starting treatment for hepatitis c

[blesdeb]

what am i going to feel like immediately after starting the treatment for hepatitis c which includes: ribovirin, pegalated interfueron and invicek?

[Diana66]

ha, same symtoms here, itchy and hair falling a little, and not even started. Happened only in the last couple of weeks
Must be the stress, is normal I think, just another way of showing anxiety

When are you starting?

[hrsepwrguy]

I'm not sure on the hair loss but here is some info on itching

Pruritus (Itching)

Foreword
Pruritus is one of the most common symptoms reported by people with
hepatitis C (20%), but is more commonly found in people with advanced
liver disease and cirrhosis. Pruritus is itching that may be localized to a
specific part of the body such as hands and feet, but it can also be a generalized itching all over the body. Some people even report that it feels like their internal organs itch. Pruritus can be related to high bilirubin levels,
autoimmune disease or dry skin, and can be a side effect of treatment.
Use of moisturizing lotions, oatmeal baths or lotions, antihistamines, and
cortisone creams and opiate drugs can help.

Recent studies are showing that dermatologic manifestations, and pruritus in particular, may be the only sign of chronic HCV; therefore it is important that health care professionals be aware of extrahepatic dermatologic manifestations, of which pruritus is an example.* Experts believe pruritus in people with liver disease is due to the accumulation of toxins (such as bilirubin) that are not effectively processed or filtered by the damaged liver. One function of the liver is the production of bile, which helps digest fats. Cholestasis, or blockage of the flow of bile through the liver, can result in a build-up of bile acids and bilirubin in the blood. High bilirubin levels cause jaundice (yellowing of the skin and eyes), and pruritus is common in people with jaundice. Certain extrahepatic (outside the liver) conditions associated with HCV, such as autoimmune conditions, may also lead to itching. More commonly, itching due to dry skin can be a side effect of treatment with interferon/ribavirin; this is not the same as
pruritus due to advanced liver damage.

http://www.hcvadvocate.org/hepatitis/factsheets_pdf/pruritus.pdf

[hrsepwrguy]

The fat helps the body absorb the incivek

Effects of Food on Oral Absorption
The systemic exposure (AUC) to telaprevir was increased by 237% when telaprevir was administered with a standard fat meal (containing 533 kcal and 21 g fat) compared to when telaprevir was administered under fasting conditions. In addition, the type of meal significantly affects exposure to telaprevir. Relative to fasting, when telaprevir was administered with a low-fat meal (249 kcal, 3.6 g fat) and a high-fat meal (928 kcal, 56 g fat), the systemic exposure (AUC) to telaprevir was increased by approximately 117% and 330%, respectively. Doses of INCIVEK were administered within 30 minutes of completing a meal or snack containing approximately 20 grams of fat in the Phase 3 trials. Therefore, INCIVEK should always be taken with food (not low fat).

http://pi.vrtx.com/files/uspi_telaprevir.pdf

[durabel]

Thanks for the heads up!

[blesdeb]

thanks tremendous help, why is the fat so important?  My hair is falling our alittle and i'm very itchy...not even on treatment yet..is ths normal?

[hrsepwrguy]

Follow the links for suggestion on how to get the 20 grams of fat for each dose of incivek

http://www.medhelp.org/posts/Hepatitis-C/diet-on-incivek/show/1547942

http://www.medhelp.org/posts/Hepatitis-C/Diet/show/1677013

http://www.medhelp.org/user_journals/show/333000/Incivek-Take-with-20-grams-of-fat

