Treatment

Managing Side Effects of Treatment

Most people who undergo Hepatitis C therapy experience some type of treatment-related side effect.  Fortunately, there are many steps you can take to manage them.  And it’s important to remember that not everyone will experience the same side effects, nor are they necessarily severe.  Developing a good support system before beginning therapy – with family, friends, and peer support group members – can help you cope with treatment-related side effects.

The following tips will help you manage some of the more common side effects of Hepatitis C treatment:

 

Flu-like symptoms related to interferon therapy (fever, chills, headache, body aches)

  • Use pain relievers as directed by your provider
  • Take a lukewarm sponge bath when you have a fever
  • If muscles are achy apply warm moist heat or massage
  • Drink plenty of clear fluids (6-8 glasses/day, non-caffeinated)
  • Inject interferon at bedtime to sleep through the symptoms

Fatigue

  • Rest when you can
  • Modify your work schedule if possible
  • Get regular low-impact exercise such as walking
  • Eat well-balanced meals and drink enough fluids

Insomnia

  • Develop a regular routine; go to bed and get up the same time every day
  • Use relaxation techniques such as meditation, warm baths or massage; read or listen to music
  • Avoid exercise, caffeinated products, or heavy meals close to bedtime
  • Limit fluid intake about 2 hours before bedtime so you don’t have to get up to go to the bathroom
  • Take over-the-counter (such as Benadryl) or prescription medications as recommended by your provider

Poor Appetite

  • Eat smaller, more frequent meals
  • Eat whatever appeals to you most
  • Eat snacks high in protein (cheese, peanut butter); have protein drinks (like Ensure, Boost or Carnation Instant Breakfast)

Taste Changes (metallic taste in your mouth)

  • Brush teeth frequently, especially after eating
  • Use plastic utensils if you have a metallic taste
  • Eat a small amount of yogurt 30 minutes before meals, or have a bit of dark chocolate
  • Use lemon wedges or sugar-free lemon drops

Dry Mouth or Mouth Sores

  • Brush and floss your teeth frequently
  • Rinse your mouth after every meal
  • Don’t use mouthwash containing alcohol
  • Drink plenty of water and suck on ice chips
  • Use a soft toothbrush
  • See your dentist regularly during treatment
  • Use topical medication for mouth sores as recommended by your doctor or dentist

Nausea and Vomiting

  • Eat small meals
  • Avoid smells or foods that trigger nausea
  • Avoid spicy, greasy, sweet or acidic (like citrus) foods
  • If morning nausea is a problem, eat some dry crackers when first awakening
  • Try drinking ginger ale or ginger tea
  • Take ribavirin with food
  • Take over-the-counter medication as recommended by your provider

Diarrhea

  • Try the BRAT diet (bananas, rice, applesauce, toast) which will give you more soluble fiber
  • Avoid spicy or acidic foods
  • Drink enough fluids (6-8 glasses/day, non-caffeinated)
  • Take over-the-counter medications like loperamide (Immodium) or psyllium (Metamucil) as recommended by your provider

Cough

  • Use a humidifier
  • Drink more water or non-caffeinated drinks
  • Suck on cough drops or sugar-free hard candy

Rashes and Dry Skin

  • Use gentle soaps (like Dove or Cetaphil)
  • Avoid taking long, hot showers since that dries out your skin
  • Moisturize daily after showers with unscented lotion for dry skin
  • Use unscented laundry detergent for sensitive skin
  • Apply sunscreen when needed
  • Use over-the-counter hydrocortisone creams or other anti-itch medications as recommended by your provider

Injection site reactions

  • Rotate your injection site; include thigh, upper arm, and abdomen
  • Don’t inject into an area that’s bruised or irritated
  • Warm your medicine by rolling the syringe between your palms for a minute before injecting
  • Don’t rub injection site; apply a cold pack
  • Use topical creams (like hydrocortisone) as recommended by your provider

Hair Loss

  • Wash hair less often
  • Use a mild shampoo (like baby shampoo) and a rich conditioner
  • Use a soft-bristle brush or a wide-tooth comb
  • Don’t pull hair into a tight pony tail, braids, or any other style that could strain the hair
  • Avoid harsh products like dyes, perms, or straighteners
  • Avoid using hot styling tools like curling or flat irons, hot rollers, etc.

Depression, Anxiety and Irritability

  • Do mild-moderate exercise 3 times/week when possible
  • Try relaxation techniques like deep breathing, meditation, yoga, visualization or relaxation tapes
  • Participate in a hepatitis C support group
  • Seek help from family and friends
  • Consider seeking help from a professional (social worker, mental health therapist or psychologist) if symptoms become worse
  • Talk to your provider about your symptoms; depression and anxiety can be treated with medications.
  • Discuss any thoughts of harming yourself or others with your provider