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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 goal of treatment is to slow or stop disease progression, and to limit further liver damage. Treatments for hepatitis B may only work for limited time and do not lead to a cure. New medications for hepatitis C are being developed rapidly. Many people with hepatitis C may be able to achieve a cure. Your doctor will work with you to find the combination of medications that work best for you.

Prescription Medications

  • Alpha interferons
  • Telbivudine
  • Entecavir
  • Lamivudine
  • Adefovir
  • Ribavirin
  • Protease inhibitors
    • Telaprevir
    • Boceprevir
    • Simeprevir
    • Sofosbuvir
    • Paritaprevir
  • NS5A inhibitors
    • Ombitasvir
    • Daclatasvir
    • Elbasvir
    • Velpatasvir
    • Ledipasvir
    • Grazoprevir
  • Dasabuvir
Alpha Interferons

Alpha interferon is injected, usually daily or 3 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
  • Paritaprevir

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)
NS5A Inhibitors

Common names include:

  • Ombitasvir
  • Daclatasvir
  • Elbasvir
  • Velpatasvir
  • Ledipasvir
  • Grazoprevir

NS5A inhibitors interfere with viral reproduction in the body. They are used in combination with other medications to treat hepatitis C. These medications have the most potential to lead to a cure.

Possible side effects may include:

  • Skin rash and itching
  • Nausea
  • Headache
  • Fatigue
  • Heart rhythm problems (daclatasvir)
  • Myopathy and myalgia—muscular weakness or pain
Dasabuvir

Dasabuvir is a polymerase inhibitor that blocks hepatitis C reproduction. When used in combination with other hepatitis C medications, it can result in a cure. Dasabuvir is taken orally.

Possible side effects may include:

  • Skin rash and itching
  • Nausea
  • Headache
  • Fatigue
  • Insomnia
  • Myopathy and myalgia—muscular weakness or pain
  • Liver damage
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 the medication as directed. Do not change the amount or the schedule.
  • Ask what side effects could occur. Report them to your doctor.
  • Talk to your doctor before you stop taking any prescription medication.
  • Do not share your prescription medication.
  • Medications can be dangerous when mixed. Talk to your doctor or pharmacist if you are taking more than one medication, including over-the-counter products and supplements.
  • Plan ahead for refills as needed.

Revision Information

  • Dasabuvir. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T908668/Dasabuvir. Updated February 6, 2017. Accessed February 7, 2017.

  • Elbasvir/grazoprevir. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T909692/Elbasvir-Grazoprevir. Updated February 6, 2017. Accessed February 7, 2017.

  • Hepatitis B, chronic. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/hepatitis/hepatitis-b,-chronic. Updated July 2016. Accessed February 7, 2017.

  • Hepatitis B and C treatments. US Food & Drug Administration website. Available at: http://www.fda.gov/forpatients/illness/hepatitisbc/ucm408658.htm. Updated January 31, 2017. Accessed February 7, 2017.

  • Hepatitis B virus (HBV) infection. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115624/Hepatitis-B-virus-HBV-infection. Updated June 29, 2016. Accessed February 7, 2017.

  • Hepatitis C, chronic. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/hepatic-and-biliary-disorders/hepatitis/hepatitis-c,-chronic. Updated July 2016. Accessed February 7, 2017.

  • Hepatitis C—treatment of genotype 1. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T908659/Hepatitis-C-treatment-of-genotype-1. Updated December 21, 2016. Accessed February 7, 2017.

  • Hepatitis C—treatment of genotypes 2-6. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T906076/Hepatitis-C-treatment-of-genotypes-2-6. Updated December 21, 2016. Accessed February 7, 2017.

  • Ledipasvir/sofosbuvir. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T907806/Ledipasvir-Sofosbuvir. Updated February 6, 2017. Accessed February 7, 2017.

  • Ombitasvir/paritaprevir/ritonavir/dasabuvir. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T908362/Ombitasvir-Paritaprevir-Ritonavir-Dasabuvir. Updated February 6, 2017. Accessed February 7, 2017.

  • Sofosbuvir/velpatasvir. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T909692/Elbasvir-Grazoprevir. Updated February 6, 2017. Accessed February 7, 2017.