Drug Treatment for Hep C

 

New Drug Treatment for Hepatitis C

Treatment Facts for Hepatitis C

The goal of Hep C treatment is to cure the virus. Chronic Hepatitis C is treated with drugs to eliminate the virus from the body and prevent further liver damage.

To help determine which Hep C treatment is best suited for each patient will depend on genotype (genetic virus strain), viral load (RNA), liver condition, Hep C treatment history and tolerance, and overall health conditions.

Blood tests and physical exams will take place all throughout treatment and post treatment recovery. Viral load tests can take place as early as 2 to 4 weeks from beginning of treatment and continue through 12 weeks of completion of treatment.  Many physicians will continue to test patients to 24 weeks or longer post treatment.

When HCV is undetected in the blood for 12 weeks from when treatment has been completed, the patient has achieved what is known as SVR12 (sustained virologic response) and considered cured.

The Center for Disease Control and Prevention reports there are 6 different genotypes of Hep C and multiple subtypes. Genotype describes the type of virus strain of Hep C. 75% of Hep C patients from the US have genotype 1 a or b. Genotypes 2, 3 and 4 are less common in the US. Certain genotypes are more prevalent in each country.

 

Great Improvement in Treatment

In 2011 the FDA approved the first generation of protease inhibitors to be used in triple therapy with standard combination treatment of Peginterferon and Ribavirn.  For the first time a cure to eliminate the Hep C virus was available. The cure rate was 70% using one of the two protease inhibitors in triple therapy with standard treatment time of 24 to 48 weeks and harsh side effects.

Since this short time, we have seen great improvement in treatment. A variety of new treatments have brought; new treatment options with and without use of Peginterferon and Ribavirin, treatment options for different genotypes, higher cure rates of 90% to 99%,  less treatment side effects and shorter treatment time to 8 to 12 weeks being the new standard. With certain genotypes and liver conditions, some treatments may be recommended to 24 weeks.

Clinical trial studies continue in progress with new treatments for a variety of genotypes and conditions.

 

New Treatment for Hep C: Overview

There are several Hep C treatment options now available without Interferon and Ribavirin: Harvoni, Olysio/Sovaldi, Viekira Pak, see each treatment listed for details. Talk to your physician about which treatment is best suited for your genotype, liver condition and any past treatment history. See addition Hep C Treatment combinations for a variety of treatment options.

This overview shows Hep C treatments which are approved by the United States FDA and recommended by the American Association for Study of Liver Disease (AASLD) and the Infectious Diseases Society of America (IDSA) for variety of genotypes. Please see detailed information about each treatment, cure rate, side effects, drug interactions, etc, following overview.

For Genotype 1a:

Harvoni for 12 weeks**

Or

Olysio + Sovaldi with or without Ribavirin for 12 weeks (w/o cirrhosis) or 24 weeks (with cirrhosis)

Or

Viekira Pak + Ribavirin for 12 weeks (w/o cirrhosis) or 24 weeks (with cirrhosis)

 

For Genotype 1b:

Harvoni for 12 weeks**

Or

Olysio + Sovaldi for 12 weeks (w/o cirrhosis) or 24 weeks (with cirrhosis)

Or

Viekira Pak for 12 weeks (w/o cirrhosis) or use with Ribavirin for 12 weeks (with cirrhosis)

 

For Genotype 2:

Sovaldi + Ribavirin for 12 to 16 weeks (with cirrhosis)

 

For Genotype 3:

Sovaldi + Ribavirin for 24 weeks

Or Alternative

Sovaldi + Ribavirin + Peg Interferon for 12 weeks

 

For Genotype 4:

Harvoni for 12 weeks

Or

Viekira Pak (without Dasabuvir) + Ribavirin for 12 weeks

Or

Sovaldi + Ribavirin for 24 weeks

Or Alternative

Olysio + Sovaldi with or without Ribavirin for 12 weeks

Or Alternative

Sovaldi + Ribavirin + Peg Interferon for 12 weeks

 

For Genotype 5:

Sovaldi + Ribavirin + Peg Interferon for 12 weeks

Or Alternative

Peg Interferon + Ribavirin for 48 weeks

 

For Genotype 6:

Harvoni for 12 weeks

Or Alternative

Sovaldi + Ribavirin + Peg Interferon for 12 weeks

 

**denotes 8 weeks of treatment may be considered in patients without cirrhosis who have pre-treatment viral load (RNA) less than 6 million/IUmL

Note: Victrelis (boceprevir) + Ribavirin and Peg Interferon also approved for treatment. This regimen is associated with increased side effects and longer duration for treatment and therefore not considered a preferred method of treatment. Merck the makers of Victrelis notified the FDA it will no longer be selling Victrelis in the US by the end of 2015 due to more effective methods for treatment. It will remain available in other countries as a treatment option.

