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3172665 tn?1344189235

Can you change PIs???

If for some reason you stop Incivek ... Can you then attempt Triple-tx with Victrelis??

My mothers doc told her that once you have stopped one PI you cannot treat with ANY PI ever again.

I think I read on here on some of the other threads about people changing to Victrelis because Incivek side effects were too strong or other reasons....

What is your experience of knowledge on this matter??
13 Responses
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Avatar universal
So sorry your mom is having all these problems. Sounds like her doc threw in the towel without researching. I wrote you a message on your other thread about doctors in mesa.  Hope you find a good doc for your mom soon.
Helpful - 0
3172665 tn?1344189235
Thank you for your feedback ... it will definitely help in our search for either a new doc or making this one listen to my mom and I more.
Helpful - 0
3172665 tn?1344189235
Yeah, I pretty much said the same thing to my mom... My biggest obstacle in helping her is that she and i are 2000 miles apart. I'm in michigan and she is in Arizona... cause trust me if I had been there she would DEFINITELY have been seen when the rash started cause I would not have stood for anything less.

Helpful - 0
Avatar universal
  Just to put my two cents in, I have two people in my support group, who started with one PI, and switched to the other.
   These are people from my Doctors' HCV support group, and one developed such a bad rash immediately, from the Incivek, that he was taken of of it after 4 days (and a trip to the ER) and put on Boceprevir.
    
Helpful - 0
Avatar universal
I really think you should find another Hepa Dr for your mother.  This whole thread has thrown me for a loop so I can only imagine how you feel.  If that was my mother I would be ripping!!!!  I can't believe he never physically saw her when she needed to be seen immediately.  

Please stay in touch and let us know how things are going.  This is just ridiculous what you and your mother are going through.

Jules
Helpful - 0
3172665 tn?1344189235
Thank you so much for responding... That is PRECISELY what happened to mom.

Basically she started treatment (very first dose) friday. Saturday she began breaking out in a rash. Sunday it was significantly worse so she called the on call doc. They couldn't call her in the steroid cream because the apothecary shop is not open on weekends. HER doc did not call her until after close of business on Monday and therefore STILL could not call her cream in and her rash had gotten worse yet again. Tuesday morning her doc called in the cream. Mom was not supposed to get it until Wednesday evening... and her rash had gotten even worse over night yet again... SO I remembered all the advice everyone gave in how they found to best manage their rash and that several had mentioned taking hydroxyzine in addition to the topical steroid. So I called her doc to see if they could call that in for her as well because she didn't want to risk the rash progressing before she could get the cream and making her have to stop treatment.

Her doc called her back and told her to send a picture of the worst spot of he rash and one of the least affected spot. So she did. Based on these Phone camera photos (which anyone knows depending on lighting and quality of the camera phone things can look much different than they appear in real life.) he told her to stop the incivek treatment. My mom is one to follow just what doc says no matter what and does not have the resources I have to really question what he says... so i did the digging for her.

We called her doc to see if she could continue with treatment and allow the meds a chance to work before making the call to stop treating with Incivek. Her doc called her and told her that based on protocol HE could not tell her to keep taking the medicine... but ... that since she had it there with her he could not stop her if that was what she wanted to do... BUT then told her that IF she decided to do that and the rash continued to progress then she ran the risk of having to stop the riba/interferon as well.

My mom, too afraid of what he told her, decided to stop as he said.
It's been less than a week since she stopped and she did get the hydroxyzine and the steroid cream and her rash is almost gone.

Her doc told her that she cannot treat with ANY PI because of the four and a half days she was on the incivek.
I think he is wrong... but wanted to see if I could find anything where anyone had done this.
Helpful - 0
Avatar universal
What About Drug Resistance?
Some new copies of HCV carry mutations, meaning they are slightly different
from the original virus. Some mutated virus can keep multiplying even when you
are taking anti-HCV medications. When this happens, the drug will stop working.
This is called "developing resistance" to the drug.
Resistance can develop quickly. It is very important to take antiviral
medications according to instructions, on schedule, and not to skip or reduce
doses.
If your HCV viral load is too
high after 4 weeks of treatment, your doctor might decide that you should stop
taking telaprevir to avoid having your HCV develop resistance.


http://www.thebody.com/content/63254/telaprevir-incivek.html
Helpful - 0
Avatar universal
Can you then attempt Triple-tx with Victrelis??
-----------------------------------------------------
There is no clinical data on whether or not this would result in a successful overall result.
For both these drugs the prescribing protocol is that neither is at all supposed to be stopped or interrupted.

This is not recommended ( below),therefore I personally would find the results of doing such interesting

Good luck to your mother and please keep us informed...

Will

http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/201917lbl.pdf

To prevent treatment failure, the dose of INCIVEK must not be reduced or interrupted. Refer to the respective prescribing information for dose modification
of peginterferon alfa and ribavirin [see Warnings and Precautions (5.7




Helpful - 0
Avatar universal
I am wondering if any resistance testing should be done when considering switching within the PI class of drugs?  Just thinking out loud here :)
Helpful - 0
Avatar universal
Parker19 and Doctors seem to have had a very good plan since there would be no resistance issues.............. Good luck
Helpful - 0
Avatar universal
I was on incevek for 5 days and developed such a severe rash they took me off of it.  They kept me off of all treatment for one month so I could get back to baseline, then they started me on riba/ pegasys for one month lead in to victrelis and I have tolerated this treatment fairly well.  I am now on week 17 of triple therapy.  My doctor consulted with Mayo clinic to restart me on the victrelis.  I know there are a lot of variables they consider.  Hope this helps
Helpful - 0
317787 tn?1473358451
There is one other person on here who was on the Incivek for 4 days, he could not tolerate it and is now on Victrellis.  His doctor told him that 4 days was not enough to develop a resistance.
I hope that person will see this.  I will try to find the post
Helpful - 0
3172665 tn?1344189235
Allow me to add it was not due to resistence... this was week one of treatment and she only made it 5 days before being told to stop taking the incivek.
Helpful - 0
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