Do narcotic pain relievers lower effectiveness of interferon?

[bluepeng]

Man, I can't believe I've done four shots.  I'm glad I didn't quit without giving some of the side effects a chance to calm down .. MANY did ... and some haven't.  I did my shot on Friday night and actually went out yesterday!  Of course I crashed when I got home. , but I felt reasonable throughout the day.    I owe a lot to the people here for kicking my butt (in a good way) and making me see through the first weeks.  I've still got a way to go so I'm not partying yet.   My question is this;  I've been given a prescription for Norco (hydrocodone) for headaches and general pain from treatment.   I don't want to overload on meds, but I especially don't want to ruin my chances of clearing this virus.  So, can drugs like this lower my chances of clearing the virus?  Has anybody here ever taken pain meds throughout treatment  .. either occassionally of consistently?  I've been resistant to taking anything while doing tx .. including anti-depressants only because I'm hyper aware of adding more side effects.  If I need those at some point, I will take them, but we'll see how that goes.

Many thanks again,

Peng.  

[doll face]

I forgot to mention that for most of my body aches and pains a nice soak in the hot tub or even bath if you don't have one did help alot too. Just don't over do it and make sure you drink extra water so you don't dehydrate.

Good luck to you

[bluepeng]

I'm still a little paranoid of having other meds in my body competing with the Interferon -- I don't want to put this effort in only to find that I'm not responding.  But, my doctor is of the philosophy (as others here are) that staying on tx is what's important and if meds are required, then so be it.   If there are any chronic pain people out there who completed tx with no complications from meds, please feel free to share your thoughts.

[cuteus]

that is the main thing; to stay as functional as possible, and to finish the tx, let's use whatever med helps with those things.

[KICKED]

Hi guys
I just paid almost 100.00 for 2 chiropractic visits with no results.  My choice for the pain in my head was one of 2 things, tylenol 3's or a gun. I don't own a gun so I went for the other. I was scared to take them but the pain was unbearble. My dr. said today that I can take up to 4 a day until the pain subsides.  It is hardly working but at least I am functioning through my day. I was told not to take advil.  It looks like a different story for a different doctor.

[cuteus]

I used Vicoprofen throughout TX and so far I got a negative PCR test(5 wks post), will have in a couple of wks the next PCR result. The way I see it, even if it slows down the viral clearance,  if tx compliance is enhanced by the lowering of sides teh med can produce, then go for it. It is better to ease the pain so that you can finish the tx, than not use it and be extremely stressed out and miserable or worse, quit.

[doll face]

I was prescribed antidepressants, (remeron) to help me with depression and to help me sleep. I was also given vicodin 750mg(prescribed 6-8)  a week. I did not need or want to use that many but did take them when needed for the bone pains. My hepatologist did okay this dose. He also gave me flexeril for muscle pain.(didn't use these as often)

I hope you don't need to use them too much, but some of the people here also need to see a pain management doctor. I'm sure they will be here shortly to tell you thier story.

Good Luck

[TnHepGuy_]

I was thinking of your situation (re: never having reached serum clearance in 7 tx attempts) and began to wonder about riba levels. <a href="http://www.natap.org/2005/HCV/012505_01.htm">This pilot study</a> took 10 previously untreated geno 1 patients and gave them escalating dosages of riba until it met a certain range of serum concentration. By week 24 the mean dialy riba dosage was 2,540 mg/day (with the highest individual dosage given being 4,000 mg/day). For interferon, they were given 180 mcg. of Pegasys. The end result being that 9 of the 10 gained SVR status.


I'm not sure what your levels of riba have been for your tx's. Or what your sx experiences have been from it (and they certainly can be brutal). But knowing how much of an important role the riba plays in viral suppression and overall elimination, and knowing how important viral clearance is early on in tx, would it be possible for you and your doctor(s) to consider upping your dosage of riba in an attempt to get you to the point of clearance? If not long-term, perhaps even short-term? Even if you are unable to tolerate such high dosages for the duration of your tx, perhaps you could keep it elevated for a short period, monitor your viral load levels frequently, then back down to a more standard dosing range - hopefully eliminating or keeping the virus in overall check that way.

If you think so, you could print out the study and discuss it with your doctor, with the thought in mind that you wouldn't necessarily need (or want) to be on the levels of dosage that these patients were at, but that this study demonstates that higher doses can be much more effective in viral elimination and still be tolerable.

Another thought along the same lines is that the riba pro-drug <a href="http://www.hivandhepatitis.com/2004icr/39easl/documents/0419/041904_hcv_b.html">Viramidine</a> has been shown in studies to produce less overall anemia in patients than riba, though in this study it was given in more standard dosing amounts (800-1600 mg/day). Perhaps this might be another option should it receive FDA approval.


May God's blessings and mercy be upon you.


TnHepGuy

[Califia]

Ah, synchronicity!   A couple days ago I  posted a detailed account of the Riba study under the first "What if treatment doesn't work" thread by Katee.   A very compelling study on two counts:  it underlines the importance of ribavirin not merely as an adjunct to interferon but as a full therapeutic partner and clearly demonstrates that a hard-to-treat patient group--in this case, geno 4--CAN be treated successfully the first time out.   Who among us would not  cozy up to the possibility of a 90% SVR rate?   I'm definitely with Hepguy on this one.  It breaks my heart to hear of Susan's having to endure 7 unsuccessful treatments.   Is not inadequate dosing a violation of the physician's obligation to first do no harm?

[susan400]

I've taken Ultram throughout treatment until recently.  Since my doctor had to prescribe something stronger because I got a herniated disk in my back.  So, when my pain doc prescribed Oxycodone (Codone w/o the Tylenol factor), I changed how often I was taking Ultram.  Ultram is good for when you need to be able to drive somewhere.  I can drive on Ultram w/o a problem, but on the heavy duty pain meds, I can't drive and have to get someone to drive me.  Since I've treated numerous times and have never had an SVR., I'm probably the wrong one to ask!  The first 3 treatments I wasn't on daily Ultram, in fact I wasn't on Ultram at all and I still didn't get remission.  Best of luck to you and God Bless.

Susan