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4226456 tn?1354123528

Rash on Triple Therapy

Week 7 of Treament:
Tiny Bumps of Red Raised, Hyper Sensitive, Painful Itchy Rash on Torso, Shoulders . No sores in mouth or anywhere else.  I have tried antibiotic cream, hydrocortisone cream and benadryl.
I was in the sun for a very short walk a couple of weeks ago and wore sunscreen, my neckline dipped a little in front but my back was covered, I have been pretty careful not to be in the sun, I don't think this is a sun reaction.  This is about a week old, spreading.  My oncologist PA suggested the benadryl which helps the itch but not the spreading. I will let my doctor know but in the mean time:
Please share your experience and what you did to get rid of it.
Thank you.
39 Responses
4268805 tn?1351981947
Im in week 7 also and this week Ive noticed a red itchy rash on my chest. anymore, I just figure that anything that feels bad or strange is from the drugs. Im amazed at how many there are, and they keep popping up all the time.
Avatar universal
Hi,
From looking at your other posts, it appears that you are on triple tx with Incivek.  Both Ribavirin and Incivek can cause a rash.  When my husband was on triple tx with Incivek, he had a moderately severe rash.  It had raised welts, it was itchy, and it was hot.  His skin was quite red in the rashy area.  He used Eucerin body wash in the shower, took cool showers, patted his skin dry, used Eucerin moisturizer, took Hydroxyzine (a prescription antihistamine), and used Triamcinilone ointment (a prescription ointment).  Sometimes he stood in front of the open freezer door or stepped outside in the night air.  It eventually improved, especially after the 12 weeks of Incivek.
Talk to your doctor and ask for the two prescription medications.  It's important not to let the rash progress before you treat it.
Advocate1955
Avatar universal
Hi, sorry you are going through this. Hopefully it will not get worse and turn into that incivik rash from hell.  Treat the rash early and aggressively, don't let it get out of hand!

If you search this forum from several years ago there were many posts about the "rash". Different remedies people tried so they could stay in the trials . Rash subsided after stopping the incivik. Do what ever you can to stay on incivik for the 12 weeks.
Early in trials incivik was causing rash in at least 25% of people taking it. Even some talk of discontinuing trials and pulling the plug on Telaprevir (incivik). They must of tweeked the drug because rash happen much less and was more bearable.

Not sure if your doctors have treated a lot of HCV patients but if they have they would know the protocol. If not consult with a Hepatologist and Dermatologist.

Best of luck
I was prescribed Atarax for the itching when i treated.
Avatar universal
  I also used the Atarax. I did Victrelis, and think the sun did trigger my rash, though. But it was on my torso, and was welts, and then looked like a sun-burn, and then the itching was from my torso, up to the top of my head.
2061362 tn?1353283118
Sorry about the rash. The first time I got the rash, hydrocorizone or benadryl did little to nothing and my Dr'd np decided I was being a bay and refused to have Dr prescribe anything. Even though the rash covered about 70-80 % of my body. So, I took constant oatmeal baths (cool water), used eucerin calming cream constantly and gold bond medicated lotion as well. At times when it got really bad I just slathered olive oil or eucerin aquaphor. It resolve itself after about 4-5 weeks. The second time I got the rash, it was much itchier and nothing helped at all and I was getting hardly any sleep. I really just demanded that the Dr see me and prescribe fluocininide, thanks to recommendations here. It worked very well. Good luck and I hope you get some relief. Just keep moisturizing the heck out of your skin.
3159077 tn?1356034731
I'm at week 6 and started getting the rash around week three. I took the recommendations from this forum and requested a prescription for Atarax and Fluocinonide. The rash went way down in severity and stopped spreading so rapidly. I still have it, but I treat it with the meds and my nurse is watching it every week. I have some photos on my profile.

Good luck with your treatment and I hope you get the rash contained.
1747881 tn?1546179478
http://www.incivek.com/hcp/assess-and-manage-rash
Avatar universal
They tell you up front that over 52% of people on triple therapy will have rash.  They also say to call doctor or clinical trial nurse & let know so they can help you with it.  It is also important to eat what they told you and drink fluids.  If you are on triple you had to have gone to a intake meeting where they should have told you what to do.  When I was on ribavirin and interferon alone many years ago the ribavirin caused me to have rashes and sensitive skin plus sensitivity to light.  Also you could also have singles which causes the most painful rash.  CALL YOUR DOCTOR.  Rashes not taken care of can be symptomiac of internal problems.
163305 tn?1333672171
Here's what one member did for the very common rash side effect.

