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Does Ribavirin cause anemia when used with Sovaldi??
My husband just got approved for Sovaldi + Ribavirin for 24 weeks. We are very excited but he needs to get his hemoglobin up before starting his treatment. We already have the meds in the house but can not start using them. He had a shot of procrit yesterday - labwork in a week to see if his hemoglobin is up from 8.9 (normal range starts at 13.9). His red blood cell count is 2.94 (normal range starts at 4.5).
I am confused. I had been told that when my husband was on triple treatment and had to stop because of severe anemia that ribavirin was the drug that caused the anemia but I just read in some old literature its the interferon shots that cause the anemia. So which is it? Or, is it both?
Is anyone who is using Ribavirin now with Sovaldi experiencing anemia? Just want to know what to look out for.
Thanks
Nan
I am confused. I had been told that when my husband was on triple treatment and had to stop because of severe anemia that ribavirin was the drug that caused the anemia but I just read in some old literature its the interferon shots that cause the anemia. So which is it? Or, is it both?
Is anyone who is using Ribavirin now with Sovaldi experiencing anemia? Just want to know what to look out for.
Thanks
Nan
Best Answer
Your service dog sounds just wonderful. Happy to know you have him there with you.
You wrote that your role has always been to make people happy and laugh.
I just want to say that just makes me absolutely certain there are others out there who will be willing to help you if you just ask.
Keep in touch.
Nan
You wrote that your role has always been to make people happy and laugh.
I just want to say that just makes me absolutely certain there are others out there who will be willing to help you if you just ask.
Keep in touch.
Nan
Thanks Nan,,,have been thinking about having someone do a call a day to make sure I'm still breathing.,,,course they or even an aide couldn't be with me 24/7. Just like when I overflowed the sink I felt energized and fine.
So somehow we will figure it out....oddly enough I have a small service dog...a miniature poodle that I put through the training program a few years ago to get certified after I ran into a lady at the post office who had MS and had a full size poodle... The dogs were mirror images of each other, only difference in size and I started talking to her. She gave me a number to call,,,I did..they told me they usually do not do that with such a small dog but would test him. After testing they said they would put him through training. So he gets to wear his little certified service dog vest and can go in stores with me. He is so smart...and all 13#s of him is fiercely protective of me. Never barks but if you get a foot too close to me he does a low rumbling growl and people turn thinking it is a pit bull. People are shocked at what he can do...he gets all my clothes, shoes, my hats...etc. If i say I am cold he will start pulling on a blanket until he gets it to me. He won't let me out of the door if he senses something...even that day I overflowed the sink he was resisting going out but I ignored him. He wakes me if I sleep too long...he never leaves my side when I sleep.....if I'm ill he is attached himself to me. When I broke my knee I had to stay flat and prop my knee up and he would wrap his legs, front and back around my left arm and nestle his face on my shoulder and not let go. If I am driving he will not let me start the car if he has one of his feelings. He starts kissing my face and positions himself in-between me and the steering wheel and won't even let me start the car. He knows what to do if we are out and I would collapse.... He is a little blessing that was a throw away at 8oz who someone gave me to nurse back to health for adoption and I bonded with him so much even taking him to work with me and everywhere else that I don't even have to verbally say a command...he just looks at me and knows. I am blessed to have him. Almost said no. Never really liked small dogs...last dog I had was a malamute/wolf so I wasn't real keen on this 8oz of fluff. If I could only teach my kids to be a bit more like him or at least teach him how cook, drive and shop. LOL.
Will be looking forward to future emails about your husband and thank you for your suggestions...they are taken to heart. and seriously....I know I sound like the class clown and I think that is because that was always me role to make people happy and laugh. God bless you for your knowledge.