 

Harvoni By Gilead Sciences for Genotypes 1a, 1b.

Harvoni (Ledipasvir and Sovaldi), made by Gilead Sciences was approved by the U.S. FDA October 2014.

*1 pill, once daily dose combination of Ledipasvir and Sovaldi.

*Interferon and Ribavirin Free treatment for Genotypes 1a, 1b.

Treatment Duration Time: 

*Treatment Duration is 8 weeks for certain treatment-naive patients without cirrhosis and a baseline viral load below 6 million.

*Treatment-experienced patients without cirrhosis, 12 weeks of treatment is recommended.

* Treatment-experienced patients who have failed treatment with either peginterferon alfa + ribavirin or an HCV protease inhibitor + peginterferon alfa + ribavirin with cirrhosis  are recommended to take treatment for 24 weeks.

*SVR12 Cure rates range between 94 to 99%.

*Common Side Effects reported in >10% were fatigue and headache for those treated for 8, 12 or 24 weeks.

*Other side effects listed by the FDA reports less than 10% of patients experienced nausea, diarrhea and insomnia.

*Laboratory Abnormalities of elevations of Bilirubin and Lipase  and Creatine Kinase in a small percentage of patients were observed.

*Caution Drug Interaction: Risk of Reduced Therapeutic Effects of Harvoni due to P-gp Inducers; Rifampin and St. John’s Wort are not recommended for use with Harvoni as they may significantly decrease ledipasvir and sofosbuvir plasma concentrations.

*In addition to Rifampin and St. John’s Wort, there are other drug interactions with certain Antacids and other acid-reducing meds, Dignoxin, Anti-Seizure medications, Simprevir (Olysio), Rosuvastatin and HIV and TB medications.  See a complete list of drug reactions to Harvoni listed on Gilead’s/Harvoni website.  Be sure to talk to your physician and pharmacist about all medications and supplements you are taking prior to taking Harvoni.

 

Olysio/Sovaldi by Janssen for Genotypes 1a, 1b, 4

Olysio/Sovaldi Combo  approved by the FDA November 6th 2014. Olysio/Sovaldi Combo which consists of Olysio (simeprevir), a hepatitis C virus (HCV) NS3/4A protease inhibitor, in combination with Sovaldi (sofosbuvir) as an all-oral, interferon and ribavirin-free treatment option for genotype 1 patients.

Both drugs had received prior independent approval from the FDA.  Olysio (simeprevir) made by Janssen was approved November 22, 2013. Sovaldi (sofosbuvir) made by Gilead Sciences was approved December 6th, 2013.

* Patients with HCV genotype 1a infection should be tested for NS3 Q80K polymorphism which is a subtype virus strain of genotype 1. Not all Genotype 1 have this subtype.   Hep C patients with genotype 1 need to be tested for this subtype prior to considering treatment with Olysio.  Those with this subtype NS3Q8OK variant have a decreased response rate to treatment with Olysio and need to considered for another therapy.

*All oral treatment pills of Olysio (simprevir) and Sovaldi (sofosbuvir).

*All combinations of use with Olysio are: Olysio/Sovaldi, or Olysio/Sovaldi + Ribavirin or Olysio +Peg Interferon + Ribavirin.  Note: Olysio, Sovaldi and Ribavirin are pills. Peg Interferon is pen injection. Specific treatment combination will depend on genotype, liver condition, past Hep C treatment history.

Treatment Duration Time:

*12 to 24 weeks depending liver condition and past treatment history.

*Recommended treatment duration of OLYSIO with peg-interferon alfa and ribavirin: 12 weeks, followed by 12 or 36 additional weeks of peg-interferon alfa and ribavirin depending on prior response status.

  • For specific dosage instructions for the other antiviral drugs used in combination with OLYSIO, see their respective prescribing information.

*SVR 12Cure Rates range between 91% to 94%.

