Both prescription and over-the-counter drugs can have side effects. Side effects can vary from minor problems to life-threatening conditions so it’s important to talk to your health care provider about possible side effects of any treatment plan.

 

Prior to taking medication, tell your health care provider and pharmacist about all prescription and nonprescription drugs and supplements that you take. Avoid potential drug interactions by checking in with your provider and pharmacist prior to adding a new drug or supplement to your daily regimen.

 

Ask your health care provider how to take your medication, and then create a routine. Some people find it helpful to use weekly pill organizers or other reminders.

 

Report any side effects to your health care provider. It’s better to mention a side effect in its early stages rather than wait until it becomes a bigger problem.

 

Make use of additional resources that may help you during treatment. Most drug manufacturers offer support services, available 24/7 via a toll-free number. Some insurance companies and specialty pharmacies also offer free advice services. These are handy to use, especially if you are wondering whether you should call your health care provider after regular business hours.

 

Visit the HEP Forums. Connecting to others who have experience with treatment can be enormously useful.

 

Here are some tips for dealing with specific side effects:

 

Cough, runny nose, sore throat

Dizziness and lightheadedness

Dryness (eyes, mouth, skin, etc.)

Fatigue, weakness

Flu-like symptoms (chills, fever, joint and muscle aches)

Gastrointestinal disorders (abdominal discomfort/indigestion, decreased appetite, diarrhea, intestinal gas [bloating/flatulence], nausea)

Hair loss

Headache

Injection site reaction

Insomnia

Mood issues (depression, irritability, moodiness, anxiety)

Neutropenia (low white cells)

Pain (back, joint, muscle)

Rash

Thrombocytopenia (low platelets)

 

Cough, runny nose, sore throat—If mild, manage these as you would if you had a cold with these tips:

  • Drink plenty of liquids.
  • Use soothing throat and cough lozenges.
  • Gargle with salt water (1/4 teaspoon table salt dissolved in a cup of warm water).
  • Use a humidifier or keep a bowl of water in the room to increase humidity.
  • Avoid irritants such as smoke and cold air.
  • Contact your medical provider if you have trouble breathing or swallowing, develop a fever or your symptoms last longer than a week. 

Dizziness and lightheadedness—Dizziness and lightheadedness are sometimes used interchangeably, but they are different. Dizziness is when the world is spinning around you, and it may be hard to maintain balance. Lightheadedness is when you feel like you are about to black out or faint and is more common than dizziness. Feeling lightheaded may indicate anemia, so be sure to discuss this with your health care provider.

 

A common reason people feel lightheaded is a sudden drop in blood pressure, particularly after standing up too quickly. Low blood sugar and dehydration may also cause you to feel lightheaded. Here are some tips to help with lightheadedness:

  • Stay hydrated. If your urine is clear or pale yellow, you are probably drinking enough fluids.
  • Eat at regular intervals and avoid going for more than four or five hours without eating something nutritional.
  • When moving from sitting or reclining to standing, do so slowly and gradually. Wiggle your toes, flex your feet and move your legs before you get up. Squeeze and relax your leg muscles before and as you rise. This helps to pump the blood to your upper torso.
  • Replenish your electrolytes if you are overheated or sweating too much.
  • Stay active. Exercise helps circulation.
  • If the problem is severe or your legs are swollen, ask your health care provider whether you should wear compression socks or stockings.
  • If you feel lightheaded, sit or lie down to avoid fainting and possibly injuring yourself.

Dryness—Some medications can cause dry skin and mucous membranes. This includes the eyes, mouth, nose, skin and vagina. Here are some tips to help with dryness:

  • Stay well hydrated.
  • Begin moisturizing the skin before you develop a problem.
  • Avoid extremely hot showers and baths.
  • Instead of soap, use a moisturizing cleanser such as Cetaphil or its generic substitute.
  • Apply a fragrance-free hypoallergenic cream immediately after bathing. Cream is generally more effective than lotion. For extra protection, mix in a couple of drops of unscented lightweight body oil.
  • If you live in a dry climate or have central heating in your home, use a humidifier or keep a bowl of water in the room to increase humidity.
  • Avoid direct sunlight and always use sunscreen.
  • If your mouth is dry, sip water throughout the day. Chew sugarless gum or suck on sugar-free candy. Ask your dentist or pharmacist about products specifically formulated to treat dry mouth. Practice good dental hygiene by brushing, flossing and getting regular teeth cleanings.
  • Moisten your eyes with artificial tears.
  • Use saline nose sprays to keep the nasal passages moist. A light application of petroleum jelly or A and D ointment may bring relief.
  • K-Y Jelly and other lubricants will provide moisture during sex. If using barrier contraception, avoid petroleum or oil-based products, since oil can destroy condoms and diaphragms. 

