Since everything goes through the liver, people with hepatitis C need to be especially careful when taking medications. This is doubly true during hepatitis C treatment, since medications that interact with each other may thwart your treatment results. We didn’t worry about this as much in the old days of interferon, but hepatitis C direct-acting antivirals are more vulnerable to drug and supplement interactions. For instance, you may be taking St. John’s wort for mild depression. Take this herb with sofosbuvir (Sovaldi) and you may get less of the sofosbuvir. Then you will have even more to be depressed about.
Despite the fact that these warnings are clearly printed in the prescribing information, physicians and other prescribers are not doing a good job of heeding these warnings. Pharmacists are also letting these prescriptions slip through without heeding the warnings. The October 2014 issue
of the European Journal of Gastroenterology & Hepatology evaluated data collected from 53, 461 hepatitis C patients, and found that the majority received drugs that could interact with their treatment medicines.
Julie Lauffenburger and colleagues analyzed the first generation of direct-acting antivirals boceprevir and telaprevir. Only 14 percent of boceprevir prescriptions and 23 percent of telaprevir prescriptions had recommendations to avoid co-administration of other drugs. Note: These two medications are not used in the U.S. (or at least I hope they aren’t), and they have a long list of medications that they may interact with.
Although the study used the older drugs to examine these prescription issues, there is no reason to expect prescribing habits will change with the newer hepatitis C drugs. It is up to you, the consumer, to check for potential interactions BEFORE taking medications. Fortunately, it is easy to do.
To find out if your medications or supplements might interact with your hepatitis C drugs:
- Read the prescribing information that your pharmacist gives you.
- Look at the warnings in the prescribing information on the drug manufacturers’ websites
- Use a drug interaction checker. My favorite for hepatitis C medications is hep-druginteractions
If you find a potential interaction, talk to your medical provider or pharmacist. Never stop taking a medication unless under medical advice, as abrupt discontinuation can be harmful.
Although some herbs and drugs have the potential to interact with the new hepatitis C medications, this doesn’t mean you can’t take drugs that may potentially interact. It usually means that your doctor or pharmacist will need to advise you on how to space out the timing of your medications.
Make it a lifetime habit to check for potential drug, supplements, and food interactions. A few minutes can save your life.