Tylenol vs. Motrin while on TX

Hello to all. I have a question about what pain killers are the best for us to take while on tx. My doc recommends that I take no more than 2000mg of Tylenol a day, but Tylenol doesn't do a thing for me (and I have more headaces than I can stand). Motrin seems to be much more effective for me, but I wanted to know if any of your docs have said Motrin is ok, and if so how much?

Just a little bit of info when I take Motrin I only take one and I take the generic form. I am 22/48 of treatment. I am 26 years old, Grade 0, stage 0. Had virus for 7 years. I am also having a terrible time on this tx (I have huge tummy problems) and I wanted to know if any of you would have decided to treat with current meds given my information? Also should I just try and continue it as long as I can, or give up now and wait for other drugs?

Also do any of you guys have severe gas, nausea and vomiting while on tx?

Any info would be helpful.
Thanks
Brooke

[v eggie dip]

HI I'm Beth...

You have no liver damage dear, why are you even on treatment...

I don't know anything about Motrin vs Tylenol other than I took Tylenol 3's every day of my life for years (degenerative disc disease) and when I found out I was HCV active they took the Tylenol away and now just give me codeine, said Tylenol is not liver friendly...

Best of luck to you

[Lynne5477]

I was a 1B with little to no damage and stuck it out the full 48 wks.  I, too, had terrible headaches and I think that was actually what caused most of my nausea.  I did have some vomiting in the early wks but think that was associated with the nausea caused by the headaches.  My doc rx'd Imitrex for me for migraines.  It worked wonders.....a true miracle drug for me.  You might ask about it and try it but it is expensive so I would advise only filling the rx with 3-5 pills to begin with.  Imitrex only works on migraines.....it doesn't work for a normal headache.  If your nausea is worse during a headache, then it probably is a migraine.

I took tylenol for normal pains.  My doc said stay away from NSAIDs (non-steroid anti-inflammatory drugs) although one every now and again was fine.

Good luck to you.  You've made it this far......hope the sx don't drag you down too much.

[Lynne5477]

I was a 1B with little to no damage and chose to tx.  Very Glad I did.  I'm now clear 1-year post tx.

[cuteus]

there is nothing wrong with trying to rid yourself of an infectious disease, even if you have mild liver damage. As a matter of fact, it makes more sense to try and do it while your health is good and your chances at svr at higher due to age and health. What makes no sense to me, is too chose to continue being infectious, but that is a road some take and if they are comfortable with it, it is their choice. People choose to get rid of benign tumors and non life threatening illnesses all the time. With invasive procedures and potentially toxic medications. What makes our tx unique is the fact that is so damn long, and exhausting. Tummy problems are common, I think because of the riba, and having vested 22 wks of your time and effort, you should try and finish and give yourself a shot at a virological cure. Did you have an undetected PCR at wk 12? That should be a big morale booster.
I had mild damage at stage 1 and decided to rid my body of HCV, especially since there are no guarantees that our bodies can wait, without developing hep c related conditions, for new drugs that no one really knows if they will be friendlier than the present ones. No one can tell you if you are in the majority that will progress slowly in liver disease or the minority that won't. Or if you will develop kidney problems, or thyroid, lichen planus, etc.
Try and finish, it is not that much longer. Make sure your physician assists you by prescribing effective medications for your sides. I used Vicoprofen for my aches.

[Healed24]

Hey Beth thanks for responding so quickly. I decided to treat because my gastro insisted on it. When I first found out I had HCV I was devastated, and I thought I was just going to drop dead right there, so I didn't even question him telling me to treat. It wasn't until about week 12 that I found this site and started learning that some don't treat with my stats. By then I was already undectable and thought I just keep at it (I took my PCR at week 11). But now I'm starting to second guess this. TX is a mess.

I also wanted to know do you guys take the riba at the same time everyday? I'm usually a couple of hours off. I try and let the vomiting pass before I pop a pill so as not to loose any of the meds (even though I take compazine for the vomiting it is starting not to work).

I'm on 1000mg of riba and 135ml of pegasys (since week 2), due to my sx and low ANC counts (eventhough I've been on neupogen since week 14 my ANC is still around 900). Also should I be pushing for my doc to increase my pegasys to 180ml with a ANC of 900 (wanted to know just in case I decide to keep treating).

Brooke

[v eggie dip]

sorry you're having a hard time...I can't talk of any experiences I have had with tx because I am not involved in tx (yet anyway)...I'm sure the wise ones here can shed some light on that...

