Treatment Side Effect Guide

7/28/2019 Treatment Side Effect Guide

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A Guide to Hepatitis C

treatment

side effect

management

A publication of the Hepatitis C Support Project

T h irmati i thi guid i digd t hp yu udrtad ad maag HCV ad i t itdd a mdicaadvic. A pr with HCV hud cut a mdica practitir r diagi ad tratmt HCV.Permission to reprint this document is granted and encouraged with credit to the author and the Hepatitis C Support Project.

Alan Franciscus, Editor-in-Chief

Lucinda K. Porter, RN


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TAble o ConTenTs

rwrd . . . . . . . . . . . . . . . . . . . . . . . 1

Maitaiig a Pitiv Attitud . . . . . . . . . . . . . 2

sid ect that nd Urgt Attti. . . . . . . . . . 5

Ach ad Pai . . . . . . . . . . . . . . . . . . . . 6

atigu ad sp . . . . . . . . . . . . . . . . . . . 9

Mta ad Pychiatric symptm . . . . . . . . . . . 13

symptm Ratd t eatig ad nutriti . . . . . . . 18

ski, Hair, nai, ey . . . . . . . . . . . . . . . . 28

bd Dfcici . . . . . . . . . . . . . . . . . . 33

Micau . . . . . . . . . . . . . . . . . . . . 36

Wrd r amiy ad rid . . . . . . . . . . . . . 38

Rurc . . . . . . . . . . . . . . . . . . . . . . 40


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ForewordHpatiti C tratmt ha dramaticay imprvd with th itrducti pgyatd i-trr ad riaviri r pp with HCV gtyp 2 ad 3 ad with th trip cm-iati a HCV prta ihiitr ad pgyatd itrr pu riaviri thrapyr pp with HCV gtyp 1. It i w pi t radicat th viru i i up t79% pp with HCV gtyp 1 ad up t 82% i pp with HCV gtyp

2 ad 3 with currt HCV tratmt. Hwvr, HCV mdicati hav may id -ct, which ca ad t d rducti r dictiuati thrapy.

Th icidc id ct itd i thi Guid ar tak rm DA packag irt pgyatd itrr ad riaviri thrapy ad prtati ad rprt giv th w cmiati thrapi a HCV prta ihiitr, pgyatd itrr adriaviri.

Accrdig t th natia Ititut Hath Cu tatmt HCV icti,

uccu HCV tratmt rquir tayig th prcrid d mdicati rth prcrid prid tim. Th imprtac takig a th HCV prta i-hiitr i v mr imprtat i icraig th rp rat ad prvtig thdvpmt ritac t th w HCV prta ihiitr mdicati. sid ctthat itrr with quaity i ca hampr thi ga, it imprtat t maag idct ary, aggrivy, ad apprpriaty. Th gd w i that th maagmt tratmt-ratd id ct ha a dramaticay imprvd, thu makig tratmtair t trat.

rtuaty, thr ar may imp ad practica tp yu ca tak t avid r r-duc riu id ct. A Guide to Hepatitis C Treatment Side Effect Managementprvid uu tip t hp had th id ct HCV thrapy. o th mtimprtat tratgi i t maag ay id ct r thy cm riu.

Important Note: Report all side effects to a medical provider as soon as possible.Treatment side effects should always be evaluated and managed by healthcare profes-sionals.

It i imprtat t rmmr that t vry xpric th am id ct, rar a id ct cariy vr. I act, m pp may xpric w r id ct. Hwvr, it i imprtat t prpard r th wrt, ad hpuy yurymptm wi vr ad air t maag.

Athr imprtat cmpt uccu id ct maagmt i t taih agd upprt ytm prir t tartig HCV thrapy. Pr upprt grup, amiy, adrid ca hp mt pp gt thrugh th mt difcut tim durig HCV thrapy.

May pp hav cmptd thrapy ad rmai r HCV. Jut cmptig

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Maintaining a Positive attitude

Maitaiig a pitiv attitud whi udrgig tratmt may diicut, ut

it i tia, ad hud at th tp yur it r id ct maagmt.Thr i citiic data at thi tim t upprt th ti that a pitiv attitudwi hav a impact hpatiti C r tratmt utcm. Hwvr, may patitrprt that attitud wa a imprtat part tayig thrapy. striv t maitaia pitiv attitud, ut raitic. n ca achiv prcti 100% thtim. A pitiv attitud i a prc ad t a ia ga. D t t yur upr aiur. Thi i a tim wh yu d t gt with yur.

AttitudeHw d yu maitai a pitiv attitud? Thr ar may tp yu ca tak.

r xamp, r giig thrapy, mak a it th ra why yu arrcivig tratmt ad rad th it t.

Reasons to undergo therapy include:

Toimproveyourhealth

Tolivelonger

Tofeelthatyouhavedoneallthatyoucando Tobealiveforyourchildren,grandchildren,andlovedones

Toexperiencelifeandallithastooffer

Tosimplygetridofthevirus

ToputhepatitisCanditstreatmentbehindyou

Tohavechildren

Toreducesymptomsandincreaseyourqualityoflife

2

tratmt i a ucc i ad it. I hp that thi guid wi hp giv yu th tt mak a dirc i yur i.

Aa racicuexcutiv Dirctr,

Hpatiti C supprt Prjcteditr-i-Chi, HCV Advcat

lucida K. Prtr, RnHpatiti C supprt Prjct itructr,

HCV Advocatewritr, ad authr Freefrom Hepatitis C


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Topreventlivercirrhosisandlivercancer

Tohelpyoureachpersonalandprofessionalgoals

Toavoidbeingaburdentoothers

startig th day with a pitiv attitud i ha th att. Wh yu wak

up i th mrig, try t thik mthig yu ar gratu r i yur i. rxamp:

IamgratefulthatIhavetheopportunitytotakethistreatment

Iamgratefulforthepeopleinmylife

IamgratefulIhavearoofovermyheadandabedtosleepinatnight

Try rtructurig yur thught prc. sutitut pitiv thught r gativ

. Rpat thm t yur v i yu d t iv thm at irt.

Insteadofthinking,Imoverwhelmed,say,IamdoingthebestIcan

Insteadofthinking,Imtired,substitute,Thiswilleventuallypass

Insteadofsaying,Icantdothis,trysaying,Icandothisbecauseitisonlytemporary

I th vig wh yu ar gig t p, k ack yur day ad diwhat mad yu ttr ad what mad yu wr. Cgratuat yur

r gttig thrugh th day! Rmid yur that yu ar mr day cr tyur ga cmptig tratmt.

Supportstayig pitiv whi thrapy wud diicut i a pr did t hav a

taihd upprt ytm i pac w r tartig tratmt. It i imprtat tgt upprt rm a may ara a pi. supprt ca cm rm may urc,icudig amiy, rid, c-wrkr, hathcar prvidr, ad pr ud i up-prt grup. I yu d t arady attd a hpatiti C upprt grup, cidr

jiig r tartig thrapy.

Personal AppearanceKpig a pitiv attitud i air wh yu tak gd car yur dy, i-

cudig yur apparac. Wh yu k gd, yu gray ttr. I yuwak up i th mrig ig achy ad ut rt, yu may ttr i yutak th tp t tay w grmd. startig yur day ig rh wi hava pitiv iuc yur mti r th tir day.

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Try these strategies:

Showerorbathedaily;spoilyourselfwithbathproductsthatsmellandfeelgd

Lightacandleandlistentosoothingmusic

Takecareofyourhandsandnails

Moisturize,moisturize,moisturize Considergettingadifferenthairstylethatisattractive,easytotakecareof,

ad wud attrig i ca yu xpric hair

Brushandflossyourteethregularly

Men:shaveortrimfacialhair

Women:ifyouregularlyusemake-up,continuewhileontreatment

Getdressedevenifyouwillbelyingonthecouch;choosecomfortablecloth-

ig Wearcolorsthatmakeyoufeelgood

Exerciseexrci i th mt imprtat cmpt hath maitac, ad thi

rmai tru durig thrapy. Phyica activity hp yu tay pitiv ad cudad imprv yur gra w-ig. Mdrati i th ky t phyica activity.exrci cm i may rm. Yu d t hav t pd a rmu amut

my r ru a marath t tay it. Try w-impact activiti uch a: Stretching

Walking

Hula-hooping

Swimming

Dancing

Gardening

Yoga Pilates

Taichiorqigong

Relaxationbig HCV tratmt ca tru. May pp vrwhmd y

tryig t rmmr t tak thir mdicati, daig with id ct, ctiuigt wrk at a j, ad hadig amiy rpiiiti. It i imprtat t uid i

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tim r raxati. Try m th tratgi t hp yu rax:

Meditation:trysayingMayIbewellwhileyouinhaledeeply,andsaying,Mayothersbewellasyouexhale

Prayer:practiceyourpreferredspiritualorreligiousobservanceatleastoncea day

Lightacandleandlistentomusic Insteadofholdingyourbreathwhenyoufeelstressedout,trybreathingin

ad ut gty ad wy

Sitorwalkinaplaceofnaturalbeauty,suchasabeach,forest,garden,orpark

Social EventsTratmt-ratd id ct ad th vryday dmad i ca crat m

ucrtaity. Maitai a cia i, ut raitic wh chduig dat r ap-pitmt. Th urt way t cm dprd i t iat yur rm amiyad rid. Hwvr, it i imprtat t tak with amiy ad rid r tartigtratmt that thy ca udrtad ad upprtiv i yu d t cac radjut yur pa. smtim jut th kwdg that yu ca cac r av acia activity ary may hp rduc tr. Try t rax ad jy th tim ptwith rid ad vd .

Other Daily Strategiesegag i activiti that mak yu augh. Ch cmdi rathr tha mvi

with paiu thm. Rad th cmic, watch itcm, r d mthig yujy. U humr durig diicut mmt t gt a ttr prpctiv.Laughtermaynotbethebestmedicine,butitsurehelps. Indulgeinafavoritehy. Mt a, ar t pampr yur, ad t thr pampr yu, t.