Fatigue and weakness—In addition to being a side effect of some medications, fatigue is a symptom of hepatitis. Since there are many other causes of fatigue, such as anemia, depression, insomnia, pain and thyroid problems, your health care provider will want to find the cause of your tiredness. Here are some tips to help with fatigue:

  • Get enough sleep. The National Sleep Foundation recommends seven to nine hours of sleep per night for adults. If sleep is a problem, discuss this with your health care provider.
  • Light exercise is a good remedy for fatigue. Find an activity you like or can tolerate and do it for 10–15-minute intervals, two to three times daily. If you are not accustomed to physical activity, start with five minutes. Activities to try are walking, biking, swimming, dancing, gardening, yoga and tai chi.
  • Vary your activities—do not sit too long or stand too long.
  • Drink plenty of water.
  • According to the Institute of Medicine, men need about 13 cups (3 liters) of total beverages a day; women need about 9 cups (2.2 liters) daily. If you are drinking enough liquids, your urine will be pale yellow or colorless.
  • Stress can be wearing. Reduce stress and find ways to relax.
  • Take short naps of 20 minutes or less. Don’t nap close to bedtime.
  • Use caffeine. Coffee and tea may give you a lift. Coffee may protect the liver and help with HBV treatment side effects. Do not drink caffeinated drinks late in the day, as this may interfere with sleep.
  • Prioritize your tasks. This is a good time to do what is necessary and focus on completing treatment.
  • Ask for help. Some of us feel good when we can help someone else, so we are helping others to feel good when we let them help us. 

Flu-like symptoms (chills, fever, joint and muscle aches)—Schedule your medication before bedtime so that you can try to sleep through some of the reactions. Talk to your health care provider about taking over-the-counter pain relievers such as Tylenol (acetaminophen), aspirin, Advil/Motrin (ibuprofen) or Aleve (naproxen). Never exceed the total daily recommended acetaminophen dose.

 

Gastrointestinal Disorders

  • Abdominal discomfort/indigestion—You may experience occasional mild upset stomach. Call your health care provider if you have severe or chronic stomach pain. Ask your health care provider or pharmacist to recommend safe over-the-counter medications that do not interact with any other medications you are taking. Try not to get too hungry, as stomach pain may be caused or worsened by hunger. Eat small, frequent meals.

  • Decreased appetite—Try to eat small, frequent meals of nutritional, high-calorie foods such as peanut butter, nuts, avocados, protein shakes and smoothies. If weight loss is a problem, supplement with nutritional powders and drinks. If food doesn’t taste good, try to vary what you eat.
     
  • Diarrhea—Frequent, loose, watery stools may occur occasionally. Be sure to drink plenty of clear liquids, such as water, tea, juice and broth. Gradually add solid food to your diet, starting with crackers, toast, rice, eggs or plain chicken. Avoid high-fiber, fatty, greasy and spicy food. Avoid alcohol, coffee and dairy. Ask your doctor whether you should take over-the-counter anti-diarrheal medications, such as Imodium A-D (loperamide) or Pepto-Bismol (bismuth subsalicylate).
     
  • Intestinal gas (bloating, flatulence)—Avoid rich, fatty foods as well as gas-inducing foods such as artificial sweeteners, beans and dairy products. You may also want to skip vegetables such as Brussels sprouts, cabbage and cauliflower. etc.) Avoid taking in excess air when eating by chewing food slowly. Skip carbonated beverages and don’t drink with a straw. Reduce discomfort by wearing clothes that are loose around your abdomen. Products with simethicone may provide relief.
     
  • Nausea—Try taking your medications with food (if allowed). Hunger can intensify nausea, so eat a cracker or other small piece of food every hour. Ginger helps with mild to moderate nausea. Peppermint, chamomile or raspberry leaf tea may also alleviate nausea. Try an acupressure technique by applying pressure to the inside of your wrist, approximately two fingers above the crease where your hand meets your arm. You may also purchase wristbands developed for motion sickness sold in drugstores. If nausea is severe or you are vomiting, your health care provider may prescribe something for you. 

Hair loss—This side effect is more hair thinning rather than actual baldness. There is not much you can do to prevent it, but you may be able to keep hair loss from getting worse with these tips:

  • Avoid harsh chemicals on your hair.
  • Use the coolest setting on your blow dryer, curling iron or flat iron.
  • Shampoo your hair less often. Use dry shampoo products between hair washes.
  • Apply hair detanglers or conditioners.
  • Brush with a wide-toothed comb. 

