10.7.0 Side Effects

10.7.0a Nausea

Nausea and vomiting can often be controlled or at least lessened. If you experience this side effect, your doctor can choose from a wide and ever-growing range of drugs that help curb nausea and vomiting. Different drugs work for different people, and it may be necessary to use more than one drug to get relief.

Don’t give up. Continue to work with your doctor and nurse to find the drug or drugs that work best for you.

You can also try the following ideas:

Avoid big meals so your stomach won’t feel too full. Eat small meals throughout the day.
Drink liquids at least an hour before or after mealtime, instead of with your meals.
Eat and drink slowly.
Stay away from sweet, fried, or fatty foods.
Eat foods cold or at room temperature so you won’t be bothered by strong smells.
Chew your food well for easier digestion.
If nausea is a problem in the morning, try eating dry foods like cereal, toast, or crackers before getting up.
Drink cool, clear, unsweetened fruit juices, such as apple or grape juice, or light-colored sodas, such as ginger ale, that have lost their fizz.
Suck on ice cubes, mints, or tart candies.
Try to avoid odors that bother you, such as cooking smells, smoke, or perfume.
Prepare and freeze meals in advance for days when you don’t feel like cooking.
Rest in a chair after eating, but don’t lie flat for at least 2 hours.
Wear loose-fitting clothes.
Breathe deeply and slowly when you feel nauseated.
Distract yourself by chatting with friends or family members, listening to music, or watching a movie or TV show.
Popsicles
Sea Bands are elastic bands worn around the wrist, with a small built-in “bump” which presses against an acupressure point on your wrist. Many people find these to be extremely helpful for both nausea and dizziness. Sea Bands can be found in most Sporting Goods departments, or fishing supply stores.
Peppermint tea works wonders for nausea, as does a small (very small) drop of peppermint essential oil on the tip of your tongue.
Many people find chewing on candied ginger helpful. You can find candied ginger available in the spice department, or in the Oriental foods section of your grocery store. Or you can put a pinch of dried ginger in powder on the tip of the tongue or chew a piece of the root. Or drink a tea: boil one cup of water with a slice of fresh ginger root (or 1/2 teaspoon of dried ginger powder) for 10 minutes. Strain it and add a few drops of lemon.

10.7.0b Hair loss

Some people experience hair loss as a side effect of interferon, but it doesn’t always happen. It may range from a slight to moderate amount of hair loss, but I have never seen anyone become completely bald from the dosages given for hepatitis. The hair grows back after the treatments are over.

When your hair does begin to grow back in, it may come in thicker, curlier, or straighter than it did before your interferon therapy. Hair loss can occur on all parts of the body, not just the head. Facial hair, arm and leg hair, underarm hair, and pubic hair may all be affected.

Hair loss usually doesn’t happen right away; more often, it begins after a few weeks. At that point, hair may fall out gradually or breaks at or near the skin, and the scalp may become tender. Any hair that is still growing may become dull and dry.

To care for your scalp and hair:

Use mild shampoos.
Use soft hair brushes.
Use low heat when drying your hair.
Don’t use brush rollers to set your hair.
Don’t dye your hair or get a permanent.
Have your hair cut short. A shorter style will make your hair look thicker and fuller. It will also make hair loss easier to manage if it occurs.

There is a special type of shampoo and conditioner designed specifically for people undergoing chemotherapy. Many people have reported good results using it while taking interferon. The brand name is “Nioxin” and it is sold only in salons.

10.7.0c Fatigue

Fatigue is a common symptom of hepatitis, and it can become worse while you are taking interferon. Here
are some things you can do to help yourself feel better:

Get plenty of rest. Sleep more at night and take naps during the day if you can. Try to schedule regular rest periods each day.
Limit your activities: Do only the things that are most important to you.
Delegate tasks. Don’t be afraid to get help when you need it. Ask family and friends to pitch in with things like child care, shopping, housework, or driving.
Eat well, and be sure to include plenty of healthy foods.
When sitting or lying down, get up slowly. This will help prevent dizziness.
Don’t stand when you can sit.
Plan your activities and assemble everything before you start.
Reschedule daily tasks so you do some only 3 or 4 times a week so you have time to rest each day.
Use a cart, wagon or basket to carry things from one part of the house to the other to eliminate retracing your steps.
Sit on a stool in the bathroom while shaving or applying makeup. Prop elbows up on counter if you can.
Use warm, not hot water for baths or showers. Hot water increases muscle fatigue.
If your fatigue is severe, think about asking your doctor for a handicap sticker for your car.
Shop when you are at your peak energy.
When shopping alone, ask a grocery clerk to carry out groceries.
If you arrive home from grocery shopping tired, put away only the perishables. A family member or friend can do the rest.
Shop by phone whenever possible.
Avoid peak shopping/traffic hours.