2. side effects that need urgent attention

al y mm, mp kw ympm m . cll y mmly y xp y l-lw:

Severedepression

Thoughtsofharmingyourselforothers

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Chestpain

Persistentfeverorfeverthatcontinuestoincrease

Lossofvisionorblurryvision

Difficultybreathing(shortnessofbreathwithexertioniscommonwiththerapy)

Moderatetosevererash;worseningofpsoriasis

Bloodydiarrhea Unusualbleedingorbruising

Severeabdominalorlowerbackpain

Youoryourfemalepartnerbecomespregnant

Anysymptomthatmightbepotentiallylife-threatening

Anysymptomsthatcauseexcessiveanxiety

3. aches and Pains

Flu-Like SymptomsItrr i a atura chmica prducd y ur immu ytm. Wh w

ight a cd r u, w th ct ur w itra itrr: vr, chi,maai, dy ach, ad hadach. Mauacturd itrr cau th am

ct. Mt pp th ymptm r vra hur r day atr thir irtitrr ijcti. Th u-ik ymptm gray at r a w hur, ut mayxtd it th xt day. sm pp hav u-ik ymptm atr vry ijcti,whi thr hav migy radm ymptm that d t w a rguar pattr.Hwvr, m patit vr hav u-ik ymptm, r might hav thm y atrthir irt ijcti. Athugh irqut, m patit xpric may thid ct thrughut th cur thir HCV tratmt.

Tips for managing flu-like symptoms:

schdu ijcti r jut r dtim

Donotschedulethefirstinjectionthenightbeforeamajorevent,suchasyourwddig

Askyourmedicalproviderifitisallrighttopre-medicatewithregularstrength(650mg)acetaminophen(Tylenol)

Drinksufficientwaterthroughoutthedaybeforeyourinjectionandthroughouttratmt

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Putlayersofblanketsandclothesatyourbedsidetomanagechills

Ifyourteethchatter,removedenturesorotherbreakabledentalappliances

Toreducefever,staycool,butdonotgetchilled.Acetaminophen,removingayr akt ad cthig, ad ukwarm pg ath ca prvidri

Getplentyofrest Remember that these initial reactionsare only temporary(typically lasting

fourtoeighthours)andthatlosingagoodnightssleepisnottheendofthewrd. Dt rgt, yu ar ivtig i yur utur

Body AchesMuc, jit, ad dy ach ar cmm id ct itrr tratmt.

sm pp th ct jut atr thir irt ijcti. othr xpric dyach thrughut tratmt, ithr itrmittty r ctiuuy. Thr ar vra-hp maur yu ca try. irt, gt a prpr diagi r th cau pair giig a -hp rgim. May cditi ca cau dy ach, a prpr diagi i th irt ad mt imprtat tp i gd mdica car.

Tips for managing body aches:

Askyourphysicianabouttheuseofprescriptionandnon-prescriptionmedica-ti t hp with pai

Trygentlestretchingexercises

Avoidprolongedperiodsofinactivity

Applyheatoricepacks

Trywarmorhotbaths.Spoilyourselfwithabubblebath.(Beware:hotbathscandrytheskin)

Massagemaybehelpful

sm ditary uppmt ar purprtd t riv iammati ad arthriti. I

thi itrt yu, dicu th iu with yur mdica prvidr.

HeadachesAut 40 - 60% patit xpric hadach whi HCV thrapy. A-

thugh i m ca th hadach aciatd with HCV tratmt ca dii-tatig, mt pp id that thy hav mid hadach that cm ad g. I yuxpric a pritt r gig hadach r mr tha 24 hur, ctact yurhathcar prvidr immdiaty.

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Thr ar may tratgi t hp riv th hadach pai. irt, it i impr-tat t ru ut ay cau thr tha tratmt id ct that may cauig rctriutig t a hadach. str, imia, ad dit ca a iduc hadach.Atr ruig ut thr pi cau, thr ar m imp tp that may hpprvt th ccurrc r rduc th vrity a hadach.

Tips for preventing headaches: Limitcaffeineintakebyavoidingcaffeinatedcoffee,teas,and/orsodas,es-

pciay i th at atr r vig

Drinklotsofwaterorotherclearfluids

Avoidloudnoises,brightlights,andstrongodors

Trytogotosleepandwakeupatthesametimeeachday

Eatallmeals,especiallybreakfast,atroughlythesametimeeachday

Pamperyourselfduringstressfultimes Getmoderateexerciseregularly,atleastthreetimesperweek

Dontforgettoplay,relax,andenjoylife

Trytofindapatternorthereasonfortheheadache,suchasfood,stress,orthr triggr actr

Ak yur mdica prvidr r a it vr-th-cutr r prcripti mdica-ti. nvr -mdicatthi ca a rcip r diatr! I yu tak crtaityp pai mdicati, yu may dvp rud hadach, which cud a ad a r wr tha th rigia hadach.

oc a hadach ha tartd, th am tratgi that prvt hadach caa hp a th pai.

Tips for relieving headaches:

Dependingonthetypeofheadache,acooldampcloth(orfrozenpeas)ap-

pid t th ack th ck r rhad may prvid m ri Someheadachesrespondtowarmcompresses

Placealavender-scentedaromatherapypillowonyoureyeswhileyourest.lar acuprur pit r hadach ri

Tryrelaxationtechniquessuchasbiofeedback,prayer,ormeditationtohelpwith th pai ad tr that cm with a hadach

Occasionallyheadaches respondtosmallamountsofcaffeine. Blacktea,

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c, ca drik, ad excdri a ctai cai. Try thi y ccai-ay, ic cai ca a cau hadach. A, d t try i th atatr r vig, ic cai ca kp yu awak at ight

4. fatigue & sLeeP

Fatigueatigu i athr cmm id ct HCV tratmt, ad hpatiti C it-

. I ciica tria a HCV prta ihiitr ad pgyatd itrr puriaviri, th majrity patit rprtd atigu. Tak t yur mdica prvidr ithi i a ccr. othr mdica cditi that ad t atigu may ccur durigHCV tratmt. Amia, dpri, imia, ad hypthyridim ar id ct HCV thrapy aciatd with ig xhauti. Th ca a tratd.

Aumig yu hav arady cutd yur dctr, xami thr imprtat ac-tr that iuc rgy v: p, utriti, ad xrci. Iadquat r prquaity p ca ad t ig daytim tird. Mak ur yu ar gttiguicit p. Th natia sp udati tat that th avrag adut dv t i hur p pr ight.

b ur t at d with high utritia vau. ruit ad ut ar gd chic.

eat ma, rqut ma. Mak ur yu ar gttig uicit quatiti vitamiad mira. stay w hydratd y drikig pty watr. r th avragadut, thi ma drikig a ha t a wh ga watr daiy.

light xrci i pray th ig mt ctiv atidt r atigu. Thi ca hard t iv, pciay i jut gttig ut d i a rda. Wh yu dnotfeellikemoving,moveanyway.Asapopularadvertisementsays,Justdoit.Try xrciig r 10 t 15 miut itrva, tw t thr tim daiy. I yu ar taccutmd t phyica activity, tart wy ad r hrtr, rqut prid.

sm activiti t try ar wakig, ikig, wimmig, dacig, gardig, yga,tai chi, qigg, ad Piat.

Tips for managing fatigue:

Stresscanbedraining.Learnrelaxationtechniques

Unmanageablepaincanbeexhaustingseekhelp

Varyyouractivitiesdonotsittoolongorstandtoolong


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Balancerestwithactivity.Trytorestbeforeyougettoofatigued

Restevenifyouarenottired.Thismayhelpyouavoidfuturefatigue

Takeshortnapsnomorethan20minutesandnotclosetobedtime

Takeashower.Alternatewatertemperaturesfromhottocold

Practicegoodposture

Stretch Avoidalcohol,tobacco,andrecreationaldrugs

Makesureyourindoorspaceissunnyorwelllit

Askforhelpwithchoresandotheractivities

Createshortcuts

Organizeyourworkareassoyoucanworkmoreefficiently

Scheduleyourmostdemandingtasksforthetimesofthedaywhenyouare

uuay at yur t Takeminivacations.Spendanafternoondoingsomethingyoureallyen-

jy

Rubyourearlobesforatleastsevenseconds

Findwaystolaugh

Practicedeepbreathingforaminutewheneveryoufeeltired

TryChinesemedicineorhypnosis

Attitud cat cur atigu, ut it ca a pwru ay. Watch th gativself-talk.

Wh a ai, augh. Thr i dut aut it: atigu put a dampr i. Hwvr, atigu accmpaid y humr i mr tra tha atiguaccmpaid y miry. Th chic i yur.

Thr ar a hr, uppmt, ad vitami that may hp riv atigu.Hwvr, thr ha t much rarch th u hr, uppmt, advitami durig HCV thrapy. Th t advic i t avid th utac durigthrapy, r dicu thir u with yur mdica prvidr r tryig thm.

InsomniaImia, r havig tru gttig t p ad tayig ap, i th

mt cmm id ct HCV tratmt. Ay wh ha vr urd rmimia ca attt t th act that it ca mak yu mira. It may v mak


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th thr id ct tratmt wr.

start y takig t yur dctr. A varity mdica iu ca cau p pr-m. o xamp i p apa. sp apa itrr with rathig durigp ad ca cau riu hath prm. Pp with p apa t dt kw thy hav it. rtuaty, p apa ca tratd.

T yur hathcar prvidr aut a th ditary uppmt ad drug yuaretaking(over-the-counter,prescription,orrecreational).Someofthesemaybectriutig t yur p prm. r itac, gig ad crtai cd mdi-ci ca kp pp awak.

Gttig t tirrd up r dtim ca a mak it hard t a ap. Wr-ryig ca cau u t t ad tur. Watchig th w r xrciig r d-tim ca vry timuatig. sp xprt rcmmd avig th TV ut thdrm. Tur th TV ad yur cmputr a hur r tw r dtim.

