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The First Injection
It is recommended to take the first few injections in the evening. Interferon
side effects generally begin 4-6 hours after the first injection. Usually, side
effects related to the first or second injection include fever & chills,body
aches & headache. They generally last about 6 hours. By taking the first few
injections in the evening, these effects may be obscured by sleep.

Before starting therapy, talk with the prescribing provider about the use of
over the counter ****gesics for fever reduction and relief of body aches. If it
is deemed safe for the patient to use non-steroidal anti-inflammatory drugs
(NSAIDs), the more long acting the better. Long acting (once or twice a day)
preparations deliver the most sustained benefit using the least daily amount of
medication. All NSAIDs are processed by the liver, so they should be used
sparingly.

In patients with compensated liver disease, a recommended measure for reducing
side effects is to increase fluid consumption from the first day of therapy. A
gallon a day is the goal. Increased fluids include non-caffeinated, non-
alcoholic beverages. Some examples are most clear colored soft drinks, powdered
drink mixes, herbal tea, and sports drinks. Caffeine and alcohol cause more
frequent urination (diuretic), so fluids containing caffeine should not be
counted. It is recommended that alcohol should not be used at all. Increasing
fluids helps eliminate toxic byproducts of treatment from the body. The result
is that fatigue, headache and mental confusion may be reduced by simply
increasing fluid intake to at least a gallon a day.

Patients on a fluid restricted diet should strictly adhere to their prescribed
fluid restriction.

The First 2 Weeks
The first two weeks of all interferon therapies can be trying. While the body
acclimates to interferon, often persons receiving interferon with or without
ribavirin feel run down, fatigued, emotional, irritable, or may have difficulty
concentrating or sleeping. These are frequently occurring side effects. The
good news is these side effects tend to decrease or disappear for may people
after the first month on treatment.

Some people may feel depressed. Depression may be characterized by a loss of
interest in usual activities, difficulty falling back to sleep, sadness,
hopelessness, or thoughts of suicide. These should be reported to the treating
provider by phone or in person.

One should meet regularly with a knowledgeable health care provider to monitor
side effects and laboratory results for safety, as well as monitor the
effectiveness (efficacy) of therapy.

The First Month
In general, the first month is the toughest part of treatment. The first month
is something to weather, then things begin to improve. Most people report fewer
and less severe symptoms.