Fifteen suggestions to discuss with your physician for managing the most common side effects of combination therapy are outlined below:
1.
Insomnia Getting a full night's sleep helps the body recover from physical and emotional stressors. Being fully rested lessens the side effects of fatigue, headache, fever, myalgia (muscle pain), irritability and insomnia. Talk to your health care provider; there are many medications available.
2.
Hydration Keeping hydrated is helpful to counteract the drying properties of combination therapy. Keeping hydrated is advised to improve fatigue, headache, fever, myalgia and dry mouth. Hydration is key in helping lessen 'brain-fog'.
3.
Nutrition Eating well-balanced meals helps the body bounce back from fatigue, headache, fever and myalgia. Small frequent meals are often helpful.
4.
Exercise Engaging in regular exercise keeps your circulation going and thus helps prevent fatigue, headache, fever and myalgia. It has also shown to promote a sense of normalcy and well-being. While on treatment,you may not be able to do what you used to be able to do but some exercise decrease loss of muscle mass.
5.
Relax Taking a hot bath or using hot packs is recognized for helping relieve myalgia, decreases stress and aids in sleep hygiene.
6.
Aches/Pains Taking acetaminophen (Tylenol) or NSAIDS can reduce fatigue, headaches, fever, myalgias or liver pain. However, dosage and safety considerations must be confirmed by your doctor since these drugs may place an additional burden on the liver.
7.
Blood disorders Ribavirin is well documented for causing
anemia, (low red blood cells). This causes more side effects of fatigue, shortness of breath, and feeling like a couch potato. A low white blood count
neutropenia can interfere with your ability combat infection. Your health care provider will regularly do blood tests to check levels, but do not hesitate to contact them if you feel there is a problem.
8.
Nausea/Indigestion Taking ribavirin with food and eating small, frequent meals helps ease ribavirin-related nausea. This is very important. Prochlorperazine (compazine) is a prescription medication which is used to stop nausea but should only be done under a physician's guidance. Take to your doctor about using one of the proton pump inhibitors (omeprazole, Nexium, Aciphex, Prevacid for example) for symptoms of indigestion or reflux. Include ginger in your day by drinking it in tea, ale or snacking on ginger baked goods to relieve indigestion and/or nausea.
9.
Fatigue Interferon can cause fatigue. It is the most reported side effect. Consider treatment and ridding yourself of hcv your primary goal. Take care of yourself. Monitor how much you do and pace yourself. Fatigue is worsened by anemia. Interferon can inhibit thyroid function. This too can cause fatigue, malaise, dry skin and hair loss.
10.
Caffeine Avoiding stimulants like caffeine at night can reduce insomnia and irritability.
11.
Irritability/Anxiety Practicing relaxation techniques, such as taking a deep breath and counting to ten, can significantly help reduce irritability. Irritability is caused by treatment. Your family and friends can help you recognize when you may be showing signs of irritability or anxiety. Talk to your primary care provider. There are many medications available.
12.
Depression Taking selective serotonin re-uptake inhibitors (SSRIs) have been proven effective in treating the depression associated with interferon therapy for certain individuals. The additional side effects of SSRIs and treatment guidelines must be carefully evaluated by your physician. If you have ever had a history of depression, anti-depressant therapy should be initiated prior to treatment. There are also other classes of anti-depressants.
13.
Support Sharing feelings with friends, family or a support group can help many people cope with the irritability and depression often accompanying HCV therapy.
14.
Hair loss Being gentle with your hair can help minimize hair loss. This includes not pulling on or braiding the hair, avoiding vigorous combing or brushing and only using natural (not harsh) hair products.
15.
Mouth sores Avoiding hot or spicy foods minimizes mouth irritation. For those dealing with the side effects of a dry mouth or mouth sores, avoiding these types of foods is a must.
Some of these tips for managing side effects are easily accomplished at home while others require collaboration with your physician. However it is accomplished, reducing side effect severity helps people endure a full course of combination therapy, a feat that increases their odds of eliminating the Hepatitis C virus.
References:
www.clevelandclinic.org, Managing Side Effects of Hepatitis C Treatment, The Cleveland Clinic Department of Patient Education and Health Information, 2008.
www.hepatitis.va.gov, Clinical Manual: Interferon and Ribavirin Treatment Side Effects, United States Department of Veteran Affairs, 2008.
www.hepcawareness.net.au, Treatment Side Effects, Australian Hepatitis Council, 2008.