The following can interfere with a good nights sleep:

Caffeineincoffee,sodas,tea,chocolate

Tobacco

Aroomthatistoohotortoocold

Light

Noise Anuncomfortablebed

Usingalcoholbeforebedtime

Beinghungry

Eatingalargemealclosetobedtime

Drinkingtoomanyliquidsbeforesleep

Asnoringbedpartner

Apetinthebedroom

Tips for promoting sleep:

Makeeighthoursofsleeparegularhabit.Sleepinglessduringtheweekandtryig t catch up th wkd dt wrk

Trytogotobedatthesametimeeverynight

Ifyouhaveaclockthatisalwayslit,turnitsoyoucantseethetime


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Exerciseeveryday

Ifyounap,keepitshortandearlyintheday

Tryreadingbeforebedtime,butusealow-wattbulb

Donoteatduringthefewhoursbeforebedtime,butdontgotobedhungry.I yu at mthig, ch d that i ight ad utritiu. Avid picy r

gray d Takeahotbathbeforeretiring

Ifyoufeelyouneedtoworry,tellyourselfthatyouwillonlyworryintheday-time.Makeyourbedroomafret-freezone.Learnrelaxationtechniquestorduc tr ad wrryig

Listentorelaxationtapesbeforeretiring

Donotlayawakeinbedformorethan20to30minutes.Getup,dosome-thig rig r a itt whi, ad th g ack t d

Yourbedisforsleepandsex.Ifyouarenotdoingeitherofthese,stayout d

sm hra ta ca ud t aid raxati. Chammi ta i thmr widy ud hr r p prmti. Th dwid hra ta i thatm pp ar awakd durig th ight y th d t uriat. Th ct avdr i r ar th d i thught t prmt raxati. I yu uhr t aid p, vry cautiu. Pp with hpatiti C hud avid m

hr, pciay whi udrgig HCV tratmt.

I p prm prit, yur mdica prvidr may wat t prcri mdicatit hp yu p. bth prcripti ad vr-th-cutr drug ca vry c-tiv. sm mdicati ca hait-rmig, it imprtat t t yur prvidri yu hav a hitry utac au. With uicit ad accurat irmati,

yur mdica prvidr i iky t id a mdicati that i uitd t yur d.I th mdicati yu try d t wrk w r yu, rprt thi t yur prvidr.

Thr ar may drug t trat imia, ad mtim it i a mattr tria adrrr t id a gd it.

Insomniacanbeadrainonyourqualityoflifealifealreadyaffectedbyothertratmt id ct. D t ay awak thikig aut it. Gt m hp!


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5. MentaL & PsYchiatric sYMPtoMs

Imprtat nt: Th diagi ad tratmt pychiatric ad thr mdica di-rdr rquir a traid mdica pria. Irmati ctaid i thi guidi itdd r ducatia purp y. It hud t ud a a utitut r

pria diagi ad tratmt ay mta r pychiatric dirdr. Pacut a mdica pria i th irmati hr ad yu t iv yu rm yu kw may hav a pychiatric r thr mta i.

Cognitive Changes and Difficulty Concentratingl cctrati, mmry, ad th aiity t thik cary ar rqut id

ct HCV tratmt. but t vry ha th ymptm, ad th whd hav a wid rag xpric. I thi i a prm r yu, tart y takig

t yur mdica prvidr. May actr ca cau cgitiv chag. Mdicatica hp aviat m cgitiv prm.

Tips for managing concentration and cognition problems:

Bephysicallyactiveonadailybasis.Acombinationofstretching,strengthtraiig, ad aric activity i a ida apprach

Eatanutritionaldiet.Fruitsandvegetables,alongwithotherhigh-valuefoods,ca prvid urihmt r yur rai. D t kip ma

Drinksufficientwater Managestress.Meditationandrelaxationtechniquescanhelpyouthinkmore

cary

Avoidalcoholandunhealthysubstanceuse

Getsufficientsleep.Theaverageadultneedsseventoninehoursofsleepach ight

Breatheoxygenisessentialtoourbrains

StaymentallyactiveA r rgtu, thr ar tchiqu yu ca u t imprv yur mmry.

lirari uuay hav k mmry imprvmt.

Tips for improving memory:

Usedailyorweeklypillcontainers

Useacalendarorjournaltorecordwhenyouarescheduledtotakemedica-ti a w a wh yu hav tak thm. Yu ca a u thi t kp


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track yur mdica appitmt

Usepost-itnotestoremindyourselfofmedicalappointmentsandmedicationchdu

Setthealarmsonyourwristwatch,alarmclock,electronicorganizer,orcom-putr t rmid yu aut mdicati ad appitmt tim

Getyourselforganized Createhabitsanddailyroutines

Writethingsdownandkeepyourlistsinthesameplace

Doonetaskatatime,ratherthanmulti-tasking

Payattentiontowhatyouwanttoremember

Visualizewhatyouwishtorecall

Userepetitiontofastensomethinginyourmemorybank

Depression, Anxiety, Mania, and Other Mood ChangesTh prcriig irmati that accmpai pgyatd itrr ad riaviri

it dpri, pychi, ad uicid amg th pttia id ct. Agitati,md atrati, aggriv havir, diicuty cctratig, maia, ad ipardirdr hav a rprtd. I ciica tria, irritaiity, axity, ad r-vousnesswerereportedbyathirdofpatients.Insomniaoccurredinabout1/3ofpatientsandandabout2/3experiencedfatigue.Insomniaandfatiguearebothymptm dpri, ad ca a cau r wr dpri ad axity.nrvu, imia, ad atigu may a ymptm thr udryigdirdr, uch a thyrid armaiti, utac au, r mdicati prm.Thi cti wi dcri m th urpychiatric id ct HCV mdica-ti yu ca dicu thm with yur hathcar prvidr.

imp n: i my l- py- . i y yl , kmm pl lp.

Anxiety and DepressionDpri i th mt cmm id ct HCV thrapy. Dpri

may rag rm mid t vr. I tria, 1% t 2% patit rprtd uicidathught r attmpt, ad 2% tppd tratmt prmatury du t dpri.

Mt pp thik that axity ad dpri ar ppit id th ci,


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ut i act, thy t ccur tgthr. Axity accmpai dpri i c tha a dprd patit. smtim rrrd t a agitatd dpri, uchpatientsmayhavefeelingsofirritability,anger,restlessness,orbeingonedge.sm pp may rprt a icra i wrryig r hav iv thught.

Symptoms of Depression

Th ymptm HCV tratmt-iducd dpri ar t imiar t th i rguar dpri, ad may icud:

Feelingsad,down,orblue

Fatigueorlowenergy

Irritabilityoranger

Agitationorrestlessness

Feelingonedge

Moodswings Feelingapatheticorempty

Inabilitytoconcentrate

Excessiveworry

Changeinappetite

Thoughtsofself-harmorsuicide

r patit with a hitry dpri, itrr-iducd dpri may

xpricd dirty tha prviu pid. r xamp, a patit whprviuy t withdraw wh dprd might xpric ig agr adirritaiity durig tratmt. Thi i imprtat t kw, cau i what yu arxpricig w d t ik prviu pid dpri, yu may iky t rprt it.

Help for Anxiety and DepressionI yu ar cidrig HCV tratmt, t yur hathcar prvidr i yu hav

a currt r pat hitry dpri r pychiatric i. It i pciay impr-tanttoreportseveredepression,hospitalizationforanypsychiatricillness,oranyuicid attmpt.

smtim atidprat mdicati ar ud i cjucti with HCV tratmt.May patit ay that atidprat mad a hug dirc i thir quaity i whi udrgig HCV tratmt. Dpri d t away tart immdiatyatr giig HCV thrapy. ot, patit d t tic dpri uti ur ttwelveweeksorevenlongerintotreatment.Ifyounoticeanyfatigueormood


18/4416

chag uch a irritaiity, ack paur, r ig dpri atr tartigitrr, tak t yur dctr.

It tak tim r atidprat mdicati t tak ct, d t xpct im-mdiat rut. Whi m pp may tic imprvmt atr a wk r tw,atidprat typicay mut tak rguary r ix t ight wk r thir

u ct i t. startig atidprat r giig itrr ca hp prvtdpri r it vrity. sic atidprat ca hp with thr mdicacmpait, uch a atigu ad imia, m dctr rutiy tart patit th mdicati prir t iitiatig HCV tratmt. Tak with yur dctr autwhthr yu hud tart atidprat prir t HCV thrapy r tart itrrirt ad th whthr yu thik yu d tratmt r dpri.

Thr ar may dirt typ atidprat mdicati. Atidpratthmv ca cau id ct, ut thy ar uuay mid. Hwvr, m ideffectscanbeserious;tellyourdoctoraboutanysideeffectsthatareunusual,an-yig, r act yur activiti r quaity i. Cmm atidprat id -ct icud drwi, hadach, aua, ig agitatd r jittry, ad xuaprm. smtim a drug id ct ca actuay wrk i a pitiv way.Imia, r xamp, may aviatd y a atidprat that i ighty dat-ing.Antidepressantscaninteractwithcertaindrugs;informyourdoctoraboutanyvr-th-cutr r prcripti mdicati, rcratia drug, hr, r upp-mt yu ar uig, ic th may act hw yur atidprat wrk.

Important Note:Avoid alcohol, since it can worsen depression and may interactwith antidepressants and reduce their effectiveness.

Wh it i tim t tp takig atidprat mdicati, patit d t tapr wy. nvr tp a mdicati withut irt takig with yur dctr. Th ymp-tm itrr-iducd dpri ad axity wi graduay ad away atr

yur HCV thrapy ha dd. Uuay pp wait a mth r mr atr cmpt-ig HCV tratmt r thy rady t tp takig atidprat. Yu maytic icrad axity ad dpri atr dictiuig atidprat. It maytaketimebeforeyoufeellifehasreturnedtonormal.Patienceandsupportwillrv yu w.

Bipolar Disorderbipar dirdr, rmry kw a maic-dpriv i, i a rai cditi

characterizedbymoodswings.Mostofushavenormalupsanddowns.However,th ymptm ipar dirdr ar much mr it ad ca xtrmy -


19/4417

vere.Thedownphaseofbipolarisdepression,whiletheupphaseiscalledmaia. occaiay, a ipar patit wi hav ymptm dpri, utt hav ay viu ymptm maia. Hwvr, th ymptm maia maycm appart atr tartig mdicati r th tratmt dpri. I yutic ymptm maia atr tartig atidprat, rprt th immdiaty.lik imp dpri, ipar dirdr ca tratd.