*Common Side Effects: the most common side effects for Olysio/Sovaldi are fatigue, headache and nausea.  Sun or light sensitivity and rash have also been reported. OLYSIO® combination treatment may cause rashes and skin reactions to sunlight. These rashes and skin reactions to sunlight can be severe and you may need to be treated in a hospital. Rashes and skin reactions to sunlight are most common during the first 4 weeks of treatment, but can happen at any time during combination treatment with OLYSIO®.

*Common Side Effects if Peg Interferon-alfa/Ribavirin are used: skin rash, itching and nausea. When taking OLYSIO® in combination with Peg-IFN-alfa and RBV, you should also read full Medication Guides at Olysio.com.

*Caution Drug Interaction: OLYSIO® and other medicines may affect each other. This can cause you to have too much or not enough OLYSIO® or other medicines in your body, which may affect the way OLYSIO® or your other medicines work, or may cause side effects. Do not start taking a new medicine without telling your healthcare provider or pharmacist.

Especially tell your healthcare provider if you take any of the following medicines (when taken by mouth or given by injection, where applicable): amiodarone (Cordarone®, Pacerone®) , amlodipine (Norvasc®), atazanavir (Reyataz®), atorvastatin (Lipitor®, Caduet®), carbamazepine (Carbatrol®, Epitol®, Equetro®, Tegretol®), cisapride (Propulsid®, Propulsid Quicksolv®), clarithromycin (Biaxin®, Prevpac®), cobicistat-containing medicine (Stribild®), cyclosporine (Gengraf®, Neoral®, Sandimmune®), darunavir (Prezista®), delavirdine mesylate (Rescriptor®), dexamethasone, digoxin (Lanoxin®), diltiazem (Cardizem®, Dilacor XR®, Tiazac®), disopyramide (Norpace®), efavirenz (Sustiva®, Atripla®), erythromycin (E.E.S.®, Eryc®, Ery Tab®, Erythrocin®, Erythrocin Stearate®), etravirine (Intelence®), felodipine (Plendil®), flecainide (Tambocor®), fluconazole (Diflucan®), fosamprenavir (Lexiva®), indinavir (Crixivan®), itraconazole (Sporanox®, Onmel®), ketoconazole (Nizoral®), lopinavir (Kaletra®), lovastatin (Advicor®, Altoprev®, Mevacor®), mexiletine (Mexitil®), midazolam, milk thistle (Silybum marianum) or products containing milk thistle, nelfinavir (Viracept®), nevirapine (Viramune®, Viramune XR®), nicardipine (Cardene®), nifedipine (Adalat CC®, Afeditab CR®, Procardia®), nisoldipine (Sular®), oxcarbazepine (Oxtellar XR,Trileptal®), phenobarbital (Luminal®), phenytoin (Dilantin®, Phenytek®), pitavastatin (Livalo®), posaconazole (Noxafil®), pravastatin (Pravachol®), propafenone (Rythmol SR®), quinidine (Nuedexta®, Duraquin®, Quinaglute®), rifabutin (Mycobutin®), rifampin (Rifadin®, Rifamate®, Rifater®, Rimactane®), rifapentine (Priftin®), ritonavir (Norvir®), rosuvastatin (Crestor®), saquinavir mesylate (Invirase®), sildenafil (Revatio®, Viagra®), simvastatin (Zocor®, Vytorin®, Simcor®), sirolimus (Rapamune®), St. John’s wort (Hypericum perforatum) or products containing St. John’s wort, tadalafil (Adcirca®, Cialis®), telithromycin (Ketek®), tipranavir (Aptivus®), triazolam (Halcion®), verapamil (Calan®, Covera HS®, Isoptin®, Tarka®), voriconazole (Vfend®) .

This is not a complete list of medicines that could interact with OLYSIO®. Ask your healthcare provider or pharmacist if you are not sure if your medicine is one that is listed above.

Know the medicines you take. Keep a list of your medicines and show it to your healthcare provider and pharmacist when you get a new medicine.

See Olysio.com for more information and full product guide.

 

Viekira Pak by AbbVie for genotypes 1a or 1b with or without cirrhosis

FDA approved Viekira Pak, December 19th 2014. Viekira Pak made by AbbVie is designed to treat Hep C patients who have genotype 1 varieties, with and without cirrhosis.

*A double pill regimen contains three drugs, ombitasvir, paritaprevir and dasabuvir. The double dose regimen contains one pill with ritonavir combined with paritaprevir and ombitasvir. The second pill contains dasavbuvir. Viekira Pak, an all oral treatment is Peg Interferon free. It can be used however with or without Ribavirin.

