treatment began 08_10_12

[keyman223]

began tratment on friday ,pegysus pr click pen , ribavirin 1200 mg per day ,incivek2250 mg per day , within 24 hrs , I started vomiting , 36 hrs , severe diahreha, 48 hrs , severe rash ! does it get better ?

[Advocate1955]

It's best if you start a new thread in the forum so that people will see and be able to respond to your question journey.  Taking the fat just prior to or with your Incivek is crucial for the absorption of the Incivek into your body.  You can alter the times that you take your medications, but the time between each dose has to be the right amount of time, so changing the timing of one dose will change the timing of all of them.  It is best to set your schedule now and stick to it.  
Advocate1955

[journeytohealthy259]

hey who can tell me more about taking incivek 3/twice daily same amount of fat intake? and also any change in time between doses? startin therapy am 2morrow gonna need all the help i can get

[journeytohealthy259]

hey friend i start triple therapy tomorrow am keep me posted on all u go thru ill do same maybe we can help each other

[dontworry_behappy1]

The first 2 weeks seem to be the worst.  The meds are killing the
virus.  Like what pooh and Dawn said..... Tell the doctor you want some
fluocininide for your rash and some promethazine or something like it
so you don't throw up.   So you have it on hand when the over the counter
meds don't work.  My doctor didn't tell me either.... I had to tell the
doctor what I needed.   This makes me so ****** mad that people aren't
give this stuff before they start.   And if someone didn't tell you already....
stay out of the sun.  It will make that rash worse.

You hang in there.  
I feel for ya

[Dawn703]

Benadryl and otc hydrochortizone will not touch the rash, well it didn't mine. You need to demand that your Dr give you fluocininide or equvilent or as pooh said, see a dermatologist ASAP. This could make you have to give up treatment if it gets real bad.

[pooh55811]

It is good to hear the vomiting and diarrhea are under control.

If that Benadryl and 1% Hydrocortisone do not work, which they very well may not as they are weak, I would urge you to see a dermatologist ASAP on an urgent basis about the rash and itching. The Hep C docs often have no clue about the rashes and their treatment, but a dermatologist will.

It took me awhile to get assertive and demand appropriate side effect relief, but once I did get assertive, I got the side effect relief and my treatment went by so much more smoothly and I was so much less miserable and systemically ill.

Best of luck.

[keyman223]

today 08-12012 ,  diahareah is under control , no vomiting since saturday, took 2 immodium tabs, talked to the drs office today and was told to take benydryl and use 1% hydocortisone cream on rash which is not subsided as of this post ! lord give me the stength to finish this !

[pooh55811]

In my opinion, your doctor is making a big mistake by shrugging off your rash. Yes, it is a side effect, but that does not mean you do not treat it. Retinal detachment can be a side effect too, but you don't just say, "That's a side effect "and not treat it. Depression can be a side effect too, but you treat it. You do not shrug it off as just a side effect. The rashes and itching are due to a systemic reaction to the drugs. These reactions can be extremely uncomfortable and they can be debilitating. They can cause people to stop treatment because they cannot stand it any longer. They can also progress into a severe rash and then treatment has to be stopped because a person can die from a severe reaction. Those of us on the forum who have had severe (or moderate) rashes will tell you to treat that rash aggressively and proactively and get that rash under control ASAP. It will most likely just keep getting worse. It would be advisable to see a dermatologist ASAP on an urgent basis and he/she can prescribe some strong prescriptions to control the rash and itching. A dermatologist will not just shrug it off as a side effect. They will treat it, and treat it correctly. (If the rash is moderate or severe, over the counter meds are totally useless.)

If the crapping shards of glass pain is "internal," firming up the stools helps. Several of us have discovered this. I know firming the stools sounds counter-intuitive, but it is the soft stools and the diarrhea that are irritating the inside of the rectum (and possibly causing rectal fissures). The firm stools just slide out intact with no pain. I do not mean as hard as rocks, but I do mean quite firm, stools that will hold their shape and form. Think of a banana, at least that firm. (I don't mean a squishy ripe banana, but rather a firm one.)

I was in agony before I figured this out. (severe internal pain, cold sweat, lightheaded, felt like I would pass out from the pain, hang on to the bathroom sink/vanity and grit your teeth type of pain, white knuckle type of pain ... I am not exaggerating.) After I took loperimide at the first sign or indication of possible soft stools, I did not have the internal pain. I am not talking about external hemorrhoids or external excoriation. I am talking about the internal pain that feels like your insides are being sliced with a knife or razor blade or piece of broken glass.

I hope you can get some help for the rash and itching and also get those stools firmed up a bit.

