Hepatitis C virus (HCV) causes liver inflammation that can lead to liver problems, including liver cancer. People suffering from chronic hepatitis C need medication to treat it as these drugs can ease symptoms.
Even if a Hep C virus infection hasn’t caused symptoms a person any yet, it’s still important to treat it. Hep C medicines can also help lower the risk of complications from the virus, including dangerous liver problems.
HCV has different genetic variations (genotypes). The Hep C medicines prescribed depend on the genotype a person has. Genotype 1 is the most common type found in the United States.
Here are the Hep C medicines available to treat Hep C, as well as some helpful information about what to expect with each treatment.
Ribavirin
Ribavirin is an oral medication that comes as a capsule, tablet, or solution and is available in several strengths. It stops viruses from replicating and spreading. Ribavirin is used in combination with other Hep C medicines.
Brand names of ribavirin include:
- Moderiba
- Copegus
- Rebetol
- Ribasphere
- Ribasphere RibaPak
Ribavirin may cause congenital disabilities if a woman takes it during pregnancy. It can also cause congenital disabilities if a man fathers a child during his treatment with ribavirin.
Other side effects may include:
- changes in your ability to taste
- memory loss
- nausea
- vomiting
- difficulty sleeping
- muscle pain
- trouble concentrating
Direct-acting antivirals
Direct-acting antivirals (DAAs) are the standard of medicine for chronic HCV infection today. These Hep C medicines work by attacking HCV directly and more targeted than older treatments such as interferons. They also don’t affect as many systems in your body as interferons, so they may cause fewer side effects. All DAAs are oral drugs.
Side effects of DAAs can include:
- fatigue
- headaches
- anemia
- diarrhea
- nausea
- slow heartbeat
- vomiting
Protease inhibitor antiviral medications (NS3/4A inhibitors)
Protease inhibitors prevent the spread of Hep C infection and also stop viruses from multiplying in the body.
Protease inhibitors for Hep C include:
- paritaprevir, for genotype 1
- simeprevir (Olysio), for genotypes 1 and 4
- grazoprevir, for genotypes 1 and 4
All of these Hep C medicines are used in combination with other HCV drugs. Simeprevir is given with peginterferon alfa or sofosbuvir, ribavirin and grazoprevir is used with elbasvir (Zepatier) and paritaprevir is only available as part of the combination drug Technivie or Viekira Pak.
Protease inhibitors (NS5A inhibitors)
The action of these Hep C medicines isn’t fully understood. They may work by preventing the Hep C virus from copying itself and may also help stop drug resistance.
These drugs are used to treat all Hep C virus genotypes and can be used alone or in combination with other Hep C medicines.
Examples of directed inhibitors include:
- daclatasvir (Daklinza)
- elbasvir (part of the combination drug Zepatier)
- ledipasvir (part of the combination drug Harvoni)
- ombitasvir (part of the combination drug Viekira Pak)
Nucleotide/nucleoside and non nucleoside polymerase inhibitors (NS5B inhibitors)
Nucleotide/nucleoside and non nucleoside polymerase inhibitors work by blocking a protein called NS5B. The Hep C virus needs this protein to replicate itself and survive.
Examples of these drugs include:
- sofosbuvir (Sovaldi)
- dasabuvir
Combination drugs
All Direct-acting antivirals are given as combinations Hep C medicines. Some combinations are made into single pills and capsules to make taking it more convenient.
Brand names of current combination Hep C medicines include:
- Zepatier
- Technivie
- Harvoni
- Viekira Pak
- Epclusa
- Vosevi
- Mavyret
- Ledipasvir-sofosbuvir (Harvoni)
Interferons
Interferons were the standard Hep C medicines for years. However, today the newer treatments listed above are mainly used instead. Interferons can cause a lot of side effects and are not as effective for treating chronic Hep C virus infection.
An interferon is a protein that your body makes that helps your immune system fight viruses, including Hep C virus.
These interferon Hep C medicines include:
- peginterferon alfa-2b (PegIntron, Sylatron)
- peginterferon alfa-2a (Pegasys)
- interferon alfa-2b (Intron A)
The most common side effects include:
- anxiety
- dry mouth
- weight loss
- worsening hepatitis symptoms
- excessive fatigue
- headache
- mood changes or depression
Other more serious side effects of interferons that can happen over time may include:
- reduced white blood cell levels
- high blood pressure which can lead to a stroke or heart attack
- autoimmune diseases
- reduced red blood cell levels
- inflammation of your bowel or pancreas
- reduced thyroid function
- allergic reaction
- changes in vision
- liver disease
- lung disease
- slowed growth in children
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