Symptoms of ManiaAccrdig t th natia Ititut Mta Hath, ymptm maia i-

cud:

Increasedenergy,activity,andrestlessness

Excessivelyhigh,overlygood,euphoricmood

Extremeirritability

Racingthoughtsandjumpingfromoneideatoanother

Talkingveryfast

Distractibility,unabletoconcentratewell

Littleneedforsleep

Unrealisticbeliefsaboutonesabilitiesandpowers

Poorjudgment

Spendingsprees

Aprolongedperiodofbehaviorthatisdifferentfromusual Increasedsexualdrive

Abuseofdrugs,particularlycocaine,alcohol,orsleepingmedications

Provocative,intrusive,oraggressivebehavior

Denialthatanythingiswrong

Self-Help for Mood ChangesTh mid ad th dy ar t parat r idpdt rm athr. Yur

dy act yur mid, ad yur mid act yur dy. str ca wak thimmu ytm ad mak it hardr t rit dia. ig uw ca ad t i-crad atigu ad mr dpri. brakig th cyc dpri may rquira mid-dy apprach. Thr ar a umr way yu ca hp yur. Thwig uggti ar t itdd t rpac mdica car, ut may hac

yur quaity i.


20/4418

Tips for managing mood changes:

Getsupport.Lookforasupportgroup,eitherforhepatitisCorfordepression.Askyourfamilyandfriendsforsupport;avoidisolation

Avoidorreducestress.Trystressmanagementtechniquessuchasyogaandmditati, r tak a tr maagmt ca

Trytobephysicallyactiveeveryday.Evenifyoudonotliketoexercise,finda way t mv yur dy

Getatleasteighthoursofsleepeachnight

Avoidalcohol,tobacco,excesscaffeine,andrecreationaldrugs,whichcancau r wr dpri ad axity

Eatahealthylow-fat,high-fiberdietthatincludesfruits,vegetables,andwholegrai

Balancerestandactivity;paceyourself,takebreaks,planahead,anddel-gat.

Practicepositivethinking;trytoreplacenegativethoughtswithmessagesofhp ad airmati

Findwaystolaughandamuseyourself;trytopickatleastonepleasurableactivity ad id th tim t d it t

6. sYMPtoMs reLated to eating & nutrition

Note: Ribavirin, boceprevir (Victrelis), and telaprevir (Incivek) are to be taken withfood; the instructions for telaprevir are very specific. For more information, seeHCSPs Fact Sheetik (tlp): 20 gm f.

Nauseanaua ca a ymptm hpatiti C it, a w a HCV thrapy. It ca

a caud y may thr actr, uch a tr, hadach, thr viru ractria, ach, ack d ad drik, r vridugc i d ad drik. R-gard th cau, aua ca hav a riu impact a pr w-igad quaity i. It ca a act hw yu tak yur mdicati ad vwhthr yu wi tay thrapy.

naua i typicay dcrid a ig ick t th tmach, ad ca rag rmgra quai t a trg urg t vmit. Athugh vmitig i t a cmm


21/4419

tratmt id ct, dy r pritt vmitig rquir urgt mdica car.

It i imprtat t id ut what i cauig aua that apprpriat tp ca tak t ctr it. Try t igur ut what triggr yur aua. Th uti may a imp a atrig yur atig ad drikig hait.

Tips for controlling nausea: Ifmorningnauseaisaproblem,eatsomedrycrackerswhenyoufirstwake

up, ad gt ut d wy

Avoidfoodsandodorsthattriggernausea

Passonspicy,greasy,anddeep-friedfoods

Eatsmallamountsoffoodeveryfewhoursratherthantwoorthreelargemealspr day

Duringperiodsofnausea,avoidacidic juices (orange,grapefruit,pineap-ple);instead,tryclearjuices,gingerale,chickenbroth,herbaltea,orsportsdrik

Drinkandeatslowly

Consumefoodsatroomtemperature(neitherveryhotnorverycold)

Takeover-the-countermedicationfornauseaasrecommendedbyyourhealth-car prvidr

Usepeppermint,chamomile,orgingerteatohelpcalmyourstomach

Tryraworcookedginger

Suckongingercandyorlollipops(availableatmosthealthfoodandmaternitystores)

Tryrelaxationtechniques

Exerciselightly,suchaswalkingoryoga

Tryacupunctureoracupressure

Wearacupressurewristbands

I aua imprv t th pit whr yu a t at, ch ad, a-ilydigestiblefoods,suchasbananas,rice,applesauce,toast,andtea(theBRATTdiet).

I aua itrr with yur aiity t tak yur mdicati, d t ,r cm wr, ctact yur hathcar prvidr. Thr ar may prcriptimdici t hp trat aua. It i imprtat t a practiv a pi that


22/4420

yu ca cu tayig tratmt. sm th impt tip ca mak a hugdirc i hw yu .

DiarrheaDiarrha i did a r watry t that ccur thr r mr tim pr

day. I additi t ig a pttia id ct itrr ad riaviri tratmt,

may actr ca cau diarrha, icudig actria ad vira icti, drug,crtai d r vrag, ad axity.

A with aua, diarrha ca graty act yur vra hath ad adhrc ttratmt, it i imprtat t trat diarrha a a ymptm appar. Diarrhaca ad t dhydrati ad rducd quaity i, a w a ctri t utritdicici. ntiy yur mdica prvidr i yu xpric ay th wig:

Severediarrheathatlastslongerthantwodays

Dramaticweightloss(fivepoundsormore)thatoccursinoneday Bloodinthestooloraroundtheanalarea

Uncontrolledfever,feverhigherthan100.6F,orfeverthatlastsmorethan24hur

Severestomachorintestinalcramping

Tips for controlling diarrhea:

Drink plenty ofclear fluids, suchaswater,weak tea,or broth (vegetable,chicken,orbeef)

EatPopsiclesorgelatin

Eatsmallfrequentmeals

Keeptrackofbowelmovements

Consumefoodsthatarehighinpotassium,suchasbananasandpotatoes

Stayawayfromhigh-fiberfoods,suchaswhole-grainbreadsandcereals

Avoidspicy,fried,andgreasyfoods Stayawayfromveryhotorverycoldfoods

Abstainfromalcohol,caffeinateddrinks,andtobaccoproducts

Choosebland,easilydigestiblefoods,suchasbananas,rice,applesauce,toast,andtea(theBRATTdiet)

Diarrha ca dry, cha, ad irritat th aa ara. Atr a w mvmt,wah ad ri th ara with warm apy watr r ay wip ad pat dry with


23/4421

a t tiu r cth. Appy a watr-rpt cram arud th aa ara t hprelievepainandirritation.Awarmsitzbath(sittinginabathtubfilledwithwarmwater)mayrelievepainanddiscomfort,aswellashelpyourelax.

Rprt vr diarrha t yur hathcar prvidr immdiaty. Yur dctr mayrcmmd vr-th-cutr mdicati ik Imdium r a prcripti drug t trat

diarrha. D t -mdicat. Ctrig diarrha i a imprtat part takigcar yur. It wi ur that yu tay hathy ad ttr, ad wi hpoptimizeyourHCVtreatmentoutcome.

Weight Losssvr wight ca a riu prm durig hpatiti C tratmt. Gttig

prpr utriti rm a hathy dit i a imprtat part maitaiig yur vrahath durig thi tim. A majrity pp udrgig HCV thrapy rprt midt mdrat wight . Urtuaty, th wight aciatd with HCV trat-mt may a cmiati rguar wight ad a rducti i dy mucma. r thi ra, icudig uid ad d a part yur mdica rgimwi hp maitai gd hath. exrci i a imprtat, ic it icra mucma, timuat th apptit, hp kp th immu ytm trg, ad cmatdpri ad axity. bid HCV thrapy it, may actr ca ctriutt wight , icudig tat chag, aua, vmitig, diarrha, dpri, ra vractiv thyrid. T dtrmi th udryig cau, wight hud vauatd y a mdica prvidr.

Tips for preventing weight loss:

Consultwith a dietician or nutritionist for information on healthy foodchic

Choosefoodsthatarehighincaloriesandprotein

Drinkclearjuicesinadditiontowaterforextracalories

Add powderedmilk to regularmilk, milkshakes, casseroles, soups, eggs,mahd ptat, ht cra, ad puddig

Spreadpeanutbutteronbread,tortillas,waffles,pancakes,fruit,andcelery

Addcookedbeansorhard-boiledeggstosoups,casseroles,andpastathatarady ctai ch r mat

Tryproductsdesignedtopromoteweightgain,suchasnutritionalsupplements,cad rmua, prti pwdr, itat rakat drik, pwr ar, adhigh-cari puddig


24/4422

I yu ctiu t wight dpit uch tratgi, tak t yur hathcarprvidr aut mdicati t hp with thi. sm atidprat ca timuatappetitewhilehelpingwithothermedicalissues.Ifyouhavesevereweightloss(fivepoundsormoreinaweek),shortnessofbreath,ordizziness,consultwithamedi-ca prvidr immdiaty.

DehydrationTh imprtac drikig a adquat amut watr durig HCV tratmtcat vrtatd. May th id ct aciatd with itrr-adthrapy ca graty rducd impy y drikig watr. Ca yu drik t muchwatr? Y. Drikig xciv amut watr ca act th dy ctrytaac, which cud ad t riu hath prm. Thrr, it i imprtat tchck with yur hathcar prvidr r dramaticay icraig th amut yudrik vry day.

Th pitiv ct drikig watr id ct maagmt i quit utatia.May pp takig HCV thrapy rprt that thy xpric a markd dcra iid ct day wh thy drik pty watr, cmpard t day wh thydrik itt r watr. It i rcmmdd that yu drik watr right r adright atr -ijcti ad tay w hydratd thrughut th wk.