I hope you gain SVR and one day have all those nasty drugs out of your system...I haven't got the bx results back yet so I may or may not have to treat at this time, but if I had your 0/0 bx results I would be flying high!!! (and not on drugs either)

Beth

[Healed24]

Hey thanks for responding. This website it absolutely fantastic. Thanks for your encouraging words. I really do want to rid myself of this virus. I've already committed so much (I put off law school for a year, I've been off work since May, not to mention the 22 weeks of misery I've already gone through), but this tx just really gets me sometimes. It really made me feel better knowing that some people do treat with little or no damage (I was starting to feel stupid for not researching before I started treatment and deciding to treat).

LYNNE5477 AND CUTEUS CAN YOU PLEASE LOOK AT THE POST I SENT TO BETH AND ANSWER THOSE QUESTIONS AS WELL. I WOULD REALLY APPRECIATE IT.

Thanks
Beth

[rifleman]

I had some vomiting the first 3 or 4 weeks of tx, generally for a day or 3 after the shot. As far as gas, I am a naturally gassy person. It is like a sport for me.  
I took my ribas at 6:30-7:30 in the AM and between 6:00 and 8:00 at night.  Seemed to work OK.  The average was 7AM and 7PM.
For painkillers, I didn;t really need them except for if I got a fever.  One weekend I had a headache that took a full saturday to get rid of.  For general use, I use ibuprofen.  For tx, I bought some tylenol too and alternated them. Tylenol worked better for fever and ibuprofen for pain.  For nausea you can drink ginger ale and there are meds available from your doc.
Did you have a low viral load.  There is a study that indicates that a geno 1 person with your amount of liver damage (none) with a low VL (I think it was less than 6000 or 10,000 or something) may only need 24 weeks if clear at week 4.  Of course, if you did not have a 4 week PCR, you will never know.  You could always talk to your doc about taking a gamble on 24 weeks (if you are currently clear, had a low initial VL, and are having problems with sx).  I was a 2b, was clear at week 4, and did 12 weeks tx, so I am a bit of a gambler too.
Good luck.
DJL

[v eggie dip]

do you have the link to that study on geno 1's treating for 24 weeks with low vl and little liver damage?

[rifleman]

BTW, I put off tx back in 1997 in favor of law school.  However, the cure rate was around 25% back then for geno 2. I think it was a good idea for you to try to kill the HCV before entering the field of law.  I managed to run my sole practice thru 12 weeks of tx, but only because criminality takes a bit of a break during the hot summer.  As far as law school, it is only itimidating for the first semester.  After you get a round of exams under your belt, it gets rote.  If you don't "get it" by Feb of your first year, you should start worrying.  The third year was boring as hell, so the old adage of "1L, scare you to death; 2L work you ro death and; 3L bore you to death" is entirely accurate.
DJL

[cuteus]

I researched HCV just enough to know I wanted it out for good. MOre research would not have changed my mind. I might have considered consensus interferon first, had I known its advantages, but I think that would have kicked my butt big time. The Pegasys was easier to handle but I had to go longer because HCV was still detected at wk 12, and I did forget riba a million of times. I did not take it at exactly the same time everyday. I read somewhere that it is the total daily intake that counts not the spacing, and if taken all at once, it might kill your stomach faster, that is why the spacing.
your ANc is not that low. My GI would have gotten concerned at 500, and it seems that most hcv experts agree with that. Still, 135 ml could be enough. IF you feel he should increase it, insist on it and wait for the next CBC to see how it affects it.
I hope the tx works for you and you can put hcv behind for good. I had to go for 72 wks, and it was a hard decission to live with, but I am glad that I did. My life is back to normal, less than a yr after ending tx, and HCv has not return.
Use the online support often, it can be your lifeline to the finish line.

[rifleman]

No but I'm sure Jim does and will link it up when he sees this.
It might be at hcvadvocate.
DJL

[v eggie dip]

okay thanks, I'll check it out...

[sunspot]

Keep the riba doses at least 5 hours apart. Do what you have to do to keep the pills down. After your first week of tx, you have a syrum level of riba in your blood and adjusting your dose time will not harm that level.
I hope this helps.

Dana

[cougareyes]

I was unknowingly infectious for 25 years. During that time had 2 long term monogamous relationships and 2 children. None of which have been infected by me. It is a little insulting to use this to persuade people to go on treatment.
Although probably most don't experience horrible sides and for some the tx can be uneventful, the drugs are still pulsing through your veins. Just as silent as HCV can be so could the after effects of combo treatment. Obviously there is a risk involved either way, it's up to you to decide which is greater.
I felt more than great all the years I had HCV until the last 2 years. You don't have to be disabled on tx for it to be causing damage to your body. Just look at your blood counts, the natural chemistry of your body is being altered; that should speak for itself.
I am a person on tx, I just believe if you have the luxury to wait for something better, do it. Good Luck to everyone on their own personal decision.   Peace

[NYgirl]

Thanks healed that was a great question one I've thought of but forgot about.

