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Medications for Viral Hepatitis

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included, so ask your doctor if you need to take any special precautions. Use each of these medications as recommended by your doctor, or according to the instructions provided. If you have further questions about usage or side effects, talk to your doctor.
Medications may be given to treat hepatitis B or C. The drugs have limited success and may produce side effects. More than one drug may be advised. Not all people are candidates for treatment with these medications. Discuss your treatment options with your doctor.

Prescription Medications

Alpha Interferons
Alpha interferon is injected, usually daily or three times per week. It is used to treat hepatitis B and C. These medications may be given individually or in combination. You may receive treatment for about four months or longer, but time varies. Alcohol must not be consumed during treatment with interferon.
Possible side effects may include:
  • Irritability
  • Anxiety
  • Personality changes
  • Depression
  • Flu-like symptoms such as:
    • Fatigue
    • Muscle aches
    • Headache
    • Nausea and vomiting
  • Bone marrow suppression
  • Autoimmune thyroiditis
Telbivudine
Telbivudine is available in liquid and tablet forms. It is appropriate for adolescents 16 years of age or older and adults with chronic hepatitis B. It is usually taken once daily. Optimal duration of therapy is unknown.
Possible side effects include:
  • Lactic acidosis, a serious change in blood chemistry
  • Acute exacerbations after treatment stops
  • Upset stomach
  • Abdominal pain or distention
  • Nausea
  • Diarrhea
  • Fatigue
  • Myopathy and myalgia—muscular weakness or pain
  • Neuropathy—impaired nerve function
  • Headache
  • Cough
  • Pain while swallowing
  • Joint pain
  • Fever
  • Rash
  • Back pain
  • Insomnia
  • Lightheadedness
  • Changes in kidney and liver lab results
Entecavir
Entecavir is given orally or in tablet form to adults and adolescents older than 16 years of age to treat chronic hepatitis B virus infection.
Possible side effects include:
  • Lactic acidosis, a serious change in blood chemistry
  • Acute exacerbations after treatment stops
  • Diarrhea
  • Stomach upset
  • Nausea
  • Vomiting
  • Fatigue
  • Headache
  • Lightheadedness
  • Insomnia
Lamivudine
Lamivudine is given orally to treat chronic hepatitis B. It is usually taken daily for about one year. In some cases, it may need to be taken longer.
Possible side effects include:
  • Enlarged liver
  • Lactic acidosis, a serious change in blood chemistry
  • Headache
  • Fatigue
  • Nausea
  • Diarrhea
  • Nasal congestion
Adefovir
Adefovir is given orally to adults and adolescents older than 16 years of age to treat chronic hepatitis B.
Possible side effects include:
  • Liver toxicity
  • Kidney toxicity
  • Lactic acidosis, a serious change in blood chemistry
  • Headache
  • Fatigue
  • Nausea
  • Diarrhea
Ribavirin
Ribavirin is given orally to treat chronic hepatitis C. The pills are taken twice daily.
Possible side effects include:
  • Severe anemia
  • Fatigue
  • Irritability
  • Skin rash and itching
  • Nasal congestion
  • Headache
  • Chills
  • Muscle aches
  • Gout
Protease Inhibitors
Common names include:
  • Telaprevir
  • Boceprevir
  • Simeprevir
  • Sofosbuvir
Protease inhibitors are used to treat hepatitis C. They interfere with viral reproduction in the body, slowing the growth of hepatitis C. Protease inhibitors are taken in combination with other medications. It is important to remain adequately hydrated when taking them.
Possible side effects include:
  • Rash
  • Itching
  • Anemia
  • Nausea or vomiting
  • Fatigue
  • Problems with or loss of taste
  • Anal irritation (telaprevir)
  • Sensitivity to light (simeprevir)
When to Contact Your Doctor
  • If you develop any side effects to the medications
  • If any of your symptoms worsen

Special Considerations

If you are taking medications, follow these general guidelines:
  • Take your medication as directed. Do not change the amount or the schedule.
  • Do not stop taking them without talking to your doctor.
  • Do not share them.
  • Use a measuring spoon, cup, or syringe to give the right dose. Make sure it has the same measurements as the medication. For example, if the medication is given in milliliter (mL), the device should also say mL.
  • Know what the results and side effects. Report them to your doctor.
  • Some drugs can be dangerous when mixed. Talk to a doctor or pharmacist if you are taking more than one drug. This includes over the counter medication and herb or dietary supplements.
  • Plan ahead for refills so you do not run out.

References

Hepatitis C. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated December 16, 2013. Accessed February 14, 2014.

Kasper D, Harrison T. Harrison's Principles of Internal Medicine. 16th ed. New York, NY: McGraw-Hill; 2005.

Mosby’s Drug Consult. St. Louis, MO: Mosby Inc; 2002.

Viral hepatitis headquarters. National Prevention Information Network website. Available at: http://www.cdcnpin.org/scripts/hepatitis/index.asp. Updated October 15, 2010. Accessed January 19, 2011.

What I need to know about Hepatitis B. National Digestive Diseases Information Clearinghouse website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/hepb%5Fez/index.aspx. Updated December 19, 2012. Accessed February 14, 2014.

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