Dosing recommendations:

*Taken in the Morning: Two tablets of the combined ombitasvir, paritaprevir and ritonavir.

*Taken in the Morning and Evening: One tablet of dasabuvir.

*Viekira Pak is to be taken with a meal without regard to fat or calorie content.

*If Ribavirin is prescribed, dosing will be based on patient’s weight.

Treatment duration time:


Patient Population
Treatment* Duration
Genotype 1a,
without cirrhosis
VIEKIRA PAK + ribavirin 12 weeks
Genotype 1a,
with cirrhosis
VIEKIRA PAK + ribavirin 24 weeks**
Genotype 1b,
without cirrhosis
VIEKIRA PAK 12 weeks
Genotype 1b,
with cirrhosis
VIEKIRA PAK + ribavirin 12 weeks
*Note: Follow the genotype 1a dosing recommendations in patients with an unknown genotype 1 subtype or with mixed genotype 1 infection.
**VIEKIRA PAK administered with ribavirin for 12 weeks may be considered for some patients based on prior treatment history.

For Use in Liver Transplant Recipients

In liver transplant recipients with normal hepatic function and mild fibrosis (Metavir fibrosis score of 2 or lower), the recommended duration of Viekira Pak with ribavirin is 24 weeks, for Hep C patients with genotype 1 subtype.  When Viekira Pak is administered with calcineurin inhibitors in liver transplant recipients, dosage adjustment of calcineurin inhibitors is needed.

 SVR12 Cure Rates between 91% to 100%.

Common Side Effects for VIEKIRA PAK used with ribavirin, side effects include fatigue, nausea, itching, skin reactions such as redness or rash, sleep problems, and feeling weak.

For VIEKIRA PAK used without ribavirin, side effects include nausea, itching, and insomnia.

These are not all of the possible side effects of VIEKIRA PAK. See Viekira.com for more information and full product guide.  A healthcare provider should be notified if there is any side effect that is bothersome or that does not go away.

Drugs Contraindicated with Viekira Pak: Certain drugs may decease loss of therapeutic activity of Viekira Pak or lead to harmful side effects.  Make sure to talk to your physician about all medications, and supplements you take prior to starting treatment with Viekira Pak.  *Important review FDA release of Contraindicated Drugs and List of Drug Interactions for Viekira Pak.

Note: A contraindication is a specific situation in which a drug, procedure, or surgery should not be used because it may be harmful to the patient. There are two types of contraindications: Relative contraindication means that caution should be used when two drugs or procedures are used together. Absolute contraindication means that event or substance could cause a life-threatening situation. A procedure or medication that falls under this category should be avoided.

Caution Drug Interaction: Potential for VIEKIRA PAK to Affect Other Drugs and Potential for Other Drugs to Affect One or More Components of VIEKIRA PAK

VIEKIRA PAK can cause increases in liver function blood test results, especially if people use ethinyl estradiol-containing medicines (such as some birth control products).

Ethinyl estradiol-containing medicines (combination birth control pills or patches, such as Lo Loestrin® FE, Norinyl®, Ortho Tri-Cyclen Lo®, Ortho Evra®; hormonal vaginal rings such as NuvaRing®; and the hormone replacement therapy medicine, Fem HRT®) must be stopped before starting treatment with VIEKIRA PAK. If these medicines are used as a method of birth control, another method must be used during treatment with VIEKIRA PAK, and for about 2 weeks after treatment with VIEKIRA PAK ends. A healthcare provider can provide instruction on when to begin taking ethinyl estradiol-containing medicines.

A healthcare provider should do blood tests to check liver function during the first 4 weeks of treatment and then as needed. A healthcare provider may tell people to stop taking VIEKIRA PAK if signs or symptoms of liver problems develop.

A healthcare provider must be notified right away if any of the following symptoms develop or if they worsen during treatment with VIEKIRA PAK: tiredness, weakness, loss of appetite, nausea, vomiting, yellowing of the skin or eyes, or color changes in stools.

