Hepatitis C (hep C) infection used to be a lifelong condition for most people.
With advances in hep C treatment, most people can now be cured of HCV.
Many people don’t seek treatment for chronic hepatitis C infection because they don’t know they have the virus. It’s only years later, when hepatitis C leads to serious health issues, that many people seek medical attention.
Early intervention is important because it may help prevent longer-term complications.
There are more treatments for hepatitis C available now than ever before. Up until just a few years ago, people living with hepatitis C only had two medication options:
- pegylated interferon
Now, there are several medications that your doctor may prescribe.
Newer drugs include:
- protease inhibitors
- polymerase inhibitors
- direct-acting antivirals
Each type works a bit differently to block a biological process that the hepatitis C virus needs to thrive.
Your eligibility for each medication depends on the type of hepatitis C virus you have. There are six different genotypes of hepatitis C.
The following medications have FDA approval to treat all six hep C genotypes:
Mavyret is a protease inhibitor aimed at most people with chronic hepatitis C except for those with decompensated cirrhosis (a complication of advanced liver disease).
- Complications: The most common side effects can include headache and fatigue.
- Dosage: Each Mavyret tablet contains 100 mg of glecaprevir and 40 mg of pibrentasvir and is intended to be taken 3 times per day.
Epclusa is a pangenotypic NS5A-NS5B inhibitor is an option for those with HCV genotype 3, including those with compensated cirrhosis.
- Complications: Headache and fatigue are the most common side effects.
- Dosage: Epclusa is a once-daily pill containing 400 mg of sofosbuvir 100 mg of velpatasvir to be taken with or without food.
Vosevi is a pangenotypic inhibitor that is especially useful for those who’ve had treatment failure with direct-acting antiviral (DAA) therapy.
- Complications: Headache, fatigue, diarrhea, and nausea are the most common side effects.
- Dosage: A once-daily tablet containing 400 mg of sofosbuvir, 100 mg of velpatasvir, and 100 mg of voxilaprevir to be taken with food.
Other medications that only have approval to treat certain genotypes of hep C:
Harvoni is a once-daily pill approved for genotypes 1, 4, 5, and 6.
- Complications: Fatigue and headache are the most common side effects.
- Dosage: Ledipasvir-sofosbuvir contains 90 mg ledipasvir and 400 mg of sofosbuvir and is recommended to be taken once per day with or without food.
Sovaldi is a once-daily pill approved for genotypes 1, 2, 3, and 4. Depending on the genotype, it’s used in combination with either peginterferon and ribavirin or with just ribavirin.
- Complications: The most common side effects, when used in combination with ribavirin, have been headache and fatigue.
- Dosage: Sofosbuvir is a once-daily 400 mg tablet to be taken with or without food.
Zepatier is a once-daily pill approved for genotypes 1 and 4.
- Complications: Fatigue, headache, and nausea are the most reported side effects.
- Dosage: Zepatier contains 50 mg of elbasvir and 100 mg of grazoprevir to be taken once-daily with or without food. If taken with ribavirin, the ribavirin should be taken with food.
It’s important to take medication as directed. Talk with your doctor to address any concerns you have about how and when you take the drug. They may have support options available or may recommend a different treatment plan.
Not every drug is right for every person. Some medications aren’t for people with cirrhosis, people with HIV or hepatitis B, or people who’ve had a liver transplant.
Your past treatments, viral load, and overall health are also factors.
Newer treatment options are easier to take and have fewer side effects. The latest medications for hepatitis C are taken by mouth, in pill form. Treatment generally lasts between 8 weeks to 6 months, depending on the medication.
Overall, new drugs cure the hepatitis C infection in
In contrast, the older interferon treatments last between 6 months and 12 months.
Interferon treatment is administered by injection and often causes flu-like side effects. In addition, interferon only cures the hepatitis C infection in about
Those statistics may make the choice seem easy. But only you and your doctor fully understand the state of your health. It’s important to find the drug that’s the best match for you.
Discuss any herbal therapies with your doctor. Some of these may interfere with hepatitis C medications and make them less effective.
Some natural products can cause liver damage, including:
But this doesn’t mean you can’t take any over-the-counter supplements. Just make sure to talk with your doctor first when considering these products. They may be able to recommend other ways for you to manage medication side effects.
The latest drugs available for hepatitis C have high success rates when it comes to curing the condition.
In conversations with your doctor, you can discuss the full range of treatment options. Some of these are combination drugs.
But it’s important to note that not every medication may be effective for you, even if it’s for the right genotype.
Some people stop therapy because of side effects. Since hepatitis C can lead to liver damage, cirrhosis, and liver cancer if not treated, it’s vital to stick with a treatment plan.
Newer drugs have fewer severe side effects than pegylated interferon and ribavirin. Nevertheless, you may feel some effects while taking hepatitis C medication. Side effects can include:
- headaches or muscle aches
- cough or shortness of breath
- depression, mood changes, or confusion
- itchy, dry skin, or skin rash
- nausea, vomiting, or diarrhea
- appetite loss or weight loss
Serious side effects can occur with pegylated interferon and ribavirin treatment. If you’re taking these medications, you should be monitored for these serious side effects:
- anemia (low red blood cell count)
- thrombocytopenia (low level of blood clotting cells)
- light sensitivity in the eyes
- trouble breathing because of lung tissue inflammation
- suicidal thoughts, depression, or irritability
- thyroid disease
- elevated liver enzymes
- autoimmune disease flares
Some medications aren’t recommended if there’s evidence of liver damage, like cirrhosis (scarring of the liver). A co-infection with HIV also affects medication options.
Since hepatitis C treatment plans last several weeks, you should regularly attend medical appointments. Your doctor may have a list of local groups where you can find emotional support.
There may also be other resources like community nurses and walk-in clinics. With this information, you’ll know where to go for help between appointments.
Another option is to explore the online hepatitis C community, where people share their experiences with hepatitis C.
For example, the Inspire hepatitis C group allows people to connect, share stories, discuss treatment, and more.
Hepatitis C is an infection that needs active treatment. If you have the hepatitis C virus, you may have several different medication options. Your doctor can advise you on the best choice for your condition and circumstances.
There are more effective treatment options available now than ever before. The vast majority of people can be cured of hepatitis C with the right treatment.
Deciding which treatment plan to follow is an important process. Each medication has possible side effects.
Try to be open with your doctor about your concerns. Through open communication, you can get the information you need to support your health.