I was in an auto accident in '93 and have horrible, horrible headaches sometimes. the ONLY thing that can cure them is if I get enough Ibuprofen into my body BEFORE they explode.

For some reason I thought we had to stick to tylenol and that had me pretty frightened because when one of them come I HAVE to take the ibuprofen or I have to go to the hospital and get loaded full of Demerol.  Being sober now I dont want to do that either!

so thank you very much.  A good question and it seems I'd be ok taking them if need.

[cuteus]

the fact that we are not aware of anyone infected by the hcv in our bodies, does not negate the fact that it is an infectious disease with the potential to be spread. Thank God not by casual contact.
There was a study I read that searched the transmisibility of HCV as compared to HIV. A single ***** by a syringe produced infection of hcv more often than it  did HIV. But HIV was more frequently transmitted by sexual encounters than HCV was. NOt sure what the process used was to determine these results. THese ARE infectious diseases, I would not consider it an insult to acknowledge this fact and use it as part of the consideration for tx.  
IF a person has mild damage but wants an HCV free life, it is a life altering decission as much as choosing to live with the virus and waiting things out, if they so choose.
Every aspect of what HCV is and can be has to be considered. It is a scary disease, though not fast moving.

[cuteus]

this is a stupid filter MH is using, what other word do you use to describe what a syringe does?
a finger gets p r i c k ed! I guess punctured is what is allowed? stupid filter does not know the difference between a verb and an insult!?

[Forseegood]

This is the NIH Study I was talking about by the NIH


Glucosamine/Chondroitin Benefit Proven

NIH study results show supplements are effective in treating pain of osteoarthritis.

Initial results from the multi-centered Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) conducted by the National Institutes of Health has shown glucosamine and chondroitin to be as effective as Celebrex

[Healed24]

You guys really made me think about somethings regarding quitting. I'll try and stick around here and post when I feel down or ask questions when I have them. I get the idea that the consensus is to keep going and treat regardless of damage, so I'm going to try and get through it. If I'm falling apart now and I'm 26, I probably wouldn't be able to handle it in 20 years anyway.

Rifleman, Unfortunately I didn't get the 4 week PCR, so the 24 week plan is out for me (but boy would that have been great). My viral load when I started was 208,000 so I wouldn't have qualified anyway. As someone currently in the legal field your post was really helpful to me, because I am terrified of starting law school next year.

Friole, You were right on with your advice of starting tx because I do plan on having children, and the idea of infecting them drives me crazy. I guess there is no time like the present to treat, it just drives me nuts counting the days until I'm finished (it seems like forever).

Cuteus, thanks for your comments, you're really good at this. I hope you stick around here until I finish tx (how selfish of me). Your post really made me think about infecting others which is something I need to consider before I quit tx. By the way my doc prescribed neuopgen when my ANC reached 100 (I don't know why he let it drop that low). After my first shot (180ml) my ANC dropped to 200 and with neupogen its gotten up to 900 (but he said that with my sharp drop in the beginning 180ml is risky). I became undectable (week 11) with 2 shots at 180ml and 9 at 135ml. Can you  please let me know if you think I should press for my doc to increase it since my ANC has increased. As someone who has achieved SVR, your opinion is greatly appreciated. By the way congrats on your SVR, you deserve it.

Thanks to all who answered, I was scared everyone would ignore the post.
Brooke

[GreatBird]

Here's the <a href="http://www.biotech-intelligence.com/html/html/de23abadef48c89fe11300886e9c25db.html">link</a> to that study (at least I think it's the one you are interested in).

http://www.biotech-intelligence.com/html/html/de23abadef48c89fe11300886e9c25db.html

[friole]

I also have little liver damage and chose to treat.  I don't know if I would of at your age, but at 57 I felt it was imperative.  None the less - regardless if you began only because a doctor told you you had to - you have gone almost half the way and are clear.  With those two factors alone, I would continue.  Brooke, it interrupts your life whenever you do it.  You are going to be just as busy down the road.  If  you have children and are not clear, you will worry about infecting them.    And what if you develop liver damage and need to treat when you want to have children - starting treatment then will delay conception.

