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1964979 tn?1325538025

Week 3: Platelets down to 30k.. reducing INF to 90mcg

Oh well..  made it through two weeks of the full 180 dose of Pegasys.. but my latest CBC yesterday showed a platelet count in the 30's so the doctor is having me cut the dosage in half for the interferon...

Get my 4 week VL test done on Jan. 25th, so hopefully will get good news and be able to continue..   otherwise, it is off the train and back to the station to wait for the all oral treatments to hit..

It is in the Lord's hands now..
9 Responses
190885 tn?1333025891
good luck hal....that sounds low....you'll get some good advice here....billy
446474 tn?1446347682
What was your platelet count before starting treatment?
For it to drop to the 30,000 in just 2-3 weeks is really tough as platelets tend to fall for quite a while (months sometimes) before they stabilize.

Do you have cirrhosis? Enlarged spleen and portal hypertension?

Your doctor is correct you should be taking 90mcg as your platelet count is under 50,000.
Hopefully they will come back up.

2.4 Dose Modifications

...'Adult Patients
When dose modification of PEGASYS is required for adverse reactions (clinical and/or laboratory), initial dose reduction to 135 mcg (which is 0.75 mL for the vials or adjustment to the corresponding graduation mark for the prefilled syringes) is recommended. Dose modification to 135 mcg per week can also be achieved by using a 135 mcg/0.5 mL strength disposable autoinjector. Dose reduction to 90 mcg (which is 0.5 mL for the vials or adjustment to the corresponding graduation mark for the prefilled syringes) may be needed if the adverse reaction persists or recurs. Following improvement of the adverse reaction, re-escalation of the dose may be considered."

Platelet <50,000 cells/mm3 - Reduce to 90 mcg
Platelet  100,000 platelets to be allowed to participate.

Best of luck to you.
Hector
1964979 tn?1325538025
have some portal hypertension..  starting platelet 3 weeks ago was 70K..  have some level of cirrhosis, but not totally sure what stage..  so, I was concerned from the outset..  but hopefully will be able to tolerate the 90mcg dosage and still reach undetectable at 4 weeks to continue..

thanks!
1964979 tn?1325538025
PS.. spleen normal..  
Avatar universal
hang in there buddy...

my platelets have dropped from 105 to 59, just had my 8 week blood test yesterday.

i've been taking ibruprofen everyday for the past 4 weeks, i read that vitamin C is good for raising platelets, but I was told no vitamins on my rescue study...going to call the nurse right now...

peace
163305 tn?1333668571
"i've been taking ibruprofen everyday for the past 4 weeks,"

I was told ibruprofren is bad for the liver and never to take it.
Tylenol is approved but that too can damage the liver if taken in large quantities.
Did your doctor approve your using it?

I've never heard of any vitamin, food or supplement that improves platelets. And I've looked.
Avatar universal
i was told i could take ibruprofen but not tylenol, by the study coordinator.

i read that vitamin C (best from food) will help with platelet count...
1711722 tn?1356487554
Hi Hal,

Wishing you the best!  Pegasys -- I started at 180, was reduced around week 10 to 90, then increased to 135 the following week (and ever since).

Blessings to you.

OC & OH -- I was told I could take either Tylenol or Ibuprofen, within the limits they provided.  And yes, I had the same concerns about how this affects the liver.  The docs told me the issue is when people take too much, that it's the problem (but I'm guessing it's different depending on the stage of the liver damage too).  Tylenol has not been sold for over a year where I live.  And since I have other issues that respond better to Ibuprofen, that's my go to drug, as needed.
419309 tn?1326503291
Ibuprofen, which is a non-steroidal anti-inflammatory drug, is contra-indicated for cirrhotics specifically because the bleeding risks compounded with low platelets frequent in cirrhosis makes most physicians advise against Ibuprofen in the setting of Stage 4 disease, low platelets, bleeding disorders, and/or variceal decompensation.  In most populations use of either Tylenol or Ibuprofen within recommended doses is not dangerous, but with platelets in the 50s you should not be taking any NSAIDs if possible; imho Tylenol, up to 2000 mg per day, is the recommended medical protocol when platelets are below 90,000.  

HippyHal:  Hopefully the Peg reduction will boost your platelets... 30s and lower do present some significant bleeding risks, and better to be safe in that respect... wishing you that golden undetected at week 4!  
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