10.7.0d Mouth problems

If mouth dryness bothers you or makes it hard for you to eat, try these tips:

Ask your doctor if you should use an artificial saliva product to moisten your mouth.
Drink plenty of liquids.
Suck on ice chips, popsicles, or sugarless hard candy. You can also chew sugarless gum.
Moisten dry foods with butter, margarine, gravy, sauces, or broth.
Dunk crisp, dry foods in mild liquids.
Use lip balm if your lips become dry.
Avoid food with a lot of condiments (chilies, salt, acidity).
If possible, see your dentist before you begin taking interferon to have your teeth cleaned and to take care of any problems such as cavities, abscesses, gum disease, or poorly fitting dentures.
Brush your teeth after every meal. Use a soft toothbrush and a gentle touch; brushing too hard can damage soft mouth tissues.
If your gums are too sensitive for even a soft toothbrush, use a cotton swab or gauze. Use nonabrasive toothpaste or a paste of baking soda and water.
Rinse your toothbrush well after each use and store it in a dry place.

Magic Mouthwash
Magic Mouthwash was developed at Duke, and consists of the following ingredients (any pharmacist can do
this):

NDC Number	Metric Quantity
00143-1254-01	6.00 Hydrocortisone 20 mg tablet
000536-1220-85	60.00 Nystatin 100000 U/mL Susp (an antifungal)
99999-9999-99	420.00 Benedryl

More mixtures from Peppermint Patti:

First Magic Mouthwash Recipe

1/3 Maalox
1/3 liquid Benadryl
1/3 lidocaine viscose 2% solution

(You can buy Benedryl and Maalox at the pharmacy, over the counter. I easily got a prescription for
Lidocaine at walk-in clinic when they saw my mouth.)

Second Magic Mouthwash Recipe

1/3 liquid prednisone syrup 5mg/5mL
1/3 liquid Benadryl
1/3 liquid Nystatin

10.7.0e Infections

Interferon can decrease your white blood cell count (these are the cells that fight infections). Your doctor will check your blood cell count often while you are taking interferon, and if your white cell count falls too low, your doctor may lower the dosage of interferon for a while to give your body a chance to rebuild its defenses.

When your white count is lower than normal, it is very important to try to prevent infections by taking the following steps:

Wash your hands often during the day. Be sure to wash them extra well before you eat and before and after you use the bathroom.
Clean your rectal area gently but thoroughly after each bowel movement. Ask your doctor or nurse for advice if the area becomes irritated or if you have hemorrhoids.
Stay away from people who have diseases you can catch, such as a cold, the flu, measles, or chickenpox. Also try to avoid crowds.
Don’t cut or tear the cuticles of your nails. Use cuticle cream and remover instead.
Be careful not to cut or nick yourself when using scissors, needles, or knives.
Use an electric shaver instead of a razor to prevent breaks or cuts in your skin.
Use a soft toothbrush that won’t hurt your gums.
Don’t squeeze or scratch pimples.
Take a warm (not hot) bath, shower, or sponge bath every day.
Pat your skin dry using a light touch. Don’t rub.
Use lotion or oil to soften and heal your skin if it becomes dry and cracked.
Clean cuts and scrapes right away with warm water, soap, and an antiseptic.
Wear protective gloves when gardening or cleaning up after animals.
Do not get any immunization shots without checking first with your doctor to see if it’s all right.

Even if you take extra care, you may still get an infection. Be alert to the signs that you might have an infection and check your body regularly for its signs, paying special attention to your eyes, nose, mouth, and genital and rectal areas.

The symptoms of infection include:

Fever over 100 degrees F.
Chills.
Sweating.
Loose bowels
A burning feeling when you urinate.
A severe cough or sore throat.
Unusual vaginal discharge or itching.
Redness or swelling, especially around a wound, sore, pimple, or boil.

Report any signs of infection to your doctor right away.

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10.6.0 What do I do when I Can’t Afford the Interferon	Hepatitis C FAQ	10.8.0 Injection Hints

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