So somehow we will figure it out....oddly enough I have a small service dog...a miniature poodle that I put through the training program a few years ago to get certified after I ran into a lady at the post office who had MS and had a full size poodle... The dogs were mirror images of each other, only difference in size and I started talking to her. She gave me a number to call,,,I did..they told me they usually do not do that with such a small dog but would test him. After testing they said they would put him through training. So he gets to wear his little certified service dog vest and can go in stores with me. He is so smart...and all 13#s of him is fiercely protective of me. Never barks but if you get a foot too close to me he does a low rumbling growl and people turn thinking it is a pit bull. People are shocked at what he can do...he gets all my clothes, shoes, my hats...etc. If i say I am cold he will start pulling on a blanket until he gets it to me. He won't let me out of the door if he senses something...even that day I overflowed the sink he was resisting going out but I ignored him. He wakes me if I sleep too long...he never leaves my side when I sleep.....if I'm ill he is attached himself to me. When I broke my knee I had to stay flat and prop my knee up and he would wrap his legs, front and back around my left arm and nestle his face on my shoulder and not let go. If I am driving he will not let me start the car if he has one of his feelings. He starts kissing my face and positions himself in-between me and the steering wheel and won't even let me start the car. He knows what to do if we are out and I would collapse.... He is a little blessing that was a throw away at 8oz who someone gave me to nurse back to health for adoption and I bonded with him so much even taking him to work with me and everywhere else that I don't even have to verbally say a command...he just looks at me and knows. I am blessed to have him. Almost said no. Never really liked small dogs...last dog I had was a malamute/wolf so I wasn't real keen on this 8oz of fluff. If I could only teach my kids to be a bit more like him or at least teach him how cook, drive and shop. LOL.
Will be looking forward to future emails about your husband and thank you for your suggestions...they are taken to heart. and seriously....I know I sound like the class clown and I think that is because that was always me role to make people happy and laugh. God bless you for your knowledge.
Congratulations on the wonderful job you did on raising your family.
You wrote:
"Think my biggest problem is everyone looks at me and I look healthy...and I have always been so strong....and have overcome so much in life that they just think I will do that with this too." I understand that completely.
These meds are tough which I know you already know. With your liver disease so advanced now, it can get serious fast. You need to have someone
check on you regularly - if your kids can't do it - how about getting a home health aide for the time you will be on treatment? You need someone to make sure you are taking your meds how and when you need to. Bouts of HE can interfere with that.
I think you know all this already. Sometimes it just takes someone else who is been there to make you realize you need to do something now. I hope so.
I think your son-in-law is someone you can count on - besides he owes you. (big time!) :-)
Nan
You wrote:
"Think my biggest problem is everyone looks at me and I look healthy...and I have always been so strong....and have overcome so much in life that they just think I will do that with this too." I understand that completely.
These meds are tough which I know you already know. With your liver disease so advanced now, it can get serious fast. You need to have someone
check on you regularly - if your kids can't do it - how about getting a home health aide for the time you will be on treatment? You need someone to make sure you are taking your meds how and when you need to. Bouts of HE can interfere with that.
I think you know all this already. Sometimes it just takes someone else who is been there to make you realize you need to do something now. I hope so.
I think your son-in-law is someone you can count on - besides he owes you. (big time!) :-)
Nan
Hi Nan,
I read your link on HE, and my heart goes out to both you and your husband. I'm happy that you are rallying love and support on this forum, as I know it must be more than difficult.
Hang in there, and take care of yourself too.
His viral load is getting close to undetectable so if he can just hang in there through the treatment he can be well on the road to recovery, right?
Bless your hearts.
Ribavirin is brutal. Really it is. I think it must not only be destroying RBCs.
Thinking of you and praying for you both.
I read your link on HE, and my heart goes out to both you and your husband. I'm happy that you are rallying love and support on this forum, as I know it must be more than difficult.
Hang in there, and take care of yourself too.
His viral load is getting close to undetectable so if he can just hang in there through the treatment he can be well on the road to recovery, right?
Bless your hearts.
Ribavirin is brutal. Really it is. I think it must not only be destroying RBCs.
Thinking of you and praying for you both.
Thank you Nan. No you aren't scaring me and I value all of your information and that of some of the others. I just have been dealing with trials and protocols for almost 25 years and I am not a pill taker by nature.
As for my family and friends. Get a lot of rah-rahs from the few friends who I have left who haven't passed on and as for my family...they say they will be there..."we'll be there for you Mom" but are thinking more about the transplant stage. My one brother is in Minnesota and my other who is here is a reclusive alcoholic...if you need to go to an appointment he is johnny on the spot but I can go weeks and never hear from him. My Mom thinks I'm making it all up...was asleep the other day and she said why do you keep sleeping...I told her...she said well life's a ***** maybe you just won't wake up one day..... Nice Mom ah? My biggest supporter was her sister who just passed away.
