rescue drugs?

I am into my 9th week of tx.  My wbc count is quite low and I am aneamic.  My doc said if they go down anymore I may have to reduce my ribaviran and inteferon dose.  I have heard people here talk about drugs that you can take to counteract these sx but I cant recall what they are...any help would be appreciated.  I want to talk to the doc about these drugs asap.  I really dont like the idea of reducing my dose of tx...

[ladybug52]

So your red blood cells are low and your white blood cells? You must feeel like dirt. Neupogen (filgrastim) is used to help the bone marrow produce white blood cells. Procrit is the drug used to help produce red blood cells. I have never taken either, just up early and wanted to help.
Bug

[painterlady13]

I am on both procrit and neupogen for low red and white blood cell counts.  They are not bad but the procrit takes a couple weeks to kick in.  you are better off if your doc will prescribe them and you can get ins to pay for them.  you really don't want to reduce your IFN and Riba drugs especially when these helpers will keep you at the level of virus killing drugs in your system.

[NYgirl]

Your doctor should NOT reduce you med dosages unless NOTHING else works.  Reducing greatly hurts your chances of SVR.  Ask him straight out why he won't give you Procrit and Neupogen?

[merlino]

I know anemia very well. I feel so very bad for you. Its horrible. The procrit took a while but it does work and you will feel better. Even though my HGB went down to 8.8 my dr would not lower dosage on my meds. I went to a hematologist because my liver dr did not administer rescue drugs. Hope you feel better soon.

[GrandOak]

Over my 10 months of attempting tx, I too experienced anemia, low RBC, and was on a higher dosage of Procrit than most people (100,000 U/SQ per week).

It does take time to work.  Their product insert claims 2-6 weeks, for me it was about 3 weeks before I seen results from the initial introduction and all subsequent modification to my dosages. This is why most docs, at least the apparent knowledgable ones, watch the rate of change in the Hgb rather than specific numbers and thresholds.

My first doc made the mistake of simply reducing my Riba dosage, and although it may never be proven I believe compromised my entire tx, rather than introduce Procrit when I dropped from 13.5 to 10.5 in three weeks time at the start of tx.

For low WBC, Neupogen is used and I used that one too.  Fortunately, Neupogen acts much faster, days instead of weeks, and as such it does not seem to be as crucial to watch the rate at which your WBC falls.

Hope this helps and my suggestion from personal experience is to avoid ANY reduction in Riba if you can help it.

[sass_blue]

Thanks everyone.  Doc just said that Procrit is only used for heamophelia and Neupogen is only used for HIV patients...I will be looking into it more. Being geno 1 am am particularly paranoid about reducing my tx.....

[Pdilly]

I guess from what my doctor said is the neuprogen is expensive and insurance companies make it so hard for them to verify you need it so they will pay it.  The doctors usually let it get really low.  This is a bad time to try any of that for me.  The company I work for is changing Perscription drup companies.  Argh!  Such a hastle to get everything resent in and approved.

[sallyo]

My insurance co required a wbc < 1.5.  I did not feel bad at that time but I knew I was susceptable to infection.  Stay away from crowds and children if you can.  Wash hands frquently.  Also a light mist of Lysol on the mouse and keyboard isn't a bad idea.  I heard that keyboards have been cultured as very high contamination sources.  I once had an I.D. tell me that the immune system can not be evaluated on wbc's only.  Other tests like ANA (absolute neutraphil) and some formula which I don't remember was spoken of.  If you are prescribed neupogen remember to have your blood drawn before your scheduled injection.  This will increase the chances of it being low and the insurance payment can be justified.  My experience is that it works well and fast but does not last long before the wbc go right back down.

[MissMiss]

You should call today to find out if he will rx Procrit and Neup.  If he won't, then get an appt asap with a hematologist.  My GI refused to rx them and finally decided to send me to a hemo.  Problem was it took another month to get in and my Riba was reduced during that time.

Until I get my 6 mo pcr and it is clear, I will wonder.  The most important time NOT to reduce tx drugs is during the first 12 weeks, if I understand correctly.  

Be proactive now.

miss

[MissMiss]

He said whaaattttt?

Neither one is used to treat HIV or HCV.  They are used for blood conditions usually as a result of treating for the above.  I forget the technical terms but basically Procrit is used for extreme anemia and Neupogen is used for very low WBC.  All he has to do is change the dx on the insurance form.  HCV has nothing to do with this.

Sheesh, we need to teach our doctors so much we should charge them!  

If you have real trouble with ins getting the helper drugs, try the Patient Assistance Programs.  Let us know how it all works out.

miss

[MissMiss]

Sorry but the last part of the post above was for you.  

miss

[painterlady13]

I agree with Missmiss.   Even the cancer doc I was sent to to moniter my blood levels was more than happy to prescribe the rescue drugs.  they have NOTHING to do with the diagnosis but with the HGB and WBC counts.  I would even go so far as to talk to an oncologist who daels with the hematology aspects of tx.  They will follow your blood levels and get the rescue drugs you need.  A lot of us have to see not just our liver doc but a hema doc and pcp and dermatologist and psych all for different sides of TX.  And truly you wouldn't believe the amount of us just here in the forun that have to take procrit and neupogen.  Good luck.  and really push your doc to do more research in to it.  It TRULY is your health here we are talking about.