Procrit question

  Hi, I was wondering at what point I should think about procrit. My Liver Dr. doesn't like to use it and would rather cut ribo. He would give it to me if I insisted though. My last hct in feb. was 11.5 down from 12.5 in Jan. I didn't have my March test 'cause my platelets were 48 and if they get too low they will reduce meds. I have been having alot of monthly bleeding and feel pretty wiped out. I made an appointment to get lab done on Fri. Part of me says what you don't know won't hurt you and then I think that maybe I could feel better on procrit. I am on week 30 of 48 and don't want to reduce meds now. What # should I consider procrit?  Boy I was feeling pretty good for a while....I work full time but am starting to feel like an old Lady.( I'm 46)  Sorry so wordy but no one understands unless you've been through it.  Thanks!

[rosebud57]

my GI RN let me go down to 10.4, they have kept me hovering around 11.5 first  took 1 inj. wk for 4 weeks, they monitored blood level, then put me to everyother week.  40,000u.  

the recent black box concern was never an issue for my hmo, apparently because was direct to cancer pts. and use over 12.0. hemo level.

i am near tx end ( 4-5 weeks to go) so think they should start weaning me off w/reduced dose, any thoughts from others on reduction of procrit or other meds prior to stopping.

[goldyn]

I remember when my hemo got right below 11 I was a floundering fish gasping for air just to make it through walmart, and when i told the doc this, and showed him the way i was gasping for breath he immediately started me on procrit but i was on my 36th week already and he only gave me 15,000 a shot once a week instead of 40,000 which i am thankful for now...it kept me around 11 and a little higher so i could finish tx, its good that you have gone 30 weeks without having to have any rescue drugs......

[FlGuy]

What you don't know can hurt you. If your hgb was dropping in Feb and you've stayed on your med schedule, there's no reason to think hgb hasn't dropped further.  Get the cbc, check where you are and talk to the doc.  You are too far into tx to risk reducing dose now and it sounds like you need to remain somewhat functional for work.  With platelets at 48, they are getting low but at the point that you need to watch them.  Most experienced hcv tx docs won't take any action til they get to the 25-30 range.

[aquarius64]

my Gi sent me to the hema when i hit 10.1 and i'm usually 13.6 or so. i did 40,000 of procrit and then went 3 weeks later for the same. i have been hovering around 11.1-11.3. i am in week 11 of tx and started the procrit at about week 6. i get so out of breath walking or especially going upstairs and i used to run 3-5 miles 3-4 times per week. my ANC is low but not too bad and my platelets are low around 80. the procrit hasn't helped me too much. i feel worse now the further i get into tx. the shots seem to be affecting me more and i feel more nausea. i hope things get better for you. finding the right dosing of procrit should help. good luck to you and God bless.

[friole]

Hey, Libby, FL is right.  You need to know but whatr are your options?  Find another doctor who will prescribe the procrit?  Can you get a referral to a hemotologist?  I think that would be the best solution.  Hang in there, girl, you are getting so close!  I know what you mean about aging.  I feel my age now.  Before txing I didn't. frijole

[GrandOak]

It's not just a number, but also the rate of decrease.  It seems everyone sees a drop in Hgb as a result of Riba med when they begin tx.  For most, it seems to reach a low point and stablizes there for duration of tx.  The rate at which it decreases can sometimes be an indicator on how low it might go.

For you, 12.5 is low normal for most females and only dropping to 11.5 in one month does not seem to be an extremely fast decline.  In this case, most docs would tend to look at a threshold for Hgb to cross before prescribing, which seems to be somewhere in the lower 10's.

One of the down sides is that Procrit takes 2-6 weeks to fully kick in, so it is hard to properly adjust and one needs to be alert enough to catch drop before it drops too low to give it adaquate time to go to work.  Others are the side effects, some long term (i.e. lifetime) which could result in more harm than good.

The biggest danger seems to be in how high it kicks ones Hgb because if it goes too high it could produce some serious cardio-vascular problems.

Thus, while it really bites to have one's arse dragging on the ground, the potential longterm  effects sometimes makes it the more desirable option with which to have to contend.

Personally, I am beginning to wonder if me having to use 100,000 U per week for many moons is not resulting in some of the after effects I'm experiencing from tx,  which really bites as a double whammy given that tx failed me!

Hope this helps.

[ejoli]

Thanks for replying. I feel kind of stupid as I'm feeling a little better today. I am getting my cbc on Thurs. though. Guess you can't hide your head in the sand. Hopefully my counts aren't any lower. But I have made it 30 weeks without any rescue drugs so I'll probably be alright. Hope you all are hanging in too...
                                                                                      -Libby