A lot of people with hepatitis C worry about taking medications and those effects on their liver. But Suboxone can be safe for those with hepatitis C.
Hepatitis C doesn’t get as much public attention as it deserves considering how common and potentially dangerous it can be. The CDC estimates that 2.4 million Americans were living with the disease between 2013-2016, and infection rates of hepatitis C have been increasing each year. Left untreated, hepatitis C increases the risk of many diseases and conditions and can lead to serious liver damage.
The good news is a novel class of medications called DAAs (direct-acting antivirals) make treating hepatitis C faster, more effective, and less invasive than ever before. The current DAA cure rates have an impressive 95% cure rate using oral pills. The majority of people receiving this treatment regimen achieve undetectable viral loads in 8-12 weeks. That’s just two or three months!
These advancements are amazing but since they’re so new to the market it is expected to have questions about them. One frequent question we see is whether a person receiving treatment for hepatitis C can also safely take Suboxone (buprenorphine/naloxone). Here’s the scoop on taking Suboxone and hepatitis C medications at the same time:
Is it safe for my liver to take Suboxone and hepatitis C meds?
This is one of the biggest concerns that people have and it makes sense! Hepatitis C impacts your liver so you want to make sure you’re not putting additional strain on it with other medications. That very issue is why the University of Liverpool offers a Hepatitis C Drug to Drug Interaction Checker, to help doctors and patients understand possible drug interactions without guesswork or hearsay. Neither of the medications in Suboxone—buprenorphine and naloxone—is contraindicated with the medications for hepatitis C. This means that people can safely take Suboxone and their hepatitis C medications without fear.
But I heard that I have to take Subutex instead of Suboxone if I’m being treated for hepC.
This is a myth, but it gets spread around quite a bit. Subutex is a brand name for buprenorphine, while Suboxone is a brand name for buprenorphine-plus-naloxone. Naloxone is a medication that blocks opioids and (used on its own) can prevent overdose. In Suboxone, it’s a safety measure to help ensure that the medication is used as intended, and to reduce the risk of it being taken inappropriately. At some point, it became a common belief that the presence of naloxone in Suboxone made it unsafe to use with hepatitis C medications. But that’s just not true!
The fact is, research shows that Suboxone is tolerated well by people taking direct-acting antivirals for hepatitis C. The presence of naloxone does not increase the risk of liver damage (hepatotoxicity).
Is it important to be tested for hepatitis C even if I don’t have any hepC symptoms?
Yes! Many—maybe even a majority of people—living with hepatitis C don’t know they have it. When they’re initially infected, many don’t show any symptoms. But that doesn’t mean that there won’t be dangers or complications down the line. It’s important to test for hepatitis C so that it can be caught and treated before it has done irreparable damage.
The CDC recommends all adults be tested for hepatitis C, because such a small percentage of those who are infected realize it. People who use IV drugs are at an increased risk of infection, so it is even more vital that they be tested.
What if I drink or use drugs again after I start treatment for hepatitis C?
The American Society of Addiction Medicine says, “State of the art medical treatment for HCV should be accessible and available to all current and former drug users with chronic HCV infection. Active alcohol and/or drug use should not in itself exclude any person from receiving treatment for their HCV infection. The outcomes for patients who continue to use alcohol and/or drugs are comparable to those who do not.”
While it’s better for your liver to not drink or use drugs if you have hepatitis C, you should receive the treatment you need regardless.
How does Workit Health test for and treat hepatitis C?
If you’re part of our medically-assisted treatment clinic for alcohol or opioids, your Workit Health provider can order a blood test for you at a local lab. Should the results come back positive for hepatitis C, your provider will work with you to determine which of the direct-acting antivirals is the best option for you. They will send the e-prescription to your local pharmacy, the same way they do for other medications.
The fact that hepatitis C can now be cured with a course of tablets taken by mouth is an amazing advancement. Don’t let a fear of the unknown or of an interaction with your Suboxone stop you from getting the treatment you need!
This blog post has been reviewed for medical accuracy by Paul Leonard, MD.
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