Procrit for Sovaldi + Riba

[Verdugo]

Do you know of anyone on a S+R combo who has needed Procrit?

My hemoglobin dropped from 12.8 to 10.3 after the first two weeks, and down to 10.0 on week 4.  My doctor is concerned and we discussed Procrit, as he does not believe lowering Riba is a good option.  I did more blood work today to see if I'm down again so am waiting to hear.

My understanding was that after the first two weeks, the drop slows and levels.  I'd really rather not have to take yet another drug especially when I'm feeling okay.

Also, why does a VL take so long?  It's been over a freaking week!

[Mmorgan856]

WOW , it's so great to hear good news.  Congrats Verdugo an solvaldi 13 for finishing tx.  And, Kim,  I just know chomping at the bit for early Oct. to get here.   Think.. Your almost there to hear, " your definitely Hep C free " an go enjoy your life know your a winner an beat the dragon.  I'm sure you remember the confused, angry, crazy woman that was posting 5 wks. ago.  Everyone here helped me thru my fears, especially Nan, with her heartfelt words of wisdom.  Somewhere along the line, I went from the attitude of " why me?" To  " I'm gonna fight this" all because of the caring, encouraging help I got got here.    God is good.  Take care all,, Mary.  P.S.  I've never had the opportunity to see California an all the great places to visit an experience.  When I'm SVR , that location is going on my bucket list.  It's a small world, maybe I'll run into someone from this forum an thank them in person one day.  Stranger things have happened!!!!!! Good luck to all.  Mary

[Sovaldi13Newbie]

I just hope it starts popping up soon, sure it will. When I was taking chemo for leukemia they didn't allow us to go under 10, but the Jehovah Witness patients would go down to 8 and lower and still pop up later. (They don't believe in transfusions) I've been having a worse time of it since EOT but I know it's a phase and will pass. Best of luck to you!

[Verdugo]

I follow all of your posts because we share many similarities -so it's been really great to have a role model and very helpful to have an idea of what might be coming so thanks for that.

I finished strong in my last week of tx - at least attitude-wise and not nearly as fatigued as I had been which may have been due to the adrenline rush of finishing.  Then came the let down, nothing too bad but three days later I had a very weepy day which came out of no where!  Basically, I'm feeling good and am waiting for my hemoglobin to normalize so I can exercise properly.  All in all, I have nothing to complain about and I am very, VERY grateful for that!  And based on your experience, maybe I'll feel unstoppable in 4 months -- one can dream.  

[Livelife777]

Congrats on finishing Tx, and now the time ticks by.   Just a shout out regarding post Tx.  This was my personal experience and may not be yours, but just in case.  
Felt worse after Tx ended.  Brain fog, confusion, depression, achy joints, you get the drift.  Thought once that last pill went down "Hallaluya".   Not for me...
Took a couple of months to shake out the Riba.  Did reach SVR12 UND, so am grateful, but not the after party vibe I had so anticipated.
Hopefully you won't go this route, but if you do just be patient and know it does get better.   I'm 4 months past EOT12, and feel fantastic!
Wishing you good luck
...Kim

[Verdugo]

Just got back for my EOT appointment and am still UND, so yay about that!  Altho I did discover that my final hemoglobin level was 9.4.  No wonder I felt crappy in the last month.  I did not have a blood workup for the last four weeks even tho my anemia level bounced in the 10 range for the entire tx.  Most people stabilize after the first 2-4 weeks but I maintained through at least week 8 and THEN dropped so I'm thinking I should have pushed for that CBC  at week 10 or 11, maybe asked for a riba reduction.  I might have avoided the slog of the last third of treating.

For those of you that don't know the protocol for anemia with ribavirin, (as I didn't) I'm going to cut and paste an previous post that Hector wrote in 2011, which I believe still stands:

If you doc reads the ribavirin package insert directions it says that for anemia the standard protocol is to reduce ribavirin to 600 mg per day if hemoglobin <10 g/dl, first. If < 8.5 g/dL interrupt dose. Then see if hemoglobin level rise. In the clinical trial most patients did rise. Only 4% stopped treatment owing to anemia.

1. The proper protocol is to reduce ribavirin to 600 mg when hemoglobin is less than <10 g/dl. (* One 200 mg tablet in the morning and two 200 mg tablets in the evening).
2. Discontinue Ribavirin Tablets if: <8.5 g/dL.
Once Ribavirin tablets  have been withheld due to either a laboratory abnormality or clinical manifestation, an attempt may be made to restart Ribavirin tablets at 600 mg daily and further increase the dose to 800 mg daily. However, it is not recommended that Ribavirin tablets be increased to the original assigned dose (1000 mg to 1200 mg).

Only after this doesn't work would you need to take procrit or have a transfusion.
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You can read the Ribavirin package insert yourself
http://www.drugs.com/pro/ribavirin.html
Look at the section "Dose Modifications"

Hector

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Thanks Hector!  And good luck to all.

[Verdugo]

Finishing tx soon.  I've managed to avoid dosage reduction, procrit and/or transfusions (YAY), but I'm pretty well fatigued.  Sleeping 10 hours for the last few days and then sometimes a nap on top of that (UGG).  I'm less winded on walks so my hemoglobin may be up (guessing 10.5) so  I'm actually thinking that Sovaldi is causing the fatigue -- not that it really matters...

Hope everyone is doing well tonight in the world of tx!