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3203287 tn?1346456634

Medication reduction already

I just started treatment and had to go into lab yesterday to get blood redrawn due to a bilirubin spike after one week.  Common according to my doc but he wanted to make sure.  Sure enough the RBC is starting to go low.  He had to reduce my dosage due to low RBC (3.45), hgb 10.3, hct 30.3, RDW 14.5%.  Bilirubin went retest came down to 1.9.  It's getting better since it went up to 4 after one week of tx.  I'm on triple tx and started with 1200 mg daily riba, but doc cancelled my evening dose yesterday so only took 600 mg yesterday.  Today he has me on 300 mg (1/2 pill) until I get my 200 mg pills in the mail which he'll have me take 2 per day.  I'm only on day 16.  My viral load was:
12/5/2011 344933
7/13/2012 371829
7/30/2012 259914  (start of tx)
9/5/2012   284 (one week on tx)
He's hoping I was undetected end of week 2 which was Wed.  I won't get the results for one week so we don't know for sure.  I guess the reduction in riba is okay if I was undetected.  If not, not sure what that means, but the doc said he couldn't take the chance of my blood getting too low.
Platelets are good so far at 229.
I just thought I'd give my results as I just started and am already disappointed on having to reduced meds, but understand the blood issue can get out of control quickly and he didn't want that.  This is my second time on tx but first time was in 2005 and only the interferon/riba.  I had to do procrit a lot last tx so I have had low RBC & WBC before.  So far my WBC is okay.  I was a responder but relapsed.  Hoping for the best.
thanks to all for your support and advice.
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1815939 tn?1377991799
If a person is going to use iron supplements, that person needs to ask the Hepatologist first. Many people with liver problems already have problems with iron metabolism and iron storage so a person does not want to add to an already existing problem.

Adding iron may help if the person is suffering from Iron Deficiency Anemia prior to treatment .If a person can correct Iron Deficiency Anemia prior to Tx, then the Iron Def. Anemia would not compound the Hemolytic Anemia caused by the drugs.  

However, adding iron is not going to alter the course of Hemolytic anemia because the Hemolytic Anemia is not caused by iron deficiency. It is caused by the Hep C Tx  drugs(Ribavirin) which 1) causes the destruction of red blood cells (hemolysis), 2) can down-regulate the number of erythropoietin receptors. Interferon can also contribute to the development of anemia by suppressing bone marrow production of erythrocytes, Finally, patients developing anemia during HCV therapy often have inappropriately poor serum erythropoietin responses, probably related to their underlying liver disease.

Helpful - 0
3242225 tn?1348336521
I do realize that and again, would it be a problem for those on short therapies, let's say the 12 or 24 weeks ones, just to use the iron supplement that I mentioned (it doesn't cause diahrrea or stomach pain) just to keep that level up so the drug makers doing the study do not insist on lowering the riba?  You  see what i mean?  Just curious, would it hurt anything?
Helpful - 0
3242225 tn?1348336521
Great article explaining that treatment, thank you.
Helpful - 0
3242225 tn?1348336521
Thank you.
Helpful - 0
1815939 tn?1377991799
Here is the link to that data:

http://www.fda.gov/ForConsumers/ByAudience/ForPatientAdvocates/ucm256328.htm
Helpful - 0
1815939 tn?1377991799
"Jeepers, I don't understand all that, does anyone else? "
_____________________________________________

Let me try to explain Can-do's data:

Treatment Outcome for Teleprvir 12 (weeks) plus Peg (Inf) and Riba
Number  in study: 363
Overall SVR 79% (285/363)

Percentage of people in the study who attained: eRVR (early rapid viral response) was 58% (212/363)  (eRVR is UND at week 4)
SVR rate in the 58 % of people who attained eRVR  was 92%

Percentage of people in the study who did not attain eRVR:  42% (151/363)
SVR rate in in the 42 % of people who did not attain eRVR:  60% (90/151)

Outcome for Subjects without SVR
On-treatment virologic failurea 7% (26/363)
Relapseb 4% (11/298)
Otherc 11% (41/363)

Hope that helps.
Helpful - 0
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