Rifleman gives you some good pointers being in your chosen field. The headaches and nausea must be overwhelming to make you think of quitting.  I hope you can resolve that and be able to continue
Kathy

[jmjm530]

In general, I like to support treatment decisions already made, but you asked a direct question and I have to respect your thoughts behind that. You asked, "if any of you would have decided to treat with current meds given my information? "

Maybe three years ago my answer would have been "maybe" -- but today, with newer, better, less harsh and less potentially damaging drugs hopefully around the corner, my answer is I would have not have treated. And while I don't know of any polls on the subject, my educated guess would be that most heptologists would also take this position.

In your case, however, you're already at week 22/48, almost half way there. On the other hand, you're also having bad side effects. It's a very tough call.

One very important question -- apologies if already answered -- is how effective has the tx been so far? By that I mean, how many PCR's have you had so far, at what week, and what were the results? If you didn't have a two-log drop by week #12, your chances of SVR are greatly diminished, especially with the traditional 48 weeks. Also, I noticed you're on reduced meds. Your chances are also diminished if you haven't taken 80 per cent of the required meds for 80 per cent of the time. The first 12 weeks is especially important here.

I guess where I'm going is that you have to carefully weigh the potential risks versus rewards on any tx decision. In your case, your a stage 0 so the risk of not treating or stopping treating is extremely low especially with newer drugs currently in trial.

You also have to realistically evaluate your chances of SVR given your PCR results and lower meds. The lower you think your chances of SVR are, the less likely I'd be to continue given all your stats.

And then you have to factor in your quality of lif, side effects, some of which can be permament.

Sometimes I think we confuse two things in tx. Our goal-oriented will to succeed/finish what we started, the stigma of "failure" and an objective analysis of what is really going on.

Point here is that "quitting" is not necessarily failure, but can also be viewed as a strategic decision to retreat today when outnumbered only to be stronger to fight tomorrow. All great generals have used strategic retreat to win tough battles.

Again, it's not an easy decision. You really have to step back, look into your own heart, monitor very carefully your side effects, chances for success, etc,  and come up with something you feel very comfortable with inside. Something that will generally please you -- not people here, not your doctor, just you.

On a personal note, I am 58 years old, 1b, stage 2-3, and currently at week 32/48. I'm having a miserable QQL on tx with constant gastro/reflux problems, sinus infections, and skin problems that currently require five light treatments a week just to keep in check. Haven't worked since tx began. If I were a stage 0 or 1, I would have stopped treatment by week 20 in spite of being non-detectible at week 6.

Hopefully, if I read your question right, you won't view this too negatively but as more data to plug into an equation you are now wrestling with.

All the best.


-- Jim
-----------------------------------------------------

Regarding the short-course study Rifleman referred to, I don't have the link handy, but from memory the viral threshold was 600,000 IU/ml, so in that respect you qualify for the shorter 24 weeks of tx. The catch of course is that you'd need a negative week 4 PCR and I also imagine the study was done on full meds, so probably not that relevant to your case, although people have stopped tx early for many reasons and have achieved SVR. No idea what your odds would be however.

###

[johnisme]

Hi, just wanted to say that i agree with what jim said. This tx is very serious business. The doc told me that this medicine that is going in to your body is nothing to take lightly. For some the long term sx. that is possible could be worse then waiting for newer tx.

Plus there is the unknown effects that could appear from this medicine years from now. That said, there are some of us that don't have much choice but to roll the dice and hope for the best. If i was younger and had stage 2 or less i would not even consider tx. at this time.

But that is how i feel and i think thats how my doc feels.

Please keep in mind that everyone has to do what they feel is what THEY need to do. Its your life and only you that will live it.

In closing i've had this for over 30 years, i been married for over 26 years and have 2 kids. Neither my wife or kids have this. What ever you or anyone else decides to do i only hope the best for...........John

[RobBetz]

hi all,

my bio was a 2/2 on 5/18/05...started tx on 06/17/05..bio said mild fibrosis, "no bridging"...i have noticed a few spider veins on shoulder...very subtle and almost cannot see......should I be worried....I am very fair skinned....thx so much....

Robert

[rifleman]

Well, I did law school, and I dealt with hep C.  Law school was a joke compared to dealing with and treating hep C.  You have nothing to worry about.  Get rid of the virus and go on with your life.
Here is a tip for law school.  If you haven't figured out who the class jerk is within 2 weeks, then it must be you.  You'll see what I mean.
DJL

[jmjm530]

I contracted hep c in 1969. I've had very fine spider veins on shoulder and chest since the early 70's if I can remember that far back. It very well could be hep c related. It could not. My current biopsy shows stage 2-3.