The benefits of drinking water include:

Flushesoutwastesandtransportsnutrients

Regulatesbodytemperature

Hydratestheskin,whichhelpsreducethedryskinsyndromecausedbyHCVmdicati

Lubricatestherespiratorytract,whichhelpsrelievethecoughsomepeoplegt whi uig riaviri

Aidsthedigestivesystem,helpingtopreventconstipationandotherproblems

Replacesfluidslostduringaboutofvomitingordiarrhea

CountersthereducednaturalsalivaproductioncausedbyHCVmedication,which ca icra th rik dta caviti ad dia

Keepsyourgumshydratedandrinsesawayharmfulbacteriainthemouth

Tips for drinking enough water:

Drinkwaterbeforeyoufeelthirsty.Thiswillhelpyoutostaywellhydrated,ic thirt i a ig dhydrati


25/4423

Drinkwaterinsteadofcaffeinatedbeveragessuchassodas,tea,andcoffee.Caiatd vrag dpt th dy uid, which citat drikigv mr watr

Keepwaterinplacesyoufrequentathome,intheoffice,andinthecar

Addasliceoflemon, lime,mint,ginger,orcucumbertoadd flavor tothewatr

Sipwaterthroughout thedayinsteadofgulpingit,togiveyourbodymoretim t ar it

How Much Water?

Thr ar may way t cacuat a hathy pr miimum daiy watr d.Whi HCV thrapy, yu hud drik at at th daiy rquirmt ad piymr, dpdig yur hathcar prvidr advic. o mthd cacuatig

yur miimum daiy watr rquirmt i t divid yur dy wight i pud ytw. That umr rprt th tta umr uc yu hud triv t c-um ach day. r itac, a pr wh wigh 150 pud wi d t drik75ouncesofwaterperday(nine8ozglasses,orslightlymorethantwoquartsortwolitersperday).

Additional information on converting measurements is available athttp://www.easysurf.cc/cnver13.htm.

Note: When you compute the daily amount of fluid needed remember that thefood you eat and other liquids you consume count towards your daily total.

How Can You Keep Track?

numru tudi hav maurd th amut watr pp drik daiy. It ha hw that th amut watr mt pp drik ach day i much thathy d t tay hathy ad w hydratd. A, pp uuay drik watrtha thy thik thy d, cau mt pp d t kp track thir daiy cump-

ti. r thi ra, it i imprtat t kp a rcrd hw much yu drik.

Tips for keeping track of water intake: Fillabottlewithfreshwater.Writedownthevolumeofwaterthebottleholds

ad hw may tim yu ri it thrughut th day. Buycommercialwaterbottlesthatlistthefluidcontent.Filluporbuyenough

tt t mt yur daiy rquirmt. st th tt i pai viw t hpyu rmmr t drik a th tt.
http://www.easysurf.cc/cnver13.htmhttp://www.easysurf.cc/cnver13.htmhttp://www.easysurf.cc/cnver13.htmhttp://www.easysurf.cc/cnver13.htm


26/4424

Taste ChangesChag i th way d ad vrag tat i a ra prm r may pp

HCV thrapy. Patit uuay dcri thi a havig a mtaic tat i th muth.Medicaltermsfortastechangesarephantogeusia(phantomorfalsetastes),dys -geusia(unpleasanttastes),andparageusia(abnormaltastes).Othermedicalcon -ditions,suchasazincorvitaminB12deficiency,cancausephantogeusia.Report

tat chag t yur mdica prvidr ad dtit thy ca ru ut thr cau.Tat chag ca act may ara i, ic d i uch a itgra part ur cia iv ad vra hath. T utai w, it i imprtat t maitaia hathy dit thrughut tratmt. Trat d a part yur mdica rgim.

Tips for managing taste changes:

Drinkplentyofwater

Eatwithplastic,wooden,orporcelainutensilsinsteadofmetalones

Usenon-metalliccookware,suchasglass

Add tart flavorings such as vinegar, lemon, lime,ororange juice to yourd

Eatcoldfoodsratherthanhotones

Marinatemeatstoenhanceordisguiseflavors

Avoidstrongfoodsandodors

Tryfoodsthatarehighinprotein,suchaseggs,tofu,chicken,fish,ornuts

Samplevariousdairyproducts,suchascheese,yogurt,cottagecheese,oricecram

Sorbet,sherbets,frozenfruitbars,andsmoothiesmaytastebettertoyou

Flavoryourfoodwithhorseradishormustard

Avoidcannedfoods,especiallythosewithlowornosodium(Watchyourso-diumintakeifyouareonasodium-restricteddiet)

Ifafooddoesnottastegoodtoyou,takeabreakfromitforawhile

Tryanewfoodoronethatyoudidnotlikeinthepast.Youmightfindthatyu jy it whi yu ar gig thrugh HCV tratmt

Eatcrisp,coldfoods,suchasjicama,bellpepper,andapples

Beforeeating,rinseyourmouthwithclubsoda,warmsaltwater,oramouth-wah mad tap at ad tap akig da i 1 cup warmwatr

Donoteatordrink flavoredfoods,especiallycitrus, immediatelybeforeor


27/4425

atr ruhig yur tth

Takegoodcareofyourteethbrush,floss,andreceiveregulardentalcheck-up

Askyourhealthcareproviderifzincsulfatewouldbeworthatry;atypicald i 220 mg twic daiy

Remember,yoursenseoftastewillreturnafteryouhavecompletedHCVtreat-mt

Somepeoplereportthateatingjustasmallpieceofchocolatehelpstoelimi-at th mtaic tat

Mouth SoresDurig HCV tratmt, m patit cmpai muth r. Thi may

icud r r ucr th gum, chk, ad tgu, piy accmpaid

y rd. Muth r ar mtim cad cakr r. Th mdica trm iaphthu ucr. br tratig muth r, cut yur hathcar prvidr ttai a prpr diagi. May actr ca cau muth r, ad it i imprtatt udrtad what caud th prm r it ca ixd.

Hw d yu cur cakr r? Th awr i, yu pray cat. Thr arremediesthatcanmakethemlesspainfulorhastentheirhealing,butaswiththecommoncoldthereisnoreliablecureforthecommoncankersore.Theexceptioni i yur particuar varity cakr r i caud y a udryig cditi that

ca rmdid. Cakr r that ar aciatd with d itiviti, mdica-ti, utritia dicici, r th u dium aury uat ca tratd ith cditi ar rvd.

Thr ar vra hm rmdi yu ca try. Tak t yur hathcar prvidraut th uggti, particuary prir t uig ay hr r uppmt.

Tips for preventing and relieving mouth sores:

Maintainoralhygiene.Begentlewhenbrushingyourteeth,butdontskipit Avoiddentalproductsthatcontainsodiumlaurylsulfate

Useasoftbristletoothbrush.

Drinklotsofwater.Adequatehydrationisimportantforhealthmaintenance,particuary durig HCV tratmt

Donotdrink liquids that areexcessivelyhot.Iceorfrozenjuicebarsmayth muth r


28/4426

Tryover-the-counterproductsthatnumbcankersores.Productsthatcontainbenzocaine, benzoin tincture, lidocaine, camphor, or phenol canprovidetemporaryrelief from thepainofmouthsores (OrabaseandZilactac-Baretwoexamples)

Applyaprotectivebarriertothelesion.Thereareover-the-counterproductsthat rm a im t cvr muth i, makig thm vura t irrita-

ti Maintaingoodnutritionbyeatingwell.Discusswithyourdoctorwhetheryou

shouldtakeamultivitaminorotherdietarysupplement.(Somepeoplesuckonzinclozenges,butthereisnodatatosupporttheeffectivenessofthisrem-edy)

Avoidfoodsthatarehard,crunchy,spicy,salty,oracidic

Reducestress

Keepafooddiaryto see ifa particular food iscausingmouth sores. Tryimiatig upctd d

Swish,thenspitorswallowateaspoonfulofanantacidsuchasmilkofmag-nesia(magnesiumhydroxide)orMylanta(aluminumandmagnesiumhydrox -ides)withateaspoonfulofliquidBenadryl(diphenhydramine)fourtosixtimesdaiy

Trytea.Blackandsomeherbalteasarehighintannin.Ausedteabagplaced a cakr r may prvid ri

Considertakingananti-inflammatorymedicationsuchasibuprofen.Becare-u cau thi mdicati ca a cau aphthu ucr, ad t vryca r hud tak iupr

Acetaminophen(Tylenol)mayhelpreducepain.Donotexceedrecommendeddag, ic thi drug ca pttiay harm yur ivr

Infusesageandchamomileinwater,anduseasamouthwashfourtosixtimesdaiy

Tryraspberry,peppermint,andlicorice

Trytakinglactobacillus.Theseharmlessbacteria,sometimescalledprobiotics,ar part th atura ittia ra. Thr ar may rad actaci-lus,suchasLactinex.(Althoughrelativelysafe,itisnotrecommendedifyouhav a prthtic hart vav r vavuar hart dia, athma, a argy tdairyproducts,orarepregnant,tryingtogetpregnant,orbreast-feeding)

Lysinemaybebeneficialforherpes-relatedmouthsores.Thegeneralrecom-mdati i 500 mg t thr tim daiy


29/4427

imp n: e my p m l, b l b hcv m, y hiv-p, y mm -.

MedicationI -prcripti rmdi d t prvid uicit ri rm muth r-

, tak t yur dctr aut prcripti drug. Dpdig yur particuarcditi, thr ar a umr dirt chic. Aphtha i a rativy wmdicati that rm a prtctiv arrir wh appid vr muth ucr. Crti-ctrid mixd it oraa ar mtim ud. Yur dctr may prcri aiquid atiitic muth ri. Thaidmid i mtim prcrid r HIV-pitivpatit urig rm vr aphthu ucr, ut thi drug hud t ud yHIV-gativ pp r y wm wh ar prgat r tryig t gt prgat. Ia hrp viru cau yur muth r, tak t yur mdica prvidr, thy mayprescribeacyclovir(Zovirax)orotherprescriptionmedicationtopreventorlessenth durati ad vrity utrak.

