The document outlines various medications (A-H) prescribed to treat hepatitis C and combat their severe side effects. Medication A includes interferon treatment that can cause flu-like symptoms, tiredness, stomach issues, and risks to mental health. Medication B includes ribavirin that commonly causes anemia, headaches, irritability, and depression. Additional medications (C-G) are prescribed to address side effects of the hepatitis C treatments, including ibuprofen, triamcinolone, Zegerid, Paxil, and Zolpidem. The total monthly cost of the medications is around $3,200 without insurance. The side effects are a "private hell" and 32% cannot

1. MEDS
A: Peginterferon alfa-2a - 180mcg per week - Hepatitis C treatment
Side effects: The most common side effects of PEGASYS are:
• Flu-like symptoms (including fever, chills, muscle aches, joint pain, headaches)
• Tiredness
• Upset stomach (like nausea, taste changes, diarrhea)
• Blood sugar problems (may lead to diabetes)
• Redness and swelling at injection site
• Skin problems (like rash, dry or itchy skin)
• Hair loss (temporary)
• Trouble sleeping
The most serious side effects of PEGASYS and are:
• Risks to pregnancies
• Mental health problems (such as irritability, depression, anxiety, aggressiveness,
trouble with drug addiction or overdose, thoughts about suicide, suicide attempts,
suicide, thoughts about homicide, and hallucinations)
• Blood problems (like a drop in blood cells leading to increased risk for infections,
bleeding and/or heart or circulatory problems)
• Infections (which sometimes cause death)
• Lung problems (like trouble breathing, pneumonia)
• Eye problems (like blurred vision, loss of vision)
• Autoimmune problems (such as psoriasis, thyroid problems)
• Heart problems (including chest pain and, rarely, a heart attack)
• Rash with fever or blisters
• Liver problems (rarely, liver function worsens). Patients with both the hepatitis C
virus and HIV can have an increased chance of having liver failure during
PEGASYS treatment. Change in a blood test that measures liver inflammation
occurs more often in patients with hepatitis B. If you have a rise in this blood test
you may need to be watched more closely with additional blood tests.
B: Ribavirin - 1000mg per day - Hepatitis C treatment
Side effects
• Anemia. Anemia is a blood disorder where there aren't enough red blood cells to
carry oxygen. The result is that you're tired. After about two weeks of ribavirin
treatment, about 10% of people develop a severe form of anemia.
• Headache
• Irritability and anxiety
• Depression. Sometimes people taking ribavirin develop severe depression and can
even have suicidal thoughts. These side effects, along with general irritability, are
unofficially known as Riba Rage, even though they're really caused by the
interferon. For most people, these side effects can be controlled with

2. antidepressants or other medicines. It's important to look for signs of behavioral
change during treatment so your doctor can help control any developing
depression as quickly as possible. For people with known psychiatric problems,
it's possible your doctor will want to start you on a preventative therapy before
you start treatment. Some people with severe depression or a history of suicidality
may not be able to start treatment of hepatitis C.
• Alopecia (hair loss)
• Itchiness
• Insomnia (having trouble sleeping)
• Arthralgia (joint pain)
• Myalgia (muscle pain)
• Anorexia (loss of appetite)
• Neutropenia. Neutropenia is a blood disorder caused by a loss of neutrophils, a
type of white blood cell that destroys bacteria. Neutropenia is probably the result
of decreased bone marrow function, which the combination therapy suppresses,
and may mean your body will have trouble fighting off bacterial infections.
• Nausea and vomiting
• Fever
• Chills
• Fatigue (tiredness)
C: Ibuprofen - 1200mg per day - For combating items A and B side effects.
Side Effects of long term use:
chest pain, weakness, shortness of breath, slurred speech, problems with vision
• black, bloody, or tarry stools;
• coughing up blood or vomit that looks like coffee grounds;
• swelling or rapid weight gain;
• urinating less than usual or not at all;
• nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools,
jaundice (yellowing of the skin or eyes);
• fever, sore throat, and headache with a severe blistering, peeling, and red skin
rash;
• bruising, severe tingling, numbness, pain, muscle weakness; or
• fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots
on the skin, and/or seizure (convulsions).
Less serious side effects may include:
• upset stomach, mild heartburn, diarrhea, constipation;
• bloating, gas;
• dizziness, headache, nervousness;
• skin itching or rash;
• blurred vision; or
• ringing in your ears.

3. D: Triamcinolone Acetonide - For combating side effects of item B
Side effects
itching, burning, irritation, or dryness which may occur when first applied
E: Zegerid - 1100mg per day - For combating side effects of item B
Side effects:
easy bruising or bleeding, unusual weakness; or
• fast, slow, or uneven heartbeat.
Less serious side effects may include:
• headache;
• nausea, stomach pain; or
• diarrhea or constipation;
• white patches or sores inside your mouth or on your lips;
• mild fever.
F: Paxil - 20mg per day - For combating the side effects of items A and B
Side effects: Abnormal ejaculation, abnormal orgasm, constipation, decreased appetite,
decreased sex drive, diarrhea, dizziness, drowsiness, dry mouth, gas, impotence, male and
female genital disorders, nausea, nervousness, sleeplessness, sweating, tremor, weakness,
vertigo
• unusual or severe mental/mood changes (e.g., agitation, thoughts of suicide)
• shakiness (tremor)
• restlessness
• inability to keep still
• decreased interest in sex
• changes in sexual ability
• blurred vision
• numbness/tingling
Major withdrawal complications.
G: Zolpidem Tartrate - 10mg per day - To combat the side effects of item F
Side effects:
• drowsiness
• dizziness
• lightheadedness
• difficulty with coordination
• diarrhea
• nausea
• vomiting
• vertigo
• headache
• asthenia
• amnesia
• tolerance

4. • dependence
• changes in behavior and thinking
Major withdrawal complications.
H: Synthroid - 75mg per day - Consequence of first interferon treatment.
Side Effects:
An increased appetite, along with weight loss Feeling hot all the time and increased
sweating Fever Hyperactivity, nervousness, anxiety, or irritability Insomnia (see
Synthroid and Insomnia) Emotional changes Shakiness or muscle weakness Heart
palpitations High blood pressure (hypertension) A rapid heart rate (tachycardia) Heart
failure, chest pain, or a heart attack Difficult or painful breathing Diarrhea, vomiting, or
abdominal cramps (stomach cramps) Hair loss (see Synthroid and Hair Loss) Flushing
Broken bones or other signs of weakened bones Menstrual problems or fertility problems
Seizures.
All these medications were avoided at all cost until there was no other choice.
The list was not just “possible side effects” I experienced 95% of them. Exception; It is
unknown what side effects may be experienced by synthroid until the other meds are
discontinued.
The cost of the meds alone are about $3200.00 per month over the six month period.
Without good insurance this treatment is prohibitive.
Without excellent support from job and family this treatment is impossible.
The doctors stress you must keep a positive attitude. That’s because there is no other
advice. That’s all ya got.
The Interferon and Ribavirin cause some unknown damage to all major internal organs.
So far Thyroid failure.
Each patient has a different experience. For me it is a private hell that no one will ever
know. About 32% are not able to tolerate side effects, most of them discontinuing
treatment before the half way point.
At the time of this writing I am going through Paxil and Zolpidem Tartrate withdrawal
including insomnia, profuse sweating, vivid dreams, night terrors, mild hallucinations,
feelings of unreality, dizziness, short of breath along with the side effects of items A and
B which should be over before too much longer. I am in week 23 of the 24 week
treatment.