Think my biggest problem is everyone looks at me and I look healthy...and I have always been so strong....and have overcome so much in life that they just think I will do that with this too. Have sat down with all of my kids and gone over this several times and my oldest son who had a phd listens and then will say you will beat this Mom. So they have faith in my mental strength but at the same time get upset with me when I am physically too tired to do something's. An oxymoron for sure. Got a wake up call when I busted my knee 5 weeks ago on the ice.....am rethinking my "support team" right now my best supporters are my 7 year old granddaughter and my son-in-law.
Have been straight with them...this disease has just been going on for so long that the urgency of it almost becomes insignificant if you know what I mean and I have been very, very good in not asking for help, physical or financial and created such successful independent individuals. All graduated from IU with honors...one with Masters and Phd inv Finance...the other is a vice president of major bank, and the 3 works for the railroad. Their spouses all have similar positions and my older grandkids are at IU and Purdue. So darn me for doing such a great job....LOL. But really wouldn't want it to be any other way. And I try to lead by example. I had a high power job about 10 years ago I had to take a LOA to care for daughter and son-in-law who were sitting at a dead stop at a stop light and some kid careened through the light mowing them over and breaking all limbs, pelvis, ribs in both. His mom is a nurse and she I worked together taking care of them. Oddly my daughter responded better to her and my son-in-law to me. Think that even though he is finance manager he is the one who checks on me because he remembers and he can see though the veil of health.
So I am worried too but I try to deal with it. I am extremely asute except for periodic spaceiness but really I have been that way most of my life. People has always been bewildered how I can have such a high IQ for which I've been tested t
As for my family and friends. Get a lot of rah-rahs from the few friends who I have left who haven't passed on and as for my family...they say they will be there..."we'll be there for you Mom" but are thinking more about the transplant stage. My one brother is in Minnesota and my other who is here is a reclusive alcoholic...if you need to go to an appointment he is johnny on the spot but I can go weeks and never hear from him. My Mom thinks I'm making it all up...was asleep the other day and she said why do you keep sleeping...I told her...she said well life's a ***** maybe you just won't wake up one day..... Nice Mom ah? My biggest supporter was her sister who just passed away.
Think my biggest problem is everyone looks at me and I look healthy...and I have always been so strong....and have overcome so much in life that they just think I will do that with this too. Have sat down with all of my kids and gone over this several times and my oldest son who had a phd listens and then will say you will beat this Mom. So they have faith in my mental strength but at the same time get upset with me when I am physically too tired to do something's. An oxymoron for sure. Got a wake up call when I busted my knee 5 weeks ago on the ice.....am rethinking my "support team" right now my best supporters are my 7 year old granddaughter and my son-in-law.
Have been straight with them...this disease has just been going on for so long that the urgency of it almost becomes insignificant if you know what I mean and I have been very, very good in not asking for help, physical or financial and created such successful independent individuals. All graduated from IU with honors...one with Masters and Phd inv Finance...the other is a vice president of major bank, and the 3 works for the railroad. Their spouses all have similar positions and my older grandkids are at IU and Purdue. So darn me for doing such a great job....LOL. But really wouldn't want it to be any other way. And I try to lead by example. I had a high power job about 10 years ago I had to take a LOA to care for daughter and son-in-law who were sitting at a dead stop at a stop light and some kid careened through the light mowing them over and breaking all limbs, pelvis, ribs in both. His mom is a nurse and she I worked together taking care of them. Oddly my daughter responded better to her and my son-in-law to me. Think that even though he is finance manager he is the one who checks on me because he remembers and he can see though the veil of health.
So I am worried too but I try to deal with it. I am extremely asute except for periodic spaceiness but really I have been that way most of my life. People has always been bewildered how I can have such a high IQ for which I've been tested t
Thank you very much for your kind words. My husband is my first and only love. We have been together for over 40 years. He is a part of me and I of him. There is no way I could not do whatever I could to help him. I am just very grateful that I have the ability and time to do more than most in this situation. I know it has helped us both to get through everything he has been going through.