Yur dctr may prcri a uti vicu idcai, magium hydrxidatacid, ad diphydrami t wihd ad ithr wawd r pit ut, d-pdig yur particuar cditi. Vicu idcai a may appid tmuth r r tmprary ri. I yur dctr prcri a mdicati that mut appid dircty t th cakr r, d th wig. Dry th r y gty daigit with a tiu. Put th mdici a ca ctt wa ad da th r with th

wa. D t at r drik uti th mdicati ha had a chac t dry ad rma arrir. U a mdicati r th gth tim yur dctr advi.

Mouthsorescanbeagonizingandcaninterferewithyourabilitytoeatandyourvra quaity i. D t igr muth ucr that ar vry paiu r arg,r r that rcur, d t ha, r appar i cutr. Cakr r may t mt a ig da, ut th wh hav urd thrugh thm kw jut hw paiuthy ca . Rducig pai ad ctrig rcurrc ca hp immy adimprv yur quaity i.

Dental HygienePr dta hygi ca ad t tth dcay, gum dia, muth itr, ad

thr prm. It i gray rcmmdd that a dta xam cmptd -r giig HCV thrapy. Pp ar a curagd t hav prcdur ucha dta iig, gum urgry, r rt caa w r tartig HCV tratmt.Durig HCV thrapy, atura aiva prducti i dcrad, which ca ad t i-crad rik r dta prm uch a tth dcay ad icti.


30/4428

Tips for maintaining good dental health:

Brushteethregularly(beforeandaftermeals)withasoftbristletoothbrush

Flossonaregularbasis,butbegentlesothatyourgumsarenotinjured

Usesalivasubstituteproductsifnecessary

Self-examineyourteeth,gums,andallareasofthemouthfrequently

Rinseoutyourmouthoften,especiallyaftermeals Suckonsugarfreecandies,suchaspeppermint,toproducemoresaliva

Ifyoucanaffordit,scheduleanadditionalteethcleaningduringHCVtreatment.I yu rguary yur dtit twic a yar, cidr gig thr tim

7. sKin * hair * naiLs * eYes

Skin Rashes and ItchingIt m ik amt vry patit udrgig HCV tratmt dvp m typ

ki prm. Th mt cmm ki prm ar rah caud y riaviriandtelaprevir.Skinproblemsareusuallynotserious,butcanbeveryannoying;however,therearesomerashesassociatedwithtelaprevir(Incivek)thatcanbextrmy riu ad pttiay i-thratig. Cut with yur hathcarprovideroradermatologist (skinspecialist) ifyoudevelop skinproblemsduring

tratmt. D thi a a yu tic ki prm ic it i much air t gta mid rah udr ctr tha it i t try t maag a vr rah. I thr i ayrd, wig, r accumuati uid r pu, thi cud idicat a icti, rprt it t yur prvidr.

I gra, HCV thrapy ca cau dry ki, it i t urpriig that mt pp

ur rm thi id ct durig tratmt. symptm may rag rm mid dry akyki t vr ki irritati icudig ump ad itr. Th itchig aciatdwith rah i uuay midy ayig. At it xtrm, itchig ca irritatig

that it itrr with quaity i. Itchig td t wr i th vig admay itrr with p.

Avoidscratching;ifyoumustscratch,neveruseyourfingernailsorsharpobjects,ic thi ca ad t icti. Thi i pciay imprtat r pp thrapy,ic itrr ca wr th whit d c cut, which, i thry, ca ad ta gratr chac icti.


31/4429

Tips for combating dry skin and itching:

Avoidsoap.Useanon-soapcleansersuchasCetaphilorasimilarsubstitute

Try rubbing,vibration,orapplyingpressureinsteadofscratching.Agoodthingtoscratchwithisanicecube

Drinkplentyofwaterorotherclearfluidstokeepyourentirebodyhydrated

Applymoisturizerimmediatelyafterashowerorbathbeforedryingoffwitha tw

Creamsaremoreeffectivemoisturizersthanlotions

Applymoisturizeratleasttwiceaday.EffectivemoisturizersincludeVaseline,Av, eucri, ad luridrm rad

Useonlynon-perfumed,mildbathandpersonalcareproducts

Avoidextremelyhotshowersandbaths

Takeanoatmealbathtorelieveitchingandhelpwithrelaxation Trybakingsodaorunscentedbathoilsforbathing

Applycoldpacks(wrappedinatowel)totheskin

Wheneverpossible,wearloosefittingclothesmadefromnaturalfabricsthatrath

Protectyourskinfromthesunwearsunscreen

Lookafteryourlipsuselipbalmwithsunscreen

Getplentyofrest Keeproomsventilatedandatatemperatureof60to70degrees

r mid itchig r rah, ak yur mdica prvidr i yu ca u a vr-th-cutr tpica hydrcrti cram. D t u hydrcrti yur ac rr prgd prid u dirctd t d y yur dctr. ora atihitamisuchasdiphenhydramine (Benadryl)orhydroxyzine(Atarax)canrelieve itchingad a hp with p prm.

Injection Site ReactionsSomepeopleexperienceageneralizedskinreactionintheareawheretheyinject

itrr. I yu xpric ctiud pai, wig, irritati, r icti at thijcti it, cut a mdica prvidr immdiaty. rtuaty, th mt cmmijcti it racti ar mid ad mr a uiac tha a riu prm.Hwvr, it i imprtat t w th cary tp t ur that yu ar uigth crrct ijcti tchiqu.


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Tips for safe injection:

Reviewinjectiontechniquesfoundinthemedicationpackageinsert

Washyourhandswithsoapandwaterbeforeinjectingtopreventinfection

Makesurethemedicationisatroomtemperature

Makesurethattheareatobeinjectediscleanandsterile

Applyalcoholandletitdryfor10to20secondsbeforeinjecting Theeasiestandleastpainfulareastoinjectincludetheabdomenandthighs;

avid ijctig it th waiti r t c t th av

Thesizeoftheneedleisimportant;checkwithaphysicianorpharmacistforrcmmdati ad a prcripti i dd

Positiontheneedlewiththebevelupwhenyouinject

Injectata90-degreeangle

Donotmassagetheinjectionsite Afterinjecting,coverthesitewithabandage

Clothingcanirritatetheinjectionsite,sowearloosenaturalfabrics

Topicalcreamscanhelpwithminorirritations

Rotateinjectionsitesuseadifferentplaceeachtimeyouinject.Somepeopleatrat tw th tmach ad th thigh t mak ur thy d t acci-dtay ijct i th am pt twic i a rw

I yu wat t war a athig uit that xp yur thigh r a tp that hwyur midri, mak a chic r th thr. Ijcti it rd i cmm,ad yu may t wat t wak arud xpig rd tch yur ki. r i-tac, i yu ar a wma paig a ach vacati whr yu wat t war a-pic athig uit, ci yur ijcti t yur adm tartig aut urwk prir t th vt. start rtatig yur it agai atr yu rtur.

nd ad yrig hud vr rud, ad ud ijcti quipmt hud

beplacedinapuncture-proofdisposablesharpscontainer(availablethroughyourpharmacyorhealthcareprovider).Donotthrowthefullcontainerintoyourhouse -hd trah. Dip it a itructd y yur mdica prvidr r pharmacit.

Nail ChangesHCV thrapy ca act yur igrai ad, t a r xtt, tai. nai may

cm dry ad ritt. Thy may a dvp ridg ad may rak aiy.


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Tips for taking care of your nails:

Keepnailsshort

Usehandlotionsandcreamsasoftenaspossible,especiallyafteryourhandshav i watr

Wearglovestoprotectyourhandswhendoingchoressuchasdishwashing,

caig, gardig, r uig chmica Atbedtime,applyoilsorthickcreams (suchasAveenoorEucerin) toyour

had. smar xtra yur ai. War ctt gv whi yu p tprtct yur ht ad cthig

Ifyoupolishyournails,usegentlepolishremovers

Betteryet,avoidnailpolishandotherharshnailproductsaltogether

Usenailstrengthenersandtrybuffingtobringoutashine

imp n: i y y l plly m, kw w kp wll yl m bl-b . tl bk k my m w bl l b ly p ly l bw l. c by y w pl l k w y kp .

Hair Losssm hair i cmm r hathy pp. I act, th avrag pr

tw 50 ad 150 hair ach day. Hair ca caud y may dirtactr, icudig hrdity, harh hair tratmt, ad variu mdica cditi.Interferontherapycancauseexcessivehairloss(alopecia)andchangesinhairtxtur. such chag may ccur a vr th dy, t jut th had. It i rarr a pr itrr t a hi r hr hair r g ad, ut may pptic that thir hair i thiig, r that it i cmig ritt ad rakig . Haircr may cm du ad hair txtur may chag durig thrapycury hair mayv cm traight r vic-vra.

Tratmt-ratd hair ad chag i txtur may act dy imag admd, it i highy rcmmdd that pp k pria pychgicaupprt r hp rm a pr-d upprt grup. Th gd w i that hair adchag i hair txtur ar y tmprary. Th hair wi uuay grw ack atrtratmt i cmptd. sm pp v rprt that thir hair grw ack urad thickr tha r.

Itisimportanttoknowthatminoxidil(Rogaine)willnotworktocounteract


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itrr-iducd hair . I act, mixidi hud avidd cau it cairritateanddryoutthescalp.Anewerdrug,finasteride(Propecia)isalsounlikelyt prvid ay it. Apprvd y r ma-pattr ad, virtuay thigi kw aut th u thi drug r itrr-iducd hair . Additiay,mt pp wi d with HCV tratmt aut th tim it tak r iatridt wrk.

Tips to reduce hair loss and related problems:

Donotwashyourhairtoofrequently

Avoidthechemicalsfoundindyesandpermanentsusenaturalproducts.Ifyu d u chmica yur hair, ch th midt prduct avaia

Ashort,layeredhaircutwillmakehairlookthickerandfuller

Keepyourhairconditioned;usemoisturizersanddetanglingproducts.Somepp war y nixi prduct, avaia at a r auty uppy tr.r maximum ct, gi uig cditir r yu tart HCV tratmt

Usehairproductsthataddbodyandtexture

Avoidhairdryers,rollers,andcurlingirons

Combandbrushyourhairless;chooseasoftbrushorwide-toothcomb

Donotteaseorback-combyourhair

Useasunscreen,hat,orscarftoprotectyourscalpandhairfromsundamage.spurg hat ad carv that acctuat yur t atur

Avoidhairstylesthatcouldstrainyourhair,suchashairweavesorbraiding

Sleeponasatinpillow

Wearahair-pieceorwig

Eye Problemssm rar ut riu y prm ca ccur durig HCV tratmt, ary

diagi ad itrvti i tia. oy a mdica prvidr r y pciait

i quaiid t vauat ay vii r y prm.

