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blood transfusions
Hi guys, I haven't posted lately because I haven't been off the couch much. I have been on procrit for 9 weeks, and my hem is 8.6. My doctor is starting to freak a little and wants me to get a blood transfusion. He has tried reducing the riba also and my hgb just won't rise. I talked him into to waiting until my labs come back this friday and hope I take a jump. He said if it didn't rise he would reduce riba pretty drastic over the weekend and have me get a blood transfusion Monday. I am currently taking 1000 mg of riba, victrelis, and 180 of peg. Just wondering if anyone else has had blood transfusions and what to expect. Thanks for any advice
thanks BoceprevirGal for sharing your experience. I think I may just reduce my riba to 800 mg today and see if that helps. I really don't want a Bt if at all possible.
thanks so much for sharing your experience with the BT and procrit. My doctor is just not a fan of keeping me on procrit so long, this is why he feels maybe a Bt would lessen my length on the procrit. But he is a very good doc and he cosults with the Mayo clinic physcians that did some of the original testing with all of these drugs, so I trust him. Thanks again for your advice and I will let my doc know your experience.
You might ask him to refer you to a hematologist, a doctor that specializes in blood for their opinion about procrit and BT. It might take some of the fears away from your doctor... Best of luck to you.
I remember you telling me about taking the procrit every five days and I mentioned that to my doc today. But he thinks the procrit has to many bad side effects to increase, I am his only pt on the Victrelis. Thanks
Thanks Hector for all the information. I have a GI doc and the first time I dropped below 9 they reduced riba to 800 and I went up some. He just hates to reduce lower than 1000 at this time. I am in week 24 of treatment. I am the only pt he has on Vic, all the rest are incevik. So I think the anemia is worrisome to him. I told him that everyone on this site whom took the vic suffered from anemia and that made him a little less concerned today as he would have had me go for a transfusion today. Thanks again
Hi there, sorry to hear you are dealing with this.The 8's are very unpleasant.. I hope you can get a handle on this so you can finish treatment without the added stress of anemia.
In my experience, I was reduced from 1200 riba to 1000 mg when I hit 10.0. I was not given procrit so I just dropped steadily until my Hgb became 8.1. I was then given a blood transfusion and reduced even more down to 600 riba. Without procrit I was just so saturated with meds I needed a second transfusion 5 weeks later.
The transfusion part was easy for me..but they probably would not have been needed had I been on procrit. Since i was RVR before reduction that and a rescue drug would have been better then two transfusions.
While I felt amazing after the transfusions, there are still risks and as Cando stated, it is surprising to give one at 8.6. Also, in my case the transfusion really didn't last long unil I needed another one...I had to wait for the reduction to kick in so I could stabilize. I spent the end of treatment in the 9's..which was hard but doable.
How do you feel? Besides being on the couch and weak...if you can manage then hang on and I hope better numbers will come your way soon with the reduction and procrit.
The anxiety does not feel good either I know, but unless you have other heart orhealth problems being in the 8's is okay..just feels really bad. :(
best wishes
Laura
In my experience, I was reduced from 1200 riba to 1000 mg when I hit 10.0. I was not given procrit so I just dropped steadily until my Hgb became 8.1. I was then given a blood transfusion and reduced even more down to 600 riba. Without procrit I was just so saturated with meds I needed a second transfusion 5 weeks later.
The transfusion part was easy for me..but they probably would not have been needed had I been on procrit. Since i was RVR before reduction that and a rescue drug would have been better then two transfusions.
While I felt amazing after the transfusions, there are still risks and as Cando stated, it is surprising to give one at 8.6. Also, in my case the transfusion really didn't last long unil I needed another one...I had to wait for the reduction to kick in so I could stabilize. I spent the end of treatment in the 9's..which was hard but doable.
How do you feel? Besides being on the couch and weak...if you can manage then hang on and I hope better numbers will come your way soon with the reduction and procrit.
The anxiety does not feel good either I know, but unless you have other heart orhealth problems being in the 8's is okay..just feels really bad. :(
best wishes
Laura
Hi Parker, I felt much better, when I reduced my Riba to 800 mgs, at 19 weeks. I waited until my HGB slipped to 9.1 (I was on Procrit from week 9~19)
I am sorry that your HGB is so low, you must feel
terrible. I would think that a blood transfusion would make you feel better. I do know of many
people that have had to have them, and I'm sure some will comeon, and share their experience with you about it.
I am sorry that your HGB is so low, you must feel
terrible. I would think that a blood transfusion would make you feel better. I do know of many
people that have had to have them, and I'm sure some will comeon, and share their experience with you about it.
I also treated with Vic, when you say your on procrit how often and at what dose? I had to take it every 5 days at 40,000 just to keep my HGB at 9, I'm surprised at 8.6 your doctor wants to even consider a BT.......... Hoping things get better for you soon.........
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You are taking too much ribavirin which is causing your anemia. Your ribavirin should have been reduced when you has less the 10 d/gl (anemia). The FULL PRESCRIBING INFORMATION instructions are on the piece of paper that comes with the drug.
http://www.drugs.com/pro/copegus.html
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* Hemoglobin <10 g/dL in patients with no cardiac disease, or
* Decrease in hemoglobin of ≥2 g/dL during any 4 week period in patients with history of stable cardiac disease
Reduce to 600 mg per day
- 1 × 200 mg tablet A.M.
- 2 × 200 mg tablets P.M.
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* Hemoglobin <8.5 g/dL in patients with no cardiac disease, or
* Hemoglobin <12 g/dL despite 4 weeks at reduced dose in patients with history of stable cardiac disease
Discontinue
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Reducing ribavirin has no effect on SVR rated with triple therapy.
http://www.hivandhepatitis.com/hepatitis-c/hepatitis-c-topics/hcv-treatment/3583-easl-ribavirin-dose-reduction-and-epo-both-work-for-managing-anemia-in-patients-using-boceprevir
EASL: Ribavirin Dose Reduction Is Effective for Managing Anemia in Patients Using Boceprevir or Telaprevir
"Early ribavirin dose reduction did not negatively impact SVR compared with early EPO use," the investigators concluded. "These data support ribavirin dose reduction for primary anemia management."
Taken together, these studies indicate that the extra potency of HCV protease inhibitors helps overcome the tendency to relapse among patients who take inadequate ribavirin in dual therapy with pegylated interferon.
In his summary of research highlights on the final day of the conference, Jean-Michel Pawlotsky from the University of Paris said these findings "validate the use of ribavirin dose reduction" rather than adding the expense of EPO to an already costly regimen.
Merck. Merck Reports Phase III Study Results Evaluating Anemia Management Strategies Used With Victrelis (boceprevir) Combination Therapy. Press release. April 19, 2012.
Good luck with treatment!
Hector