Side effect management tips

KCHA Support Group – 2-17, 24-09
HEPATITIS C TREATMENT
SIDE EFFECT MANAGEMENT TIPS
If your clinic is closed and you are having a serious side effect (such as chest pain or severe depression),
please seek immediate medical attention. These are guidelines and should be discussed with your provider.
• Try injecting interferon at bedtime if fever/chills develop 1-3 hours after the interferon injection • Take acetaminophen (Tylenol*) about 30-60 minutes before weekly interferon injection • Take acetaminophen (Tylenol*) 1-2 tablets prior to interferon injection and repeat 4-6 hours later if needed up to a maximum of 2,000 mg/day. Thus, do not exceed 6 tablets/day of 325 mg or 4 tablets/day of 500 mg acetaminophen (Tylenol*). • Use ibuprofen [Advil*, Motrin*] or naproxen [Aleve*] if approved by your provider • Try a cool sponge bath, ice pack or cold pack when you have a fever • Use extra blankets and clothes when you have the chills • Notify your provider if your temperature is above 101ºF for more than 24-48 hours
• Try injecting interferon at bedtime if body aches develop 1-3 hours after the interferon injection • Take acetaminophen (Tylenol*) about 30-60 minutes before weekly interferon injection • Take acetaminophen (Tylenol*) 1-2 tablets prior to interferon injection and repeat 4-6 hours later if needed up to a maximum of 2,000 mg/day. Thus, do not exceed 6 tablets/day of 325 mg or 4 tablets/day of 500 mg of acetaminophen (Tylenol*). • Use ibuprofen [Advil*, Motrin*] or naproxen [Aleve*] if approved by your provider • Try low-impact exercise such as walking or low-impact aerobics as directed by your provider • Maintain adequate fluid intake (at least six to eight non-caffeinated 8-oz glasses/day) • Apply warm moist heat or massage areas • Take acetaminophen (Tylenol*) or ibuprofen (Motrin*, Advil*) as directed by your provider • Keep lights dim, wear sunglasses or stay in darkened rooms • Try low-impact exercise such as walking or low-impact aerobics as directed by your provider • Maintain adequate fluid intake (may have a caffeinated beverage in the morning) • Lessen your work schedule if possible • Talk to your provider about your symptoms and medications that might help • Always discuss thoughts of harming yourself or someone else with your provider • Go to the nearest emergency room if you are in danger of harming yourself or others
• Do mild to moderate exercises at least 3 times/week as directed by your provider • Talk to your provider about your symptoms and medications that might help • Always discuss thoughts of harming yourself or someone else with your provider • Go to the nearest emergency room if you are in danger of harming yourself or others
• Do mild to moderate exercises at least 3 times/week as directed by your provider • Try relaxation techniques such as deep breathing, taped exercises, yoga, Tai Chi or meditation • Avoid stimulants like caffeine and maintain adequate fluid intake • Go to sleep and wake up at the same time every day • If ribavirin makes you jittery, take at 4-5 pm instead of before bedtime • Limit fluid intake for 2 hours before bedtime to avoid having to get up to go to the bathroom • Avoid caffeinated products, especially in the afternoon and at night • Avoid heavy meals close to bedtime • Take warm baths, read or listen to music, get a massage • Try a glass of warm milk (contains tryptophan, a natural sleep agent) • Diphenhydramine (Benadryl*) or other medications may be recommended by your provider • Brush teeth frequently, especially after eating • Drink plenty of water or use ice chips or sugar-free lemon drops • Other medications may be needed for mouth sores/ulcers • Ask your provider about medications that may help • Use sugar-free lemon drops or real lemon wedges • Eat a small amount of yogurt, ½ hour before meals or eat dark chocolate (monitor your glucose • Drink lemonade or cranberry juice (monitor your glucose levels if you have diabetes) • Eat food cold or at room temperature • Brush teeth frequently, especially after eating, to eliminate metallic taste • Use plastic utensils if experiencing metallic taste • Eat smaller, more frequent (4-6) meals throughout the day • Drink protein drinks (Carnation Instant Breakfast*, Ensure* or Boost*) • Eat snacks with protein (cheese, peanut butter, eggs) • Eat whatever appeals to you even if not hungry. Eat a variety of foods • Eat smaller meals –Progressive wet to dry diet – soft to solids diet • Avoid foods or smells that trigger nausea. Try eating cold foods and avoiding cooking smells • Eat healthy foods. Avoid greasy, spicy, acidic or sweet foods • Try eating ginger in ginger tea, ginger ale or gingersnaps • Eat some crackers or dry white toast if you feel sick in the morning • Over-the-counter antacids or other medications may be recommended by your provider • Eat more soluble fiber like Bananas, white Rice, Applesauce and white Toast (the “BRAT” diet) • Avoid foods that are spicy or acidic (like citrus) • Avoid dairy products up to several days after diarrhea resolves • Maintain adequate fluid intake (at least six to eight 8-oz glasses/day) • Your provider may recommend loperamide (Imodium*) or methylcellulose (Citrucel*) or • Increase intake of water or non-caffeinated beverages • Water down juices, Gatorade* or Crystal Light* • Increase intake of water or non-caffeinated beverages • Try sugar-free hard candy or cough drops Dry skin/ rashes • Avoid long, hot showers or baths • Use moisturizing soaps (Dove*, Oil of Olay*, Cetaphil*) • Use moisturizing lotion after showers (Aquaphor*, Absorbase*, Lac-Hydrin*) • Use mild unscented laundry detergents and avoid fabric softeners • Try rubbing or pressing on the itchy areas rather than scratching • Use petroleum jelly on dry, itchy areas. Your provider may recommend other agents to help • Avoid harsh hair products such as dyes, perms, gels, sprays and mousses • Use a mild shampoo such as baby shampoo • Avoid braiding hair; use a wide-tooth comb or soft brush • Wear a cap, scarf, turban or wig • Before injecting, warm your medicine by gently rolling the syringe in your hands for a minute • Rotate/alternate your injection site - thigh, upper arm and abdomen. If you are thin, use the • Do not inject into an area that is irritated, bruised or red • Your provider may recommend applying hydrocortisone cream or other medications to help *Generic versions are usually less expensive than brand-name products. Brand names are provided as examples only, and their inclusion does not indicate an endorsement by the Veterans Health Administration or any other Government agency. Also, if a particular brand name is not mentioned, this does not mean or imply that the product is unsatisfactory.

Source: http://hepatitisalliance.org/wp-content/uploads/2013/05/Hep_C_Side_Effects.pdf