I'd like to mention anything with oatmeal is soothing and moisturizing for the skin. You might want to try oatmeal soap.You can take whole oats and put it in the blender to make a powder. Add it to your bath water.

BTW: I had to use only products good for sensitive skin while on tx. Try natural products without any added fragrance. Coconut oil and olive oil is good for the skin, too.

http://www.medhelp.org/posts/Hepatitis-C/Side-effects-after-Incivek-is-over/show/1584953

From MrRon  Oct 07, 2011 .To: Everyone.
Sunday Oct 9th will be my lasy day of Incivek.. What a freakin ride... For your itching,blister's,hive's.......I got you covered..! Benadryl make's my skin crawl.. Nothing worked... OATMEAL ...!!! That's right plain old *** damn Oatmeal.. Take a cup  of Quaker put it in your little hand held food processor with two tbs of Corn Starch.. Mix that baby up into a powder. Get a small bowl and maybe a pop stick. Mix it to say baby food consistency with water,little at a time - spreadable not runny otherwise you'll have yourself a real mess.. Spread on a layer with the pop stick or just your finger's. . Let it dry on your skin for 20 to 30 min. Don't touch it.. It may burn at first ,but that's the bad stuff gettin sucked out. Then it's gonna itch.Don't touch it.. The reward's coming. After it drie's stand in the tub or better yet go outside and rub it off. Try not to let the nieghbor's see ya ha ha . It will be rough and  and you'll get to scratch... Rinse with cool water or a wet towel. If you get another spot paste it on there.You'll see those rashe's start to dry up within a few hour's..  You can even throw that whole cup into the bath tub and soak.. I mixed some up and kept it in a sealed container on the kitchen counter.My worst month was #2. . . .
3093770 tn?1389742726
I am early in the tx, I do not have a rash but here in NZ they are managing it with a cream called Nutraplus. Is it made in France and contains Urea.
3203287 tn?1346460234
I have had the bumps/itch since week 3 and was easily handled by a OTC cortisone spray.  Then my doctor saw the rash at about 7 weeks and gave me Fluocinonide cream.  It works great.  He told me to use it often and lots of it and that we need to control this now and not let it get out of control.  So I've gone through a tube easily and it does stop the itch and reduces the bumps considerably.  I feel it's under control now.  Hoping for the best!  
4226456 tn?1354123528
Thank you all for your support, sharing of your stories and your comments of advise!  I appreciate everyone of you.  I did let my doctor know and I am using the triamcinolone cream and benadryl oral, it has taken the itch & pain away and decreased the intensity of the rash.  
I have always used natural products but I am finding anything with a scent is nauseating for me.  I use oatmeal moisturizer and aloe, vit e baby oils too.
The cream has been great!
I am amazed at all of the stories and sharing of support.
Thank you all so much.  I pray for all of us to have and keep a SVR!   Because I believe that is possible.
1669790 tn?1333666195
Good to hear things are calming a bit.  Instead of benadryl, I preferred claritin since it didn't make me drowsy.  I also avoided heat and sweating as much as possible.  But not easy to do in Florida sometimes.  Good thing winter is approaching.  Hot showers and baths were also a big nono.  Good luck moving forward.
1654058 tn?1407162666
The heat was bad! I took cool baths all winter. The hot water soak feels good for the aches, but then you pay for it. I stayed cold as I could, which is easier with low hgb. haha. The 2 things you are using got me through all 43 weeks. I used straight up olive oil a lot as well.
I too had always used all natural and they made itching worse. Dr. Bonner's liquid soap was the best for bathing. Just think, it will soon be a distant memory.
Hang tough,
Karen :)
Avatar universal
If the Benadryl doesn't help enough, ask for a prescription Hydroxyzine (Atarax), which is stronger.
Advocate1955
4226456 tn?1354123528
I deeply appreciate everyones responces.  I couldn't get a RX for Atarax from the doctor  so I will get a dermatologist referral tomorrow, the rash is spreading with sporadic single itchy bumps to my limbs & scalp. The Benadryl is ok I guess.  I have been running hot with my core temp above normal.  Today a low grade fever.  Perspiration makes it worse, which happens at night.  Do you moisturize over the Rx ointment?
Lastly it is really hard for me to pick a best comment because you are all so wonderful and full of knowledge to assist each other.  Thank you for your support.
Avatar universal
I was on triple therapy with incivek 1 year ago. (tried Pegasys & Ribavarin 3x before w/temporary success.)  After 4 wks, this time, I developed a rash with nausea.  The rash continued to get worse. It was on torso, legs and arms.  I tried benadryl, lasix and Triamin.ointment.  Nothing worked.   After 7 wks. it started to show on my face, hands and soles of my feet.  My temp was running 101.8.  Everything was swelling up and I went to the ER and was admitted.  I stopped all hep treatment (duh!)  My PA said I was on the verge of Stevens-Johnson syndrome which can be fatal.  I was in the hospital for 3 days with IV lasix and benadryl.  Also IV isomedrol and 2 blood transfusions.  After 3 days was discharged on Prednisone and Percoset for the pain.  The worst part were sores on perianal area that must have gone up inside as well.  A bowel movement felt like I was eliminating shards of glass.  Went to dermatologist.  He gave me triamcinolone acetonide cream 0.1% for all over and balneol ointment for perianal.  
PLEASE don't wait if symptoms get this bad.  A year later skin is fine but my hep c is still kicking.  I was told that 3% of patients get this reaction.  Lucky me.  Good luck to you.  
4226456 tn?1354123528
HI Terry,
I went to a dermatologist and had two biopsy's taken this week.   She gave me the 3 new RX.  She did n't feel it was the SJS, but I have it everywhere (except on palms, bottomof feet, mouth & eyes), I itch terribly, I run hot with temp around 100 -101.  If I start to swell I will go to ER.  I saw my Hep doctor today and he said just get through 4 more weeks.  Then I am done with the incivek and things will get better.  I pray the meds will keep everything calm, I think that's what they are praying too.
Thank you for posting.
Avatar universal
You are in my prayers and thoughts.  I was disappointed I didn't finish but please listen to your body and don't worry about what the doctors say.  I was grateful my docs listened to me.  This is such a new medicine and sometimes I felt like we are the guinea pigs.  I will be looking for your posts and hope all goes well.
Avatar universal
Sorry you are having such a tough time with the Incivek rash.  What are the 3 new prescriptions that the dermatologist gave you?  As far as your other question, I would probably use the prescription ointments, creams first, and then moisturize after or in between.  Also be sure to drink lots of water.
Advocate1955
4226456 tn?1354123528
Terry I am sorry you did not get to finish tx. but happy you survived SJS.  I pray a new combo will become available for you soon so you may be cured.
Advocate: The three meds I am treating rash: Zyrtec 10mg BID, Hydroxyzine 10mg BID, Doxepin 20mg HS and continue with theTriamcinolone Cream 0.1% twice a day.
The itch can be excruciating at times.  I find even with the meds it is spreading, but the severity of appearance isn't.  I try to wear loose cotton clothing and watch not to sit against anything because my back needs air circulation, the hotter my body gets the more severe the rash.  My body already runs too hot.  
I have continious headaches, nausea and fatigue.  This has been brutal for me.  I am getting procrit injections now too. I am so thankful I have only 3 weeks left of incivek and plan on staying positive to help me get there. I don't know how anyone could work with this and my heart goes out to anyone who has too.  Thank you all for your support, advise and listening to my complaints.  I wish you all a very good Thanksgiving, I am thankful for you!
1815939 tn?1377995399
"The three meds I am treating rash: Zyrtec 10mg BID, Hydroxyzine 10mg BID, Doxepin 20mg HS and continue with theTriamcinolone Cream 0.1% twice a day. "
-------------------------------------