Headache—Mild headaches will usually respond to over-the-counter pain relievers and should be discussed with your medical provider. Limit the use of pain relievers, as overuse of these drugs may cause a rebound headache. This means that the headache will most likely return once the relief wears off. Dull headaches may respond to acupressure. Try pinching the deep tissue between your thumb and forefinger with your other hand. Hold it for at least seven seconds, repeating until the headache fades. For stubborn headaches, relax in a dark room for a while. Some people report that caffeine improves a headache, and some say it will cause or worsen a headache. You may have to experiment with this yourself.

 

Injection site reaction—This is a normal result of using an injectable medication. Redness usually goes away in four to six weeks after the last injection. Be sure you review instructions provided with your medication on how to give an injection. Your health care provider or pharmacist may be able to help you with this. Rotate injection sites. Call your health care provider if you notice red streaks or swelling or discharge or the area is warm.

 

Insomnia—Whether the issue is getting to sleep or staying asleep, insomnia is especially frustrating. It’s better to address sleep problems early, before a poor sleep pattern is established. Your health care provider may be able to prescribe something for sleep. Some patients find that when they take antihistamines for rashes, it also helps them sleep. Here are some tips to help you sleep:

  • Turn off the computer, TV and other electronic devices an hour or two before bedtime.
  • Create relaxing bedtime rituals. Read, meditate or listen to relaxing music before retiring.
  • Exercise during the day may help you sleep better at night.
  • Avoid coffee, soda, tea, chocolate and anything else with caffeine late in the day.
  • Other things that may interfere with a good night’s sleep are alcohol, certain drugs, eating before bedtime and going to bed hungry.
  • If noise disturbs your sleep, try earplugs.
  • Your bed is for sleep and sex; it isn’t for worrying. If you are fretting, get up, do something boring for a little while and then go back to bed. 

Mood issues (depression, anxiety, irritability, moodiness)—Some meds may cause a variety of neuropsychiatric side effects, such as depression, irritability and moodiness. Severe depression, anxiety and rage are serious issues that require immediate help. If you have thoughts of hurting yourself or others, call your health care provider or 911.

 

Antidepressant medications may help with depression. If you are experiencing anxiety, your provider may prescribe anti-anxiety medication. If addiction or abuse is a concern, discuss this with your provider. Here are some tips to help with moods and other neuropsychiatric side effects:

  • Join a support group, such as the HEP Forums. Sometimes it can help to have a place to vent. It can also be uplifting to help others.
  • Try to be active every day. Light exercise has been proved to lessen the intensity of depression.
  • Go easy on alcohol and drugs that have depressing or stimulating effects. If you can, avoid these altogether.
  • Stress makes it harder to cope with depression and anxiety, so find ways to reduce stress. Some ideas to try: Take a walk in a pleasing environment, listen to your favorite music or engage in activities that distracts you.
  • Get enough sleep. If sleep is a problem, discuss this with your health care provider.
  • Find ways to laugh. Humor reduces stress hormones and has a positive effect on the body.

Pain (back, joint, muscle)—If you experience muscle and joint aches, staying active usually helps. Try to avoid prolonged sitting or reclining. Hot baths may soothe aching muscles. Stretching and relaxing may provide relief. Massage, performed by a friend, a professional or yourself, may also help. Talk to your health care provider about taking over-the-counter pain relievers such as Tylenol (acetaminophen), aspirin, Advil/Motrin (ibuprofen) or Aleve (naproxen).

 

Reduced white cells and platelets—Some liver medications may cause a temporary reduction in white blood cells and platelets (the sticky part of the blood that helps us clot). Although your white blood cell count may be low, you are not at a higher risk for infection (assuming you are not otherwise immune-compromised). If your platelets are low, you may notice that it takes a little longer for your blood to clot. Call your health care provider or 911 if you feel you have lost a lot of blood or cannot get your nose or a wound to stop bleeding.

 

Rash—Tell your healthcare provider if you get a rash. It is much easier to treat a rash in the early stages, rather than in the later ones. Other tips for skin-related issues:

  • Ask your health care provider about prescription or over-the-counter anti-itch medication, such as hydrocortisone cream.
  • Try not to scratch. If you can’t resist, try rubbing itchy areas with an ice cube. You can also apply firm pressure to an itchy area.
  • Stay well hydrated.
  • Keep your skin moist; begin moisturizing before you develop a problem.
  • Avoid extremely hot showers and baths.
  • Instead of soap, use a moisturizing cleanser such as Cetaphil or its generic substitute.
  • Apply a fragrance-free hypoallergenic cream immediately after bathing. Cream is generally more effective than lotion. For extra protection, mix in a couple of drops of unscented lightweight body oil.
  • Avoid direct sunlight and always use sunscreen. Wear protective clothing, and if you must be outside, stay in the shade or use an umbrella. 

Last Reviewed: June 29, 2023