-- Jim

[rifleman]

Well, you were clear at 12 weeks and are now just pounding away with the peg to make sure it stays gone, so I would think your liver is getting better and not worse.  You must be taking shot 19 this Fri??
DJL

[RobBetz]

# 18 friday night...correct....my bio is a mild 2 ...could bio have been read wrong....I saw that a sign of cirrosis (cirrhosis) is spider nevi...should i be worried about this knowing my bio is a 2/2...

thx to all....

robert

[jmjm530]

Like I said,I've had spider nevi for over 30 years and that long ago I was a stage 0 or 1, can't really remember. You will also find that all kinds of skin problems flare on tx. Like Coug said, stay positive. It's natural for anyone with hep c to worry about their health and on tx the mind even plays more games. Damn the virus. :)

[cougareyes]

If I remember correctly before tx you weren't exibiting any symptoms. That your tx has been relatively uneventful. Your 12 wk pcr was undetectable. At this point you should be thrilled to death. Your prospects look great regardless of your bx and once svr your liver will continue to repair itself. So all's well. Peace

[Healed24]

Jim I have a question for you. You said your chances of SVR are diminished if you haven't taken 80% of meds 80% of the time. I've been on full dose of riba (1000mg, I weigh 130lbs), and have been on reduced peg since week 2 (135ml). I had my PCR at week 11 and I was <10ml. I haven't had another PCR but I think my doc is considering one at 24weeks (I'm currently on 22/48). Did you have a 24 week PCR? What do you think about doing them at 24weeks? My question is have I been taking 80% of drugs for 80% of time? Also are my chances of SVR lowered because of reduced peg? I asked my doc about chances being reduced and he said if I cleared with 135ml then I should be fine as long as my ANC is low (my ANC dropped from 2000 to 200 after one shot of 180ml). Eventhough I've been on Neuopgen since week 14 my ANC has only reached 900 and said to return to the 180ml might cause my numbers to drop too low again. Sorry for all the extra info, but I want to make sure you have all the necessary info to answer the question. Also my vl prior to tx was 208,000, genotype 1A. Any advice would be helpful.

THANKS
BROOKE

[Healed24]

Sorry for the double post but if I read correctly you said you haven't worked since tx began. If you don't mind me asking what do you do all day? I'm asking because I stopped working week 2 and I am so bored I can hardly stand it. Anyway thanks again for your advice it really made me take a step back and look at tx.

Brooke

[jmjm530]

I started tx on a very agressive and individualized protocol including high doses of ribavirn (up to 2000mg.day) and double-dosing peg between weeks 2-4. For this reason, I had weekly PCR's until I cleared at week 6. After that, every two weeks until week 12. My doc wanted them monthly after that but frankly I find waiting for the Heptimax somewhat sressful, so I only have them every 3 months or so now. Last PCR was at week 30 and I was <5.

In terms of your case, I'll try to do the math later or maybe someone with a calculator handy can. But remember, these are simply formulas taken in retrospect and it sounds like your doc has a point -- in other words you did clear with the lower dose and perhaps the rate of viral destruction overrides this formula like some suggest it does with other pre-tx facors. Just a thought.

Yes, it is boring being home most of the time, especially since I lived such a physically active life for the past 58 years. Fortunately, I'm a loner by nature which has helped me some but enough is enough. :) My symptons d'jour usually dictate what I do. If I'm having a "good" day I might go out for a walk and do some shopping but on bad days I just try getting through them. On very bad days when sx's are driving me nuts I'll try and sleep through them. I live in my "head" a lot because that's the only place I find escape from the physical. I started meditating early in tx but got too sick for that and stopped on any regular basis. I may try and do more to get me through the next 15 weeks. When I'm not feeling sorry for myself ;) I try and remember what Nietzche said about "it making me stronger" -- then I look in the mirror and have a good laugh. Actually, you do have to have some sense of humor/absurd about this whole situation or you will go crazy. You also have to understand at all times that it will be over one day, and in my case it's also empowering to know that I can pull the plug at any time if I choose.

-- Jim

[cougareyes]

So far sounds like your doctor has your protocol under control. You did clear at wk 12 and your ANC is stabile at a good #. I would get a 24 wk pcr and if clear all is good.
I'm in week 15 and have been home most of the time. I'm going crazy. I don't have the strength to do anything. I'm trying to read more and get away from the boob tube. I'm sure that will be another thing I'll have to withdraw from when I'm finished with this tx.   Good Luck

[LvdByGod]

yes brooke you need to be on the full amount of pegasys and ribaviron the whole time for the best odds of svr clearing...find out why in the heck he reduced your peg??? if it was cause your bloods were too low there are meds for that, so you don't have to reduce vital meds...if becouse of other side effects there are meds for those too.

sorry if i missed something i didn't have time to read all your responses...

hope you can get back on full doses soon!!!

sandi