November 13, 2013

Ask the Pharmacist: Are You at Risk for Hep C?

11.11.13  |   John Fowler


What do Mickey Mantle, Evel Knievel, Naomi Judd, Pamela Anderson, Jim Nabors and Keith Richards have in common? They all faced hepatitis C.

About 3.2 million Americans have chronic hepatitis C. It claims the lives of more people each year than HIV/AIDS and is the leading cause of liver transplants in the U.S.

As specialist pharmacists with disease-specific expertise in hepatitis C, my team and I flag drug interactions and provide support to patients for their therapy and side effects.

Understanding the Disease

Hepatitis C is a contagious liver disease that ranges in severity from a mild illness lasting a few weeks to one that is serious and lifelong. For a lucky few, their body is able to clear the virus. However, with most people, the initial infection leads to a long-lasting, chronic infection.

The disease is much more common among baby boomers. Many individuals were infected between 1970 and 1990, before universal screenings of the blood supply were adopted. The Centers for Disease Control and Prevention recommend that all baby boomers be tested, and Medicare will cover the cost of screening if you are at high risk or symptomatic.

Managing the Condition

Hepatitis C treatment can be difficult to tolerate and the side effects are often severe, including fatigue and flu-like symptoms. This can make adherence a challenge. And unfortunately, nonadherence can cause therapy failure and lead to liver failure. Despite this, nearly 40% of hepatitis C patients are nonadherent.

Understanding a few key things about your medication regimen can lead to better health outcomes:

  • Be adherent: Being adherent to a medication’s dosing regimen is key for the best health outcomes. People with hepatitis C often must follow a medication regimen that demands multiple doses of three separate medications each day. Talk with your doctor or specialist pharmacist if you need support with your schedule or are struggling with adherence.
  • Read the fine print: Many hepatitis C medications provide specific instructions to help minimize side effects. For example, one commonly prescribed medication may cause flu-like symptoms, so some patients take the dose at night or the day before a day off work. Taking an ibuprofen at the same time can also lessen side effects.
  • Follow specific instructions: Some of the newest medications for hepatitis C are oral medications. While oral medications are more convenient, they must be taken at precisely spaced intervals throughout the day and with food to ensure adequate absorption. In fact, some medications specify the nutritional content requirements of the food.
  • Stay well-hydrated: Consuming enough fluids is very important. A great rule of thumb is to determine your body weight (in pounds) and strive to drink half that number (in ounces) per day. For example, if you weigh 200 pounds, you should drink 100 ounces of fluid each day.
  • Delay pregnancy: Some drugs that treat hepatitis C can harm an unborn child, so women should avoid getting pregnant while on therapy and for up to six months after completion of therapy. Men undergoing hepatitis C treatment should also practice safe sex during the same time period.
  • Document the side effects: Report all side effects and other concerns to your physician and your specialist pharmacist so they can be resolved quickly before symptoms worsen.


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