How do DAAs Compare to Older Hep C Medications?

Why direct-acting antivirals are the preferred choice for treating Hep C.

Medically reviewed in September 2021

While millions of Americans have hepatitis C (HCV), most will not experience any symptoms until the disease has worsened, causing cirrhosis, liver cancer or even liver failure. That’s why diagnosing—and treating—the condition early is important in order to stop or slow liver damage.

Unfortunately, the treatment that has been around the longest, interferon and ribavirin, causes such serious side effects that many people would quit treatment or even put it off until their condition was advanced.

The good news: Newer drugs, known as direct-acting antivirals (DAAs), such as Harvoni and Viekira, have very mild side effects – if any at all.

Learn about the side effects associated with each drug to find out which treatment may be best for you.

Side Effects of Interferon and Ribavirin
Treatment with these drugs was a lot like having the flu over and over—for almost a year. Think fatigue, headaches, body aches and fever. Unfortunately, the list of other possible side effects is long:

  • Insomnia
  • Depression
  • Difficulty concentrating
  • Nausea, vomiting, diarrhea
  • Poor appetite
  • Weight loss
  • Taste changes, such as having a bitter or metallic taste in the mouth
  • Dry mouth and/or dehydration
  • Sore throat and mouth sores
  • Hair loss
  • Dry and brittle nails
  • Low libido
  • Red, itchy spots at the injection site

While uncommon, some serious side effects require immediate medial attention: severe depression, chest pain, skin rashes, loss of vision or blurry vision, shortness of breath, bloody diarrhea, unusual bleeding and severe abdominal or lower back pain.

Side Effects of Direct-Acting Antivirals (DAAs)
By comparison, these newer drugs are very gentle. People may experience mild tiredness, headache and weakness, or have no side effects at all. There are still certain dangers to be aware of, though. Some DAAs can interact with other meds and cause a slower heart rate. Others may bring on liver failure in people who already have liver damage.

Also, some people need to take ribavirin along with DAAs, which may cause side effects such as fatigue, nausea, skin reactions, headaches and difficulty sleeping.

Talk to your doctor to find the best treatment for you, and remember to tell him about the medications you’re taking so you can avoid any serious drug interactions. If you do experience any side effects during treatment, tell your doctor. He may be able to help manage any symptoms or side effects to make treatment more tolerable.

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