mounds candy bars (5 gm per bar) small honey buns (10 gm per) olive oil works well to cover needed fat gm's, peanut butter worked well 2 big spoonfulls covers 20 gm's and was the easiest to get down. Here are somethings others have used.
Taylor Ham - 6 gms/slice (you may know it as pork roll, if you are south of New Jersey!)
Egg – 5gms
American cheese – 5 grms/slice
Bran Muffin – 5 grms
Frozen Waffles – 3.5 grms each
Pancakes – 7.6, (4)
Biscuit – 5.1 grms
Granola – 33 grms / cup
Cream Cheese – 10 grms/ounce
Milk Chocolate – 10 grms/ounce
Cheeseburger 4 oz – 30 grms
Potato salad – 10 grms/ ½ cup (eggs Mayo type)
Hot Dog – 18 grms
Yogurt – 7.4 grms, 1 cup
Sausage Links – ?
Eskimo Ice cream – 17 grms
Nature Valley Roasted nut Crunch – 1 bar – 13grms
Peanut Butter – 8 grms/tablespoon
.1 avocado = 31 gr fat
40 potato chips = 20 gr fat
1 medium French fries = 28 gr fat
2 oz bacon = 20 gr fat
1 plain bagel with cream cheese = 19 gr fat
1 cup raw shredded coconut = 27 gr fat
2 oz American or Cheddar cheese
½ cup chopped black walnuts = 35 gr fat
½ cup hazelnuts = 35 grams fat
¼ cup macadamia nuts = 26 gr fat
1 cup trail mix = 20 gr fat
100 gr seasoned croutons = 18 gr fat
3 tbsp bitter = 21 gr fat
2 tbsp nut butter (peanut/almond) = 20 gr fat
2 oz/100 gr sweet dark chocolate = 20 gr fat
1 slice apple pie = 20 gr fat
1 cinnamon roll = 20 gr fat
1 cup ice cream made from coconut milk = 20 gr fat
50 gr vinaigrette dressing = 25 gr fat
200 gr black olives = 20 gr fat
200 gr sardines = 20 gr fat
3 oz goose liver pate = 25 gr fat
3 oz tilapia = 20 gr fat
A regular size 2 oz hot dog = 15 grams of fat
1 cup of zice cream = 38 grams of fat
2 oz glazed doughnut = 12 grams of fat
1 oz cream cheese = 10 grams of fat
2 eggs cooked in 1 tbls olive oil = 24g fat
1 medium avocado= approx. 20g of fat
salad + 3 tbls salad dressing= 21g fat
oatmeal + 1 tbls olive oil + 16 almonds= approx. 20 g of fat
oatmeal + 1.5 tbls olive oil= approx. 20 g of fat
Garden of Eatin tortilla chips (14g fat/24 chips) + 2 tbls guacamole (5g)= appox 19g of fat
3.5 tbls coconut + 1 whole milk yogurt blended into a smoothy= 20g of fat
1c granola + 1c whole milk or yogurt=approx 20g of fat
egg salad, tuna salad, chicken salad made with 1.5 tbls mayo= approx. 20g of fat
PB and J sandwich with 3 tbls peanut butter

There may be some repeats in there it is from others lists that I copied and pasted

Hope that helps
Have a great day

[blesdeb]

I can't tell you how important and how much I appreciate your comments..Friday I got my HepA and Hep B inoculations, nothing too bad sore arms  tired...my immune system is so low right now I had a pretty good bladder infection so spent the weekend in bed.(yuck)  don't really like that...so the incevek scares me a little..the fatty stuff with it...I already don't feel like eating so is there something in  form?   Oops here's where I can start searching..God bless you all, I pray you all stay  hep c free and thank you again for taking your precious time (it is precious,) to help me!!!! <3<3

[Dawn703]

Just want to welcome you to the forum. This place rocks. You will receive so much help and learn lots. I really have nothing to add since you have gotten great advice. Sx do very wildly between people. Just want to share my sx experience. I did not do well with incivek, but sx disappeared almost immediately after that portion was over. I had very few sx from peg/riba except loosing hair, anemia and neutopenia.

For mild to moderate nausea I drank gingerale and used something called sea bands (from pharmacy), for more severe (luckily not too terrible) my Dr prescribed Zofran.

Hemroids: get some prep H wipes now and use nothing but. As soon as they appear, if they do that is, get on it immediately, it can snowball quickly. Mine got so bad they bled to the point I had to wear a maxi pad. Anyway, for mild prep H does work, but if it doesn't, ask your Dr to prescribe something, mine prescribed 2.5% hydrocortizone, worked great.

Loose stools: Try to prevent this otherwise you may get flaming shards of glass syndrome. High fiber is the key, try to eat lots of whole grains, fruits, and veggies. I also drank kefir and ate greek yogurt when I could. Another thing (recommended from a blog), I used water soluble (has to be water soluble) fiber supplement. If you're not use to a lot of fiber (I was), ease into it so you don't cause any digestive issues.