VIEKIRA PAK must not be taken if people:

*have severe liver problems

*take any of the following medicines: alfuzosin hydrochloride (Uroxatral®) – carbamazepine (Carbatrol®, Epitol®, Equetro®, Tegretol®) – efavirenz (Sustiva®, Atripla®) – ergot containing medicines including ergotamine tartrate (Cafergot®, Migergot®, Ergomar®, Ergostat®, Medihaler®, Wigraine®, Wigrettes®), dihydroergotamine mesylate (D.H.E. 45®, Migranal®), methylergonovine (Ergotrate®, Methergine®) – ethinyl estradiol-containing medicines – gemfibrozil (Lopid®) – lovastatin (Advicor®, Altoprev®, Mevacor®) – midazolam (when taken by mouth) – phenytoin (Dilantin®, Phenytek®) – phenobarbital (Luminal®) – pimozide (Orap®) – rifampin (Rifadin®, Rifamate®, Rifater®, Rimactane®) – sildenafil citrate (Revatio®) when taken for pulmonary artery hypertension (PAH) – simvastatin (Zocor®, Vytorin®, Simcor®) – St. John’s wort (Hypericum perforatum) or a product that contains St. John’s wort – triazolam (Halcion®), or have had a severe skin rash after taking ritonavir (Norvir®).

 

What should people tell a healthcare provider before taking VIEKIRA PAK

If they have: liver problems other than HCV infection, HIV infection, or any other medical conditions.

If they have had a liver transplant. If they take the medicines tacrolimus (Prograf®) or cyclosporine (Gengraf®, Neoral®, Sandimmune®), a healthcare provider should check blood levels, and, if needed, may change the dose of these medicines or how often they are taken, both during and after treatment with VIEKIRA PAK.

If they are pregnant or plan to become pregnant or if they are breastfeeding or plan to breastfeed. It is not known if VIEKIRA PAK will harm a person’s unborn baby or pass into breast milk. A healthcare provider should be consulted about the best way to feed a baby if taking VIEKIRA PAK. For pregnant females that have both HCV and HIV infection, they should talk with a healthcare provider about enrolling in the antiretroviral pregnancy registry.

About all the medicines they take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Some medicines interact with VIEKIRA PAK.

A new medicine must not be started without telling a healthcare provider. A healthcare provider will provide instruction on whether it is safe to take VIEKIRA PAK with other medicines.  See Viekira.com for more information and full product guide.

 

Sovaldi (sofosbuvir) by Gilead Sciences for genotypes 1, 2, 3, 4.  Used in combination with other Hep C medications

Sovaldi (sofosbuvir) made by Gilead Sciences was approved  by the U.S. FDA on December 6, 2013.

*FDA approved for Genotypes 1,2, 3, 4

*Oral treatment regimen for Genotypes 2 or 3

*Regimen for Hep C patients awaiting liver transplantation to prevent HCV recurrence.

Treatment and Duration Time:

*For Gentoype 1a, 1b: Treatments with either Harvoni (Sovaldi & Ledipasvir) or Sovaldi/Olysio are recommended with combination of Sovaldi.

*For Genotype 2: Sovaldi +ribavirin for 12 weeks.

*For Genotype 3: Sovaldi +ribavirin for 24 weeks.

Further treatment recommendations by American Association for Study of Liver Disease (AASLD) and Infectious Diseases Study of America (ISDA)

*For Genotype 4: Sovaldi +ribavirin for 24 weeks

*For Genotype 5: Sovaldi +ribavirin + peg-interferon alfa for 12 weeks.

*As an alternative treatment for Genotype 6: Sovaldi + ribavirin +peg-interferon alfa for 12 weeks.

Sovaldi in combination with ribavirin for 24 weeks can be considered for CHC (chronic hepatitis C) patients with genotype 1 infection who are interferon ineligible. Talk to your physician about which treatment option is best suited for your genotype, liver condition and any past treatment history.

SVR12Cure Rates 84% to 96%.

Common Side Effects For Sovaldi used in combination with ribavirin include; tiredness and headache and for Sovaldi used in combination with peg interferon alfa and ribavirin they include additional side effects of nausea, difficulty sleeping, and low red blood count. See separate side effect information for peg-interferon and ribavirin.

See Sovaldi.com for more information and full product guide.

 

Victrelis (boceprevir)made by Merck for Genotype 1a, 1b

Victrelis (boceprevir) made by Merck was one of the first protease inhibitors approved by the U.S. FDA in May 2011.

Victrelis is not to be taken alone. Use in combination with peginterferon and ribavirin.

***Important Notice for Victrelis by Merck: Victrelis is being discontinued in the U.S. by the end of 2015 “due to advances in treatment practices, and the consequent reduction in demand for Victrelis.” It will stay on the market in many countries where it “remains a valuable treatment option.” This regimen is associated with increased side effects and longer duration for treatment and therefore not considered a preferred method of treatment.

