Medications to Avoid If You Have Hepatitis C

Common medications can produce side effects in hepatitis C patients

The effects of hepatitis C on the body are wide-ranging and serious. Since it affects the liver, which plays a big role in metabolizing drugs, some medications are contraindicated or should be taken with caution if you have this condition. Further complicating matters is the fact that it takes a while for hepatitis C to produce symptoms, and many people aren’t even aware they have it until this infection has become relatively advanced.

When the liver is damaged due to this disease—advanced cases can lead to liver cirrhosis (scarring), cancer, or liver failure—certain pills can actually become dangerous to take. And drug interactions—when medications interact in a harmful way— can be a problem too.

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Drugs Contraindicated for Hepatitis C Patients

So what should you be avoiding? What follows is a quick breakdown of common drugs to steer clear of if you have hepatitis C.

Additionally, the standard course of treatment for hepatitis C involves the use of a class of drugs called direct-acting antivirals (DAA). As you go through treatment, make sure to get your doctor and pharmacist's approval before taking any new medications, supplements, or herbs or making dietary changes that could interfere with the actions of these medications.

Alcohol can be toxic to your body if you have liver disease, and liver damage can progress if alcohol is consumed.

Acetaminophen

Available both over-the-counter and in a prescription-strength form, acetaminophen is the pain reliever and fever reducer that’s the active ingredient in Tylenol and Panadol, among others. If these are taken beyond the recommended amount or consistently for long periods of time, liver damage can result.

Healthcare providers note that no more 2 grams (g) a day of this drug should be taken to prevent the formation of cirrhosis. In those who have hepatitis C as well as liver cirrhosis, this number drops to 1g.

Patients who have hepatitis C should carefully monitor the amount of acetaminophen they’re taking, or cease use altogether. Hepatitis C patients who continue to take this drug require regular monitoring of toxicity levels.

Ibuprofen

The active ingredient in a whole host of well-known over-the-counter drugs such as Advil, Ibuprofen IB, Caldolor, and others, ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) used for pain relief. Though often a go-to for treating pain, this drug can be harmful for some people.

The standard dose of ibuprofen is 400mg every four to six hours. When taken in smaller, standard doses—usually about 1 g a day—this drug is considered safe if you have hepatitis C without liver cirrhosis, though experts caution against use.

If hepatitis C becomes chronic or cirrhosis does develop, ibuprofen is to be avoided.

NSAIDs can cause nephrotoxicity (toxicity in the kidneys). And hepatitis C, while primarily a liver disease, can harm the kidneys too.

Naproxen

Another NSAID, naproxen, often taken to provide relief for joint pain and arthritis, is the active ingredient in Aleve, Anaprox, Naprosyn, and many other over-the-counter and prescription drugs.

This drug can lead to an increased risk of liver toxicity and can be especially damaging in cases of cirrhosis.

Corticosteroids

This class of drug mimics the structure of the human hormone cortisol, and is known to be particularly effective as an anti-inflammatory and immunosuppressive agent. These drugs—including cortisone, hydrocortisone, and prednisone, among others, are used to treat autoimmune diseases and symptoms such as swelling, itching, allergies, asthma, and arthritis.

However, long-term use can have side effects, including an increased risk of infections and diabetes.

Use among those with hepatitis C needs to be very closely monitored and is generally contraindicated. In fact, studies have shown that corticosteroids can actually worsen the progression of the disease.

Sleeping Pills/Tranquilizers

One of the challenges of hepatitis C is that some of the main anti-viral drugs prescribed—especially peginterferon alfa and ribavirin—can cause insomnia and disrupt sleep. It’s a tricky situation because certain classes of sleeping pills can react poorly when taken in conjunction with hepatitis C medications.

Some sedating drugs like suvorexant (Belsomra) can hinder the efficacy of treatment; however, other types—such as zolpidem (Ambien)—can be helpful. It’s important to talk to your healthcare provider about your options.

HIV Medications

Human immunodeficiency virus (HIV), the precursor to AIDS, has a very high coinfection rate with hepatitis C; about 25 percent of those with HIV also have hepatitis C.

It's important to be adequately treated for both conditions, but some HIV-managing drugs react poorly with those that are taken for treatment of hepatitis C, including Aptivus, Edurant, Invirase, and Kaletra, among others.

Finding the Right Approach

Liver disease has many systemic effects. The valuable role that the liver plays in metabolizing medications can limit the treatments that are safe for people who have hepatitis C. And treatment for hepatitis C may interact with medications used to treat complications or other health issues. Make sure you talk with your pharmacist to ensure that hepatitis C and all treatments that you take are clearly documented in your medical and pharmacy records.

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4 Sources
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