for Health Care Providers
Pharmaceutical Options for Managing Viral Hepatitis and Cirrhosis Complications in the VA Health Care System
Tables:
| Hepatitis B | |
|---|---|
*Note: PegIFN-a2a is the only peginterferon currently approved for the treatment of chronic hepatitis B in the United States. Refer to Chronic hepatitis B. (AASLD Practice Guidelines) [Lok AS and McMahon BJ. Hepatology. 2007 Feb;45(2):507-39] for detailed information, place in therapy and dosing of peg-IFN a in hepatitis B, or consult with your local VA pharmacist. | |
| Use may be restricted to Gastroenterology and Infectious Disease Services. | |
| Adefovir (Hepsera) | |
| Entecavir (Baraclude) | |
| Lamivudine (Epivir-HBV, 3TC) | |
| Peginterferon alfa (PegIFN-a)* | |
| Hepatitis C | |
|---|---|
| See also: VA Hepatitis C Treatment Recommendations (2012) | |
| Use may be restricted to Gastroenterology and Infectious Disease Services. | |
| Peginterferon alfa-2a (PegIFN-a2a, Pegasys) | |
| Peginterferon alfa-2b (PegIFN-a2b, PEG-Intron) | |
| Ribavirin (Rebetol, Copegus) | |
| Side Effects | |
|---|---|
| Use may be restricted to Gastroenterology, Infectious Disease and Hematology/Oncology Services. | |
| Hematological | |
| Granulocyte Colony Stimulating Factor (GCSF, Neupogen, Filgrastim) | |
| Epoetin alfa (Epogen, Procrit) | |
| Other Side Effects | |
| For expanded information and options to consider for management of other side effects, see The Hepatitis C Treatment Side Effect Management Chart. | |
| Cirrhosis Management | |
|---|---|
| Note: Antibiotics may include sulfamethoxazole/trimethoprim or fluoroquinolones. Selection should depend on local antibiotic susceptibility patterns. Consult with your local VA pharmacy for the preferred antibiotic in your area. | |
| Ascites | |
Furosemide (Lasix) Spironolactone (Aldactone) | |
| Encephalopathy | |
| Lactulose (Enulose) | |
| Rifaximin (Xifaxan) | |
| Portal Hypertension and Varices | |
Propranolol (Inderal) Nadolol (Corgard) | |
| Spontaneous Bacterial Peritonitis (SBP) Prophylaxis and Treatment | |
rimethoprim-sulfamethoxazole (Bactrim DS; Bactrim; Septra DS; Septra) Fluoroquinolones (Ciprofloxacin; Norfloxacin; Levofloxacin; Ofloxacin; Gatifloxacin and others) |
Prevention
Influenza vaccination
Pneumococcal vaccination
Hepatitis A vaccination
Hepatitis B vaccination
For detailed information on the administration of hepatitis A and B vaccination, please refer to the Vaccination Pocket Card
.
.For additional information on these agents, refer to the Pharmacy Benefits Management Website.
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