Imprtat nt: A r dcra vii rquir immdiat mdica attti.

sm cmm y prm ar t immdiaty riu. Dry i th.Tak t yur mdica prvidr aut th u prrvativ-r -prcripti ar-tiicia tar. sm pp rprt that th quaity thir yight dimiih durigHCV tratmt. Thi may du t dry y, atigu, rma agig, r mdicati.Agai, tak t yur mdica prvidr i thi i a ccr.


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A ai y xam r yu tart HCV tratmt i rcmmdd. Yury hud rtur t rma i th wk ad mth wig th d thrapy.excpti t thi ar chag du t rma agig ad piy m rar r u-tratd mdica prm.

8. BLood deficiencies

Hemolytic AnemiaRd d c carry xyg t dy tiu, prvidig u th dy d t

tay aiv ad hathy. Th rma avrag i pa a rd d c i aut 120days;afterredbloodcellshavewornout,thespleenremovesthemfromcirculation.Hmytic amia i a cditi i which rd d c ar dtryd atr thath dy ca mak ugh w t rpac thm. Riaviri, cprvir adt a r xtt taprvir ar th mai cau amia.

SymptomsTh mt cmm ymptm amia icud hrt rath, atigu,

pa ki, chi, rapid hart rat, dpri, ad rducd quaity i. I tuchckd, hmytic amia ca ad t jaudic, dark uri, ad a argdp. I vr ca, it ca ad t hart attack. r thi ra, pp hudhav a phyica xam t ru ut ay pttia hart prm r tartig HCV

tratmt.

DiagnosisAsimplebloodtestcalledacompletebloodcount(CBC)measuresvarious

cmpt th d icudig rd c, whit c, ad patt. Amia idiagd uig tw tt that maur rd d c ad thir xyg-carryigcapacity: hmgi ad hmatcrit. A w hmgi r hmatcrit idicatamia.

Normal Ranges

Adult Male Adult Female

Hemoglobin 13.5-17.5 g/dL 12.0-16.0 g/dL

Hematocrit 42.0-52.0 % 37-47 %

Source: www.rush.edu


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TreatmentThr ar tw apprach t tratig hmytic amia: riaviri d rducti

anduseofagrowthfactorhormone(erythropoietin)topromoteredbloodcellpro -ducti. Riaviri-iducd hmytic amia cat tratd y atig ir richd r takig ir r vitami b12 uppmt.

I gra, riaviri d rducti r th u rd d c grwth actrarerecommendedwhenthehemoglobinlevelgoesbelow10g/dLorifthereisaigiicat drp i hmgi v vr a hrt prid tim. Pp with hartdia hud mitrd vry caruy wh thir hmgi v tart tdrp. Riaviri may hav t dictiud i th drp i hmgi v iutatia. Th gra rcmmdati i t tp takig riaviri r HCV thrapyaltogetherifthehemoglobinleveldropsbelow8.5g/dL.

sm mdica xprt iv that riaviri d rducti hud avidd,pciay durig th irt 12 wk thrapy, ic a adquat riaviri dhp prvt rap ad imprv th chac achivig utaid virgicaresponse(SVR).

Erythropoietinalfa(EPO;brandnameEpogenorProcrit)andDarbepoetinalfa(Aranesp)promoteredbloodcellproductioninthebonemarrow.Clinicalstudiesuig ePo t trat HCV tratmt-iducd hmytic amia hav hw a avr-ageincreaseinhemoglobinlevelsof2.0g/dLandimprovementinpatientsquality

i. ePo i DA-apprvd r chric kidy aiur, cacr chmthrapy, HIVthrapy, ad u r ctiv urgry. Athugh ePo i cmmy ud t tratriaviri-iducd hmytic amia, it ha t apprvd y th DA r thipurp, taiig iurac cvrag r rimurmt may diicut.

A warig ha addd t th ePo prduct packag irt aut riu adlife-threateningcomplicationsthatmayberelatedtotheuseofEPO.Tominimizeth rik it i rcmmdd that y th wt d dd i ud r a imitdamut tim.

It i imprtat t tiy ad wrk cy with yur mdica prvidr i yu ticay ymptm amia, i rdr t ur that yur HCV tratmt wi a uc-cu a pi.

NeutropeniaTh primary ucti whit d c i t ight icti. Thr ar may

dirt typ whit d c, uch a utrphi, ymphcyt, mcyt,


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eosinophils,andbasophils.Neutropeniaisaconditioncharacterizedbyanabnor-may w umr utrphi.

nutrpia ccur i m hathy pp ad m t mr prvat icrtai ppuati, r xamp back ad Ymit Jw. Dcrad prductir dtructi whit d c ca a cau utrpia. sm dia ca

cau utrpia, icudig vira icti, turcui, typhid vr, ad m marrw dirdr.

Itrr ad thr mdicati ca a cau utrpia. nutrpia i acmm id ct cvtia ad pgyatd itrr with r withut riavi-ri. Ciica tudi hav hw that a may a 95% pp HCV tratmtxpric m rducti i utrphi cut w th rma rag. Pp takigpgyatd itrr ar pciay at rik, with aut 20% patit dvpigigiicat utrpia.

Gray pakig, itrr t th immu ytm. Th vat majrity pp wh dvp itrr-iducd utrpia d t m t dvp ayriu icti. Hwvr, v thugh th rik a riu icti i w, it iti vry imprtat that patit cy mitrd t prvt vr utrpia.

nutrpia i uuay maagd y itrr d rducti accrdig t th

specificproductlabelingfoundinthedrugmanufacturerspackageinsert(Genen-

tech/Roche,Merck/Schering,KadmonPharmaceuticals,VertexPharmaceuticals,Inc.).Aboutone-fifthofpeopletreatedwithpegylatedinterferonplusribavirinre-quir d rducti du t utrpia. sic d rducti i uuay ctiv,cmpt tratmt dictiuati i rary cary.

sic maitaiig th maximum d itrr imprv th chac achiv-ig sVR, m mdica prvidr prcri graucyt cy-timuatig actr(G-CSF,orfilgrastim;brandnameNeupogen)tomanagesevereneutropenia.How -vr, G-Cs ha t w tudid r itrr-iducd utrpia, ad i tDA-apprvd r thi purp. Th dcii aut hw t maag utrpia ia cmpicatd prc that rquir xprt guidac rm a mdica prvidr.

Tips for avoiding infection:

Avoidcrowdsandsickpeople

Getaflushotandothervaccinestoprotectagainstinfections

Practicegoodhygienewashyourhandsfrequently


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Useyourelbows,shoulders,orhipswhentouchingcommonpublicobjectsuch a dr ad vatr utt

Stayawayfromraworundercookedeggs,poultry,andshellfish

9. MisceLLaneous

Anal Burning and ItchingAnalburninganditchingarecommonsideeffectsoftelaprevir(Incivek).Diarrhea

may itiy thi prm, tart y ctrig t prm.

Formild-to-moderateitching,tryover-the-counter(OTC)creamsorointmentsthat ctai hydrcrti. U th parigy ad a dirctd.

ApplyzincoxidecreamsuchasDesitinorotherprotectiveointmentto the

aa rgi. Caami ti may a hp. Thr ar may prduct that prvid ri r arcta prm. Prpara-

tionHoffersavariety;lookforonethatsuitsyourneeds.

I th maur dt wrk, yur mdica prvidr may prcri a cramorointmentand/oranantihistamine.

Prvti aa itchig maiy ivv wahig prpry ad avidigirritat.

If you already have anal itching, try these self-care measures: Kp th aa ara ca. Gty ca with a t wt cth, papr tw,

unscentedwipe,orsqueezablewaterbottle.

b ur th ara i dry. Pat dry with tit papr r t papr tw. A hairdryr at a w ttig i a gd way t dry th ara. Crtarch, tac r aypwdr may kp th ara dry.

Avid irritat, uch a u ath, prum, ctd ap, tc. U u-achd, uctd tit papr.

Dt appy gray prduct uch a Vai, which kp th ara mitad pr t itchig.

Try t t cratch, a thi icra th itch, urthr irritat th ki ad calead toother problems.Sitzbaths andcoldcompressesmay help relieveitchig.

War atura ir udrwar ad cthig. Avid paty h adtight-ittig cth.


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Libido ChangesPatit cmmy rprt dcrad xua itrt durig HCV tratmt. Ad-

ditionally,certainantidepressantmedicationsmaydecreaselibido(sexualdrive)ad xua prrmac. Dpri ad atigu may a damp itrt i x.M may hav diicuty achivig r maitaiig a rcti. Wm may idthat itrcur i ucmrta du t vagia dry caud y itrr. bth

m ad wm rprt ig attractiv durig HCV tratmt.

start y takig with yur hathcar prvidr. May actr ca ctriut tsexualproblemssuchaslowthyroidhormonelevels,otherhormonalimbalances,orsideeffectsfromothermedicationssoitisimportanttostartwithanaccuratediagnosis.Medicationsareavailabletotreaterectionproblems(Viagra,Levitra,Cialis).Ifyouaretakinganantidepressant,yourdoctormightswitchyoutoadif -rt mdicati that i iky t act yur iid. I xua prm d t

imprv, ak r a rrra t a gycgit, urgit r x pciait.

n: P l p k m w pk l- p .