Treatment Duration Time:

 Victrelis (boceprevir) protocol is beginning the first four weeks of treatment using peginterferon and ribavirin, then adding victrelis (boceprevir) with peginterfeon and ribavirin and continue treatment for additional 44 weeks, making total treatment time 48 weeks.

SVR12 Cure Rates: 70%.

Common Side Effects of Victrelis (boceprevir) in combination with peg interferon alfa and ribavirin listed from Merck

*Blood problems. Victrelis can affect your bone marrow and cause low blood cell, and low white blood cell, counts.  In some people, these blood counts may fall to dangerously low levels. If your blood cell counts become very low, you can get anemia or infections.

* tiredness

*Low blood cell count (anemia)

* nausea

*headache

*change in taste.

*See side effects from peginterferon and ribavirin below.  Talk to your doctor if you have ever dealt with depression or anxiety and the possible need to take an anti-depressant while on treatment.

See treatment recommendations for full dosing, and duration for use with pegInterferon and/or ribavirin. See Victrelis.com for more information and full product guide.

 

Common Side Effects of Peginterferon 

See for more information Medline Plus/US National Library of Medicine/National Institute of Health

Peginterferon alfa-2b may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

*bruising, pain, redness, swelling, itching, or irritation in a place where you injected peginterferon alfa-2b

*nausea   *vomiting   *loss of appetite   *change in the way things taste

*diarrhea   *constipation   *heartburn   *weight loss   *headache   *dizziness

*confusion   *hair loss or thinning   *itching   *difficulty concentrating

*feeling cold or hot all the time   *changes to your skin   *dry mouth   *sweating

*flushing   *runny nose   *difficulty falling asleep or staying asleep

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, or those listed in the IMPORTANT WARNING section, call your doctor immediately:

*rash   *hives   *difficulty swallowing

*swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

*hoarseness   *fast heartbeat   *pale skin   *lower back pain

Talk to your doctor if you have ever dealt with depression or anxiety and the possible need to take an Anti-Depressant while on treatment.

 

Common Side Effects of Ribavirin

See for more information: Medline Plus/US National Libarary of Medicine/National Institute of Health 

Ribavirin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

*Cough  *upset stomach  *vomiting   *diarrhea   *constipation   *heartburn

*loss of appetite   *weight loss   *changes in ability to taste food   *dry mouth

*difficulty concentrating   *difficulty falling asleep or staying asleep

*memory loss   *rash   *dry, irritated, or itchy skin   *sweating

*painful or irregular menstruation (period)   *muscle or bone pain   *hair loss

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them, or those listed in the IMPORTANT WARNING section, call your doctor immediately:

*hives

*swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs

*hoarseness   *difficulty swallowing or breathing

*pain in the stomach or lower back   *bloody diarrhea   *bright red blood in stools

*black, tarry stools   *stomach bloating   *confusion   *dark-colored urine

*yellowing of the skin or eyes   *unusual bleeding or bruising   *vision changes

*fever, chills, and other signs of infection   *depression

*thinking about hurting or killing yourself   *mood changes   *excessive worry

*irritability

*starting to use street drugs or alcohol again if you used these substances in the past

*intolerance to cold

Talk to your doctor if you have ever dealt with depression or anxiety and the possible need to take an anti-depressant while on treatment.

 

People are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Deciding Which New Drug to Use

Each patient will need to look at the pro’s and con’s of the new medications.  Each has side effects to be considered.  Talk to your doctor about treatment side effects and which treatment is best suited for your genotype, viral load, liver condition and any past treatment history.

Also contact pharmaceutical companies.  Each company provides detail information on how the drug is used, side effects, drug interactions and more.  Each company also provides a 24 hour 7 day a week registered nurse support.

Talk to your doctor about drug interactions of all current medications that you are taking.

See my blog posts on Daily Life, and Hep C Patient Interviews / Hep C Patient’s Treatment Journey also see Videos .

 

 

References

harvoni.com

olysio.com

sovaldi.com

viekira.com

merck.com

victrelis.com

Ribavirin information

Peg Interferon information 

Mayo Clinic for Hepatitis C 

Center for Disease Control and Prevention for Hepatitis C 

American Liver Foundation for Hepatitis C

Life Beyond Hepatitis C.com