Hepcludex (bulevirtide) is a medicine used to treat chronic hepatitis D, which is a long-lasting liver infection caused by the hepatitis delta virus. Like other medicines, Hepcludex has possible side effects and other safety considerations to keep in mind.
Read on to learn about possible Hepcludex side effects and interactions, and how to manage them. This article does not include all possible side effects or interactions. Tell your health care provider about any symptoms that concern you or do not improve.
Hepcludex Side Effects
Common side effects
Common side effects reported with Hepcludex include:
- Pain, itching, swelling, redness, bruising, or infection at the injection site
- Headache
- Stomach pain
- Tiredness
- Itchiness
Serious side effects
While less common, potentially serious side effects of Hepcludex include:
- Severe allergic reactions (such as trouble breathing, swollen tongue or lips, or widespread hives)
- Sudden worsening of hepatitis after stopping treatment
Do not stop using Hepcludex unless your prescriber recommends it. If you have symptoms that feel serious or life-threatening, seek medical care right away.
How to Manage Hepcludex Side Effects
Most people tolerate Hepcludex well. While not a complete guide, here are six Hepcludex side effects in more detail, along with steps you can take to prevent or manage them.
1. Injection site reactions
Like other medicines that are given by injection, Hepcludex may cause irritation or discomfort at the injection site. In studies, nearly one-third of people who used Hepcludex had injection site reactions.
Symptoms at or near the injection site may include:
- Pain
- Itching
- Swelling
- Redness or discoloration
- Bruising
- Pus or oozing, which may mean the skin is infected
These symptoms are usually temporary and go away on their own. Here are some tips to prevent or ease injection site discomfort:
- Review the step-by-step instructions that come with Hepcludex or on the drugmaker’s website.
- Be sure to rotate the injection site each day.
- Avoid injecting into moles, scars, bruises, tattoos, or skin that is red, hard, tender, or injured.
- Clean the injection site with a new alcohol swab before each injection and allow the skin to air dry completely.
- Ask your health care provider if it’s OK to use a cool compress on the area or if an over-the-counter (OTC) pain reliever or anti-itch medicine may help.
Let your health care provider know if injection site reactions persist or feel severe. They may suggest other ways to manage your symptoms. Ask your health care provider or pharmacist if you have questions about proper injection technique or supplies.
2. Headache
Headache is another common side effect of Hepcludex. In studies, about 20% of people who used Hepcludex reported having headaches.
To help prevent or manage headaches:
- Rest in a quiet, dark room if needed.
- Drink enough fluids and eat regular meals or snacks.
- Maintain a regular sleep schedule.
- An OTC pain reliever may help, but check with your health care provider or pharmacist first to make sure it is safe for you.
If headaches happen often or feel severe, let your health care provider know. They may want to examine you or do tests to check for other causes.
3. Stomach pain
Stomach pain is a possible side effect of Hepcludex. In studies, some people reported pain in the upper or lower abdomen.
Stomach pain can happen for many different reasons, many of which are not serious. In some cases, though, stomach pain could be related to liver complications from hepatitis D. Contact your health care provider if your stomach pain is severe, does not go away, gets worse, or happens along with other symptoms, such as:
- Vomiting
- Swollen belly
- Yellowing of the skin or eyes
- Fever
- Confusion
Your health care provider may check your liver health, order blood tests, or look for other possible causes of the pain. Depending on the cause, they may recommend treatment, closer monitoring, or changes to your care plan.
4. Tiredness
People taking Hepcludex can experience tiredness or fatigue. Fatigue is also common in people living with liver disease.
To help prevent or manage fatigue:
- Pace yourself and take breaks throughout the day.
- Stay hydrated and eat regular, nutritious meals to help support your energy levels.
- Ask family or friends for help with tasks when needed.
- Stay as active as you can, since inactivity may worsen tiredness.
Contact your health care provider if tiredness becomes severe, suddenly worsens, interferes with daily activities, or occurs along with other symptoms (as listed in the section above).
5. Itchiness
Itchy skin, also called pruritus, can occur in people taking Hepcludex. Itchy skin can also be a symptom of underlying liver problems.
To help prevent or manage itchiness:
- Use gentle, fragrance-free soaps and skin products.
- Apply moisturizer regularly, especially after bathing.
- Drink plenty of water and try to avoid scratching the skin.
Contact your health care provider if itching is severe, keeps you awake at night, causes skin damage, or does not improve. Your health care provider may suggest treatments to ease itching or protect the skin.
6. Severe worsening of hepatitis
Hepcludex has a boxed warning about severe worsening of hepatitis D or hepatitis B after stopping treatment. A boxed warning is the FDA’s strongest warning for prescription medicines.
After Hepcludex is stopped, hepatitis D or hepatitis B can suddenly flare up and worsen, especially in people with cirrhosis (advanced liver scarring). In serious cases, the liver may stop working well.
Possible symptoms may include:
- Yellowish skin or eyes
- Swelling in the belly or legs
- Confusion
- Severe tiredness
- Dark urine
- Nausea or vomiting
Do not stop Hepcludex without first talking to your health care provider. If treatment is stopped, you will likely need blood tests and follow-up visits for at least six months to monitor your liver health and virus levels.
FAQs About Hepcludex Interactions
Does Hepcludex interact with other medicines?
Hepcludex is not expected to cause drug interactions or be strongly affected by other medicines. Unlike some other medicines, Hepcludex is not broken down by liver enzymes that are involved in many drug interactions.
That said, some medicines can affect the liver and may not be safe for people with liver problems. Always tell your health care provider and pharmacist about any prescription drugs or OTC medicines you use. This is especially important if you also take medicines to treat hepatitis B or other conditions.
Does Hepcludex interact with alcohol?
It is unknown if drinking alcohol will affect Hepcludex. However, alcohol can cause more damage to the liver in people with liver problems, including hepatitis D. Your health care provider may recommend avoiding alcohol or limiting how much you drink.
Does Hepcludex interact with supplements?
There are no known interactions between Hepcludex and dietary supplements.
However, some herbs and supplements may be harmful to the liver. Always tell your pharmacist and other health care providers about any vitamins, herbal products, or dietary supplements you use. And check with your health care provider before starting any supplement.
Reducing Your Risk of Side Effects and Interactions
You can help lower your risk of side effects and interactions by using Hepcludex exactly as prescribed. Other helpful tips include:
- Go to all follow-up appointments and lab tests.
- Tell your provider about all medicines, vitamins, and supplements you take.
- Report any new or worsening symptoms to your health care provider right away.
- Do not stop taking Hepcludex unless your health care provider tells you to.
- Check with your prescriber or pharmacist before starting any new OTC medicines or supplements.