Tips for maintaining libido:

Useawater-solublevaginallubricant.Donotusepetroleum-basedproductsr vagia dry

Talktoyourpartneraboutthechangesyouareexperiencing.Yourpartnermay rivd t kw that yur currt cditi i a mdica rathr thaa itrpra prm

Findwaysotherthansextogiveandreceivephysicalandemotionalpleasure

Getadequaterestthroughouttheday

Findwaystopamperyourselfandfeelgoodaboutyourself

Checkoutbooksandvideosthataddresssexualissues

Rememberthatthisisatemporarycondition.Yourbodywillreturntonormalatr tppig HCV tratmt ad atidprat mdicati

imp n: rb w b . i l mlp, wll ml p ml p, b p-y m x m b . e

y y p lz p (.., my bl l-), mm y l m p, b m py p-lz.


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Menstrual and Menopausal IrregularitiesTh ct HCV thrapy th mtrua cyc ad mpau i a ara that

ha t w tudid. sm wm rprt mtrua irrguariti durig HCVtratmt. Th may icud havir r ightr prid, wr r mr rqutperiods,moreorlesspremenstrualsyndrome(PMS),andsoforth.Thereisnooneig prdicta cur mtrua irrguariti whi HCV thrapy.

Wm wh ar apprachig mpau a rprt chag. sm hav mrhotflashes,whileothershavefewer.Somewomenreportmorebleeding;othersay thir prid ar hrtr, wr, r ightr.

Atr mpau, wm ar at highr rik r . Arma i cad tpia. otpri ma th i igiicat ugh tcrat a rik ractur. A umr actr icra thi rik, icudig mkigad amiy hitry. sma tudi hav ikd riaviri t , ut t ugh

i kw t draw irm ccui.

It i kw that iactivity ca a icra . Whi udrgig HCVtratmt, pp wh ar rmay phyicay activ may id thmv cuttigack th itity, rqucy, r durati thir rma it ruti. Thimay av thm with t r prvti. Cacium, magium,vitami D, ad thr utrit ar cary r gd hath. Tak t yurmdica prvidr r a diticia aut which dag ar uita r yu.

10. Words for faMiLY and friends

HCV tratmt act may pp id patit. Thi may a tru adchagig tim r yu. educatig yur aut th id ct HCV thrapymay hp yu udrtad m th iu yur vd i crtig.Patientsoftenlookgoodduringtreatment.Thiscancreateproblems,especially

i th patit awu ad aum vry arud him ca thi. op cm-muicati i th t way t id ut hw yur vd . but dt xpctt much rm th pr udrgig HCV thrapy, pciay i h r h wa ta gd cmmuicatr r tratmt. sm patit d t wat t tak autthir xpric. othr wat t tak aut thm a grat da. Th tw t thig

yu ca d r yur vd ar t curag him r hr t ji a upprt grupad t tak car yur w hath.


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Depression, Anxiety, and IrritabilityDpri i a cmm id ct HCV tratmt. Watchig a vd

xpric dpri ca rightig. ig hp i a cmm racti tm dpri. I yu ar a rid r amiy mmr, yu ar aradyhpig y radig thi. by gaiig irmati ad t, yu ca a graturc pwr ad upprt.

Th xpric udrgig HCV thrapy i mwhat uiqu, ad patit r-quty tat that th y pp wh udrtad thm ar thr hpatiti C patitwithtreatmentexperience.Althoughyoumaynotbeabletoempathizecompletely,

yu ti ca upprtiv y hwig cmpai ad patic.

It may hpu t id upprt i yur vd i dprd. ecurag himr hr t pak t a dctr. Apprpriat diagi ad tratmt ar tia.

Tratmt r dpri may tak aywhr rm tw t ight wk t cm uyctiv. Yu ca curag yur rid r amiy mmr t tick with it uti thmdicati tart t wrk, r t tak t hi r hr dctr aut atrativ i thrm t imprvmt.

imp n: d mk b l .rp mmly p pl. i mp mm, ll 911. i y l p l pylly m y, mm lp. d p yl m wy.

I thr ar ay hpatiti C upprt grup avaia i yur ara, curag yurvd t attd. Yu may r t driv him r hr t th grup. I th grup ip t vry, prhap vutr t attd tgthr.

Yu may wat t curag th dprd pr t g r a wak, g t thmvi, r gag i thr activiti that prviuy gav paur. Hwvr, i thr i rud, d t puh it. It may ugh t jut it ad it t th radi

r watch TV tgthr. sm patit hav diicuty radig durig tratmt, prhap itig t a audi k might itrt yu th.

Pp with hpatiti C ar mtim irrita durig tratmt. Try t t takthi pray. Kp yur xpctati t a miimum. D t xpct a dprdHCVpatienttosnapoutofitortobeabletoturnhisorhermoodaroundthroughpitiv thikig. Mdicati-iducd dpri i iucd y phyica actr,ad a th wipwr i th wrd wt mak it g away.


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SexualityPatit cmmy rprt dcrad itrt i x durig HCV tratmt. sm

atidprat mdicati ca a cau dcrad iid. Thi wi rtur t rmaatr HCV thrapy i cmptd ad atidprat mdicati ar tppd. nvr-th, patit hud vr tp mdicati withut pakig t thir dctr frt.

Maitai a much xua, phyica, ad mtia itimacy a pi. b p-midd ad crativ whi fdig way t tai paur ad ufmt. D t takit pray i yur partr tur dw ivitati r xua r mtia itimacy.

Whi yur vd i udrgig HCV thrapy, mak ur yu tak car yur. It i t cary r yu t igr yur w d durig thi tim. Iyu d t, id m yu ca tak with, ad wh wi upprt yu. egag iactiviti that giv yu paur. I yur x i i impactd, try t id thr way

t giv ad rciv phyica acti with yur vd . Rmmr that HCVtratmt d t at rvr. It wi d, ad wi th id ct.

W ar away kig r tratgi t hp pp maag id ct. I yukw ay tip that yu wud ik t har, r i yu hav ay irmati thatwud hp t imprv thi guid, pa ctact [email protected].

11. resourcest pp p y pl :www.hcvadvocate.org/community/groups.asp

b ur t chck ut th wig supprt Grup Guid ad Hadk, whichca dwadd rm ur wit:

HCsPA Patient Guide to Finding an HCV Support Group:

www.hcvadvocate.org/hepatitis/factsheets_pdf/support_group.pdf HCsP supprt Grup Hadk

www.hcvadvocate.org/hepatitis/factsheets_pdf/Support%20Group%20Hand -k.pd

HCsP supprt Grup lwww.hcvadvocate.org/hepatitis/factsheets_pdf/Support%20Group%20Les -.pd
http://www.hcvadvocate.org/hepatitis/factsheets_pdf/support_group.pdfhttp://www.hcvadvocate.org/hepatitis/factsheets_pdf/Support%20Group%20Handbook.pdfhttp://www.hcvadvocate.org/hepatitis/factsheets_pdf/Support%20Group%20Handbook.pdfhttp://www.hcvadvocate.org/hepatitis/factsheets_pdf/Support%20Group%20Handbook.pdfhttp://www.hcvadvocate.org/hepatitis/factsheets_pdf/Support%20Group%20Lessons.pdfhttp://www.hcvadvocate.org/hepatitis/factsheets_pdf/Support%20Group%20Lessons.pdfhttp://www.hcvadvocate.org/hepatitis/factsheets_pdf/Support%20Group%20Lessons.pdfhttp://www.hcvadvocate.org/hepatitis/factsheets_pdf/Support%20Group%20Lessons.pdfhttp://www.hcvadvocate.org/hepatitis/factsheets_pdf/Support%20Group%20Lessons.pdfhttp://www.hcvadvocate.org/hepatitis/factsheets_pdf/Support%20Group%20Handbook.pdfhttp://www.hcvadvocate.org/hepatitis/factsheets_pdf/Support%20Group%20Handbook.pdfhttp://www.hcvadvocate.org/hepatitis/factsheets_pdf/support_group.pdf


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Also,Genentech/Roche,Merck/Schering,KadmonPharmaceuticalsandVertexPharmacutica, Ic. r xct upprtiv rvic r pp takig thirmdicati:

Genentech (Member of the RocheGroup): 1-877-PEGASYS (1-877-734-2797)www.genentechaccesssolutions.com/portal/site/AS/

Merck (includesSchering-Ploughsubsidiary):1-866-939-HEPC(1-866-939-4372)www.mrck-car.cm

KadmonPharmaceuticals (formerly3 Rivers Pharmaceuticals: 1-800-405-8506www.kadmon.com/docs/patients_assistance

Vertex:1-888-552-2494PatientAssistance:www.vrtx.com/patients.html

Be Sureto CheCk out theSe other hCSP GuideS:To view and download Guides, go to

www.hcvadvocate.org/hepatitis/factsheets.asp#Guides

A Guide to Understanding Hepatitis C

Easy C - A Guide to Understanding Hepatitis C

Management of Hepatitis C by the Primary Care Provider: Monitoring Guidelines

A Guide to Hepatitis and Disability

Hepatitis C Support Group Manual

treatment S ide effeCt manaGement faCt SheetS (SerieS)

www.hcvadvocate.org/hepatitis/factsheets.asp#SEM

SuGGeSted readinG

Healing Hepatitis C, y Chritphr-Kdy-lawrd ad Diaa syvtr.HarprCi.

Living with Hepatitis C: A Survivors Guide, y Grgry T. evr, MD, adHdy Wirg. Hathrigh Pr. 800-367-2550.

Free from Hepatitis C: Your Complete Guide to Healing Hepatitis C, ylucida K. Prtr, Rn. squar o Puihr.

Thi irmati i prvidd y th Hpatiti C supprt Prjct, a pritorganizationforHCVeducation,supportandadvocacy.

2012 Hpatiti C supprt Prjct. Rprit prmii i gratd adcuragd with crdit t th Hpatiti C supprt Prjct.


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Alan Franciscus

Executive Director

Editor-in-Chief, HCSP

Publications

Authors

Alan Franciscus, Editor-in-Chief

Lucinda K. Porter, RN

Managing Editor, Webmaster

C.D. Mazoff, PhD

Contact Information

Hepatitis C Support Project

PO Box 427037

San Francisco, CA 94142-7037

[email protected]

A Guide to Hepatitis Ctreatment

side effect

management

Alan Franciscus, Editor-in-ChiefLucinda K. Porter, RN

Treatment Side Effect Guide

Documents

Transcript of Treatment Side Effect Guide