.
• Avoid caffeine, alcohol, exercise or large meals before bed.
• Limit your fluids before going to bed.

Depression

• Depression may be severe. Let your doctor know right away if you are having symptoms of depression.
• If you think you may harm yourself or someone else, call 9-1-1 right away.

Muscle and body aches

• Take pain relievers if suggested by your doctor.
• Ask your doctor about the timing of your interferon shots. It may help to give the injection before bed.
• Ask your doctor about taking an over-the-counter pain reliever before your interferon shot.
• Try a warm bath or put heat on sore spots.

Nausea and loss of appetite

• Ask about taking ribavirin with meals.
• Eat smaller portions and have healthy snacks in between.
• Avoid greasy and spicy foods.
• If cooking smells make you sick, try eating foods cold.

Fever and chills

• If you have a fever above 101 degrees F, call your doctor right away.
• Ask your doctor about taking an over-the-counter pain reliever before your interferon shot.