Rash: First keep your body hydrated drink lots of water and be extremly liberal and aggressive with a good lotion (I used eucerin calming cream). Actuall vertex has reccommended applying eucerin/hydrocortizone combo (mix them together) beginning two weeks before treatment. First sign of rash, call Dr ASAP. Did I mention ASAP! This can snowball very, very quickly. My Dr prescribed fluocininide, well I demanded he prescribe it.

Make sure your Dr is monitoring your blood frequently and ask about his/her stance on rescue drugs for anemia/neutropenia. Also get copies of all your lab results and learn how to read your results.

Make sure you are drinking lots of water (I drank a gallon a day), keep moving getting light to moderate exercise (walking is great), even when you don't feel like it (it will make you feel better), be kind to yourself/your body (get plenty of rest and relaxation).

Supplements I already took and started to take before treatment (discussed with and Ok'ed by my Dr.):

Vitamin E (mixed tocopherols), Vitamin D3, sublingual B complex and B12 (5000 ug), bee pollen granules, SAMe, and fish oil.

Good luck and learn to be your own advocate during your treatment process. Post any sx you get and you will def get solutions.

[Advocate1955]

My husband usually felt signs/symptoms of a mild cold or flu about 6 hours after his Interferon injection (runny nose, low grade fever, fatigue).  During the 12 weeks on Incivek, he had a moderate rash from about week 2 - week 10, he had diarrhea and rectal pain/bleeding, and for about 1 week (week 12) he had symptoms of anemia (weak, lightheaded, hard to catch his breath).
Advocate1955

[Dee1956]

Hello!  Welcome, As Cean said, everyone is different, all react differently however Mable is also correct in that you will feel as if you have the flu with body aches, possible fever, etc.
The first injection is the most frightening as you do not know how you will react.  Once you take that first step things will get easier as far as the anxiety from anticipation.  In my case it would take about 5 hours for the reaction to occur so I would take tylenol about 4 hours after the injection
Try to do as much research as you can by googling your specific treatment as well as searching on here to find things you could have on hand so you would not have to run to the store.

For the Incivek side effects the best thing is having baby wipes so you don't get sore.
Perhaps some benedryl for itching/rash
Tylenol for aching fever
Lots of water, drinking loads of water will really help, the peg really dehydrates the body
20 grams of fat with Incivek (3 times a day)  there are many foods with fat
I used peanut butter and apples though there are many other things you can use, eggs ,toast with butter or a bagel with cream cheese etc.

Wishing you much success
Dee

[RN1234]

Hi there, I started this same treatment regimen on Thursday and so far so good.  I had really no side effects from my first shot so thank img God right now as I type for that.  Other than a slight rectal discomfort and more frequent bowel movements, I have done well.  I think the first reply is accurate.  Your overall health plays a huge role in how you tolerate tx.  

[madmable77]

ribovirin usually is given with interferion injections, excuse the spelling!! 1 injection a week, 6 or 12 months dep on genotype(usually 24wks) i did my injection fri as it made me light headed for a few days, to be honest i did work(as  a drug worker) through my treatment but looking back it was all a blurr! expect sickness, red welts around injection sites that stay for months, the pills make you nauseas and dizzy, sorry but it aint no picnic, i cant remember much of the 24 wks, but 3 1/2 yrs on, no hep c still, prepare to detach somewhat from reality, its like being there but not if that helps!

[ceanothus]

Hi, and welcome to the forum! No one can really predict just how anyone is going to react to these meds, as it is just incredibly variable. If we had more info we might be able to make better guesses, but they would still be guesses. People who are older tend to have worse side effects, people who have more liver damage (like cirrhosis) tend to get sicker, and people with other serious health problems are also likelier to have more problems from treatment.

Most people who are relatively healthy seem to get some flu-like symptoms for a couple of days after their interferon injection, especially early in treatment. That response usually diminishes after a number of injections. The ribavirin tends to cause rashes and some intestinal problems, as well as moodiness. The Incivek is probably the most variable. I've run out of time, but I'm sure others will pick up where I've left off! Good luck!