[sneakers0]

I am ******** glass but I thought the loose stool was a help. cant imagine having to push anything out of there. my rash is also bad but didnt itch till 4wks into treatment now it seems to be getting worse daily. I did wonder when is bad to bad. my doc just seems to shrug it off to ( thats a side effect)

[jerialice]

get help asap!

[Idyllic]

Hoo-boy! Sorry you were caught so off guard by the side effects. You seriously need to call your doctor tomorrow.

I read enough about Incivek and the runs to know take Loperamide (Immodium-D) every day on a preventative basis. I read that right here on the forum. You might want to consider something similar. That, and as the others suggest get a script for an antiemetic like Zofran.

[coeric]

i second dawn's recommendation regarding the 20 grams of fat.  the GI symptoms, including diarrhea, seemed much worse when i went light on the fat.  and the diarrhea subsided when i ate at least 20 grams before taking the incevik.
eric

[pooh55811]

After you get all of these acute problems under control, one helpful hint with the stools is to keep them firm. Do not let them get even a tiny bit soft. Keeping them firm will keep them from burning and will prevent the severe internal rectal pain that some of us got (crapping shards of glass or razor blades).

[Dawn703]

I'm sorry your having a hard time with sx. Ask your Dr to prescribe zofran for the nausea, and get the rash under control fast, very fast (it can snowball) def see your Dr about this, my Dr eventually prescribed fluocininide for the rash. I also used eucerin calming cream or gold bond medicated lotion. Take cool showers/baths, never hot. Stay out of the sun and heat. Never got diarrhea, but make sure you are eating a lot of bulk foods, such as oatmeal, whole grains, etc...I also drank kefir and ate greek yogurt. I think that helped to keep me from getting diarrhea. I heard of some people taking anti-diarrheal but be careful of that so it doesn't do the opposite and always ask your Dr before taking any otc meds. FYI, Incivek can also cause hemmroids, which I got very severe. For that my Dr prescribed 2.5% hydrochortizone. I can't stress enough to talk to your Dr about your sx asap, also can't stress enough to drink lots and lots of water. I drink no less than a gallon of water a day and sometimes more; it will help with sx. Also make sure you are taking your 20 grams of fat about 30 min before taking your incivek. Good luck and let us know how you're doing. Also post any other sx that you get.

[pooh55811]

They probably will not get better without intervention. I have found that it is imperative to get on top of the side effects immediately. They can snowball rapidly.

36 hours of vomiting accompanied by 48 hours of diarrhea is alarming. If you are vomiting often and having diarrhea often, you can quickly dehydrate. In addition, you may jeopardize your treatment success if it continues (the pills may get vomited up). In addition, you can throw your blood electrolytes out of balance and this can cause more problems.

Personally, it is my opinion that, if the nausea and vomiting are as bad as it appears from your post, you should go to the emergency room tonight. You may need intravenous fluids to rehydrate you. In addition, the emergency room can prescribe prescriptions for the nausea/vomiting and the diarrhea. I used Zofran 8 mg every 8 hours for the nausea. I used Loperimide for the diarrhea (loperimide is over the counter), but the ER may prescribe Lomotil. You need something that is going to work now.

Also alarming is a severe rash in just 2 days. This may be the start of an Incivek rash, something which many of us get to some degree, but your rash, which you said is severe, could be a symptom of a more severe allergic reaction to the drug.  Either way, it needs to be treated and gotten under control. If the rash is severe, that is another reason to go to the emergency room for treatment tonight.

For the record, I had a moderate rash and used prescriptions medications Hydroxyzine 50 mg every 6 hours, fluocinonide ointment (topical steroid oint.) and clobetesol solution (topical steroid solution). These worked for me.

Here is a link to Incivek rashes and their management:

http://www.incivek.com/hcp/assess-and-manage-rash

I am very sorry that you are having these symptoms. If you can get them under control you will be able to continue treatment. It is imperative to get them treated and under control ASAP. They can be potentially life threatening and/or may place your treatment in jeopardy.

[coeric]

make sure you tell your doc about the rash asap.  the PA ignored the rash which started in the first week for me.  i found a sympathetic dermatologist that prescribed clobetasol.  the PA had me see the liver doc who discontinued the incevik at week 10.  at week 11 the liver doc started the prednisone which saved the treatment. perhaps if the PA had taken the rash more seriously i would not have had to stop the incevik,.  the vomiting needs to be controlled.  i was prescribed promethazine, an antihistamine, for the nausea.  folks on this board and my primary doc think that zofran is a better choice. i also found ginger tea helpful with the nausea. most here report feeling better after the incevik is completed.
blessings
eric