I had a bad rash, probably considered moderate, but I would hate to have the severe if mine was moderate, LOL.

Just for the record, the Zyrtec, Benadryl, and over the counter steroid creams were totally ineffective for me. I may as wel have been eating M&Ms and putting water on my skin.

It is quite possible that you need higher doses of some of the meds and/or an altered regimen. I tried a lot of things and it was not until I got Hydroxyzine 50 mg every 6 hours (in addition to the Fluocinonide ointment and the clobetesol soln) that the rash was finally brought under control. It was the higher dose of Hydroxyzine that did the trick and got the rash under control.

One other word of caution ..... this may be an Incivek rash and may go away after finishing the Incivek. However, the rash could be from the Ribavirin also, and you will still be on Riba for several more weeks.

I was on Tx for 48 weeks. I got the rash about week 10. I had the allergic reaction for the duration of Tx . I am 12 weeks post end of Tx and I am still dealing with these issues. It is under control, but not totally gone. I am still on the Hydoxyzine and also on some steroid creams and ointments, all prescription.
Avatar universal
My husband found the rash to be excruciating at times too.  It was tough.  The only thing I can suggest is try to take the Hydroxyzine as often as the prescription allows, avoid sun/heat/hot water, moisturize and drink water.  I hope you can make it to the end of the Incivek, and hopefully it will improve after that.
best wishes,
Advocate1955
Avatar universal
Just wondering how you are doing.  Hope you are having a nice Thanksgiving.  Please post when you feel up to it.
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