When I read your post, it really concerned me. Do you have a close family member or friend that can support you through this treatment? Your description of your HE episodes are very reminiscent of what has happened with my husband pre-transplant and post-transplant, even before starting treatment.
I am concerned that my posts about my husband's experience are causing you to be more fearful of treatment. My husband is in a special category. He is post transplant, taking immunosuppressant drugs. He has bile duct blockages and recurrent aggressive Hep C, which have caused cirrhosis of the new liver. Your case is very different. Yes, you have end stage liver disease, and you have episodes of HE, but your immune system is intact, still fighting this virus.
It is really important for you to try to get rid of this virus before transplant. The sooner you start, the better. Although he is having such a hard time with the episodes of HE, his labwork is definitely showing great improvement already after only 6 weeks of treatment. I hope this info will be encouraging to you.
Hep C Viral Load - Pre-Treatment
11/6/13 1,638,977
2/06/14 582,497
Hep C Viral Load After Starting Treatment
2/27/14 250
3/13/14 <43 (detected - below level of quantification)
(Last labwork pre-treatment) vs (On treatment after 6 weeks)
Billirubin 2.2 Billirubin 1.2
Creatanine 1.86 Creatanine 1.4
Alk Phos 439 Alk Phos 257
The response of the liver to any form of biliary tree obstruction is to synthesize more ALP. This shows his obstructions may be improving.
AST 61 AST 35
ALT (SGPT) 24 ALT (SGPT) 11
EGFR 43.93 EGFR 55.02
I hope you will be able to turn to someone close to help you through it. Sometimes we don't want to bother others with our problems, but they are only just waiting for us to ask for help. I hope that is the case for you. If not, remember you have all of us here on the forum.
Big hug,
Nan
When I read your post, it really concerned me. Do you have a close family member or friend that can support you through this treatment? Your description of your HE episodes are very reminiscent of what has happened with my husband pre-transplant and post-transplant, even before starting treatment.
I am concerned that my posts about my husband's experience are causing you to be more fearful of treatment. My husband is in a special category. He is post transplant, taking immunosuppressant drugs. He has bile duct blockages and recurrent aggressive Hep C, which have caused cirrhosis of the new liver. Your case is very different. Yes, you have end stage liver disease, and you have episodes of HE, but your immune system is intact, still fighting this virus.
It is really important for you to try to get rid of this virus before transplant. The sooner you start, the better. Although he is having such a hard time with the episodes of HE, his labwork is definitely showing great improvement already after only 6 weeks of treatment. I hope this info will be encouraging to you.
Hep C Viral Load - Pre-Treatment
11/6/13 1,638,977
2/06/14 582,497
Hep C Viral Load After Starting Treatment
2/27/14 250
3/13/14 <43 (detected - below level of quantification)
(Last labwork pre-treatment) vs (On treatment after 6 weeks)
Billirubin 2.2 Billirubin 1.2
Creatanine 1.86 Creatanine 1.4
Alk Phos 439 Alk Phos 257
The response of the liver to any form of biliary tree obstruction is to synthesize more ALP. This shows his obstructions may be improving.
AST 61 AST 35
ALT (SGPT) 24 ALT (SGPT) 11
EGFR 43.93 EGFR 55.02
I hope you will be able to turn to someone close to help you through it. Sometimes we don't want to bother others with our problems, but they are only just waiting for us to ask for help. I hope that is the case for you. If not, remember you have all of us here on the forum.
Big hug,
Nan
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Anemia
The primary toxicity of Ribavirin is hemolytic anemia, which was observed in approximately 13% of all Ribavirin/peginterferon alfa-2a- treated subjects in clinical trials. Anemia associated with Ribavirin occurs within 1 to 2 weeks of initiation of therapy. Because the initial drop in hemoglobin may be significant, it is advised that hemoglobin or hematocrit be obtained pretreatment and at week 2 and week 4 of therapy or more frequently if clinically indicated. Patients should then be followed as clinically appropriate. Caution should be exercised in initiating treatment in any patient with baseline risk of severe anemia (e.g., spherocytosis, history of gastrointestinal bleeding)
http://www.drugs.com/pro/ribavirin.html