Hep C Treatment, Anybody tell me ablout their side effects from it?

Question

My best friend is to start treatment on ribavarin and interfelon. What side effects did you or loved ones have? I am worried about the side effects I have heard of, such as psychosis so on. Please elt me know your own experiences with it to pass on to a worried pal. Cheers

Answer 1

There are many bad side effects. A dear friend of mine was told by his liver doctor that there is only a 20% chance of the virus decreasing with this treatment. So, after careful considering all options, he opted a CAT scan every 6 months to check the liver. THE TREATMENT WILL ONLY BE GIVEN AS A LAST RESORT. He has taken milk thistle and aloe vera. The hep. C. titers have stableized.

SERIOUS ADVERSE EVENTS
FROM INTERFERON TREATMENT

Featured Passage From the
Center of Biologics Evaluation and Research
Review of Schering Plough's application for PEG-Intron
Selected clinical summaries of serious adverse events are provided below. Deaths are listed first followed by other serious events grouped by organ system. The order in which the organ systems are listed is based on the clinical significance of the adverse events. Psychiatric adverse events were the most frequent and most clinically significant serious adverse events. The clinical manifestations of the most frequent serious adverse events appeared to be similar across treatment groups. The rarer adverse events did not appear to be specific to any treatment group. The clinical descriptions of these events were consistent with those of adverse events previously reported in the literature for interferon alfa and described in the drug label.

Deaths
Suicide: Patient 148 was a 42 year-old woman on PEG-IFN 0.5pg/kg for 25 weeks who died by self-inflicted gunshot wound. Of note is the lack of history of depression. No symptoms or signs of depression were noted by the patient's physicians.

Suicide, murder, paranoid reaction in the post-treatment period: Patient 598 was a 41 year-old man on IFN for 1 year and a history of depression, antisocial behavior, and drug abuse.

Sudden death associated with straining at stool: Patient 406 was a 59 year-old man on IFN for 21 weeks. Myocardial infarction was suspected as cause of death. There were neither history nor symptoms of cardiovascular disease and the study ECG was normal. No postmortem examination was performed.

Psychiatric Adverse Events
The narratives of the psychiatric adverse events indicate that suicidal behavior, namely ideation, attempt, or completed suicide, was commonly (but by no means invariably) associated with a previous history of depression or other psychiatric diagnoses. Depression and other psychiatric disorders occurred both during the interferon-treatment period and in the post-treatment period.

Abuse of illicit drugs or ethanol was reported. Very frequently drug abuse represented a relapse of drug addiction and was often associated with development of depression. Overdoses of illicit drugs were also reported. These events did not appear to be a manifestation of suicidal behavior.

Suicide attempt: Patient 057 was a 49 year-old woman who completed PEG-IFN 1.5 pg/kg for 1 year and attempted suicide (venisection and intake of 24 g of acetaminophen) in the post-treatment period. The patient had a history of depression and anxiety.

Suicide attempt, depression, addiction relapse: Patient 371 was a 33 year-old man who completed treatment with PEG-IFN 1.5 pg/kg. The suicide attempt occurred in the post-treatment period; depression and addiction relapse were also diagnosed at that time. There was a previous history of suicide attempt, depression, and drug abuse.

Suicidal gesture, depression, anxiety, agitation: Patient 053 was a 53-year-old man on PEG-IFN 1 pg/kg for 1 year and a history of depression and drug abuse.

Suicidal/ ideation, depression, aggressive reaction: Patient 139 was a 40 year-old man on IFN-alfa-2b for 36 weeks and a history of depression.

Suicidal ideation, depression aggravated: Patient 824 was a 43 year-old woman on PEG-IFN 0.5 pg/kg for 1 year and a history of depression.

Suicidal ideation, depression, addiction relapse: Patient 96 was a 40 year-old woman on PEG-IFN 1.5 pg/kg for 8 weeks who became depressed with suicidal thoughts and resumed ethanol abuse. Patients had a history of suicidal attempts, depression and alcoholism.

Suicidal ideation, depression, aggressive moods: Patient 411 was a 29 year-old man, on PEG-IFN 1 pg/kg for 5 months. There was no previous history of depression.

Suicidal ideation, depression: Patient 012 was a 39 year-old man. PEG-IFN was discontinued after 42 weeks for severe depression and suicidal thoughts. There was no previous history of depression.

Suicidal ideation, depression: Patient 465 was a 33 year-old man; PEG-IFN 1 .Opg/kg was discontinued after 8 months for severe depression and suicidal thoughts. There was no previous history of depression.

Suicidal ideation, emotional lability, depression: Patient 304 was a 34 year-old woman who was discontinued from PEG-IFN 0.5 yg/kg after about 10 months due to suicidal ideation. There was no previous history of depression.

Suicidal ideation: Patient 288 was a 39 year-old woman on PEG-IFN 1.5pg/kg and no previous history of depression. The event resolved with treatment and IFN was continued.

Depression: Patient 084 was a 37 year-old man on PEG-IFN 0.5 pg/kg for 9 months and a history of depression and drug abuse.

Addiction relapse/overdose: Patient 084 following discontinuation of PEG-IFN due to depression was hospitalized for respiratory failure and required assisted ventilation. A drug screen was positive for amphetamine, benzodiazepine, pentobarbital, marijuana and ethanol.

Depression, drug abuse: Patient 086 was a 34 year-old woman who completed PEG-IFN 1.5 pg/kg treatment. Depression developed and was followed by use of illicit drugs. The patient had a history of depression.

Depression, anxiety, addiction relapse: Patient 024 was a 28 year-old man on PEG-IFN 1.5 pg/kg for 2 months who became anxious, severely depressed an restarted IV drug abuse.

Depression: Patient 089 was a 59 year-old woman on IFN for 2 months who developed severe depression, fatigue and somnolence; previous history of depression.

Depression: Patient 638 was a 43 year-old man who completed one year of treatment with PEG-IFN 0.5 pg/kg. Depression began within 1 month of treatment and waxed and waned in severity. In the post-treatment period the patient was hospitalized for severe depression.

Addiction relapse/overdose, depression, agitation, hypothyroidism: Patient 517 was a 47 year-old man on PEG-IFN 0.5 pg/kg for 37 weeks. He became depressed, agitated, irritable and overdosed on diazepam (#50 10 mg tabs), hydrocodone and dalmane. He developed hypothyroidism requiring treatment. There was a previous history of depression and drug abuse.

Substance abuse, injury accidental: Patient 097 was a 47 year-old man who completed PEG-IFN 0.5 pg/kg treatment. The patient sustained a crush injury with pelvic and rib fractures and bladder injury. During hospitalization for the multiple trauma he developed ethanol withdrawal syndrome.

Addiction relapse: Patient 107 was a 31 year-old man on IFN for 11 months. The patient had history of drug abuse and depression and was hospitalized for detoxification from benzodiazepines.

Addiction relapse, overdose: Patient 306 was a 35 year-old man completed 1 year of treatment with PEG-IFN 0.5 pg/kg. He was hospitalized for an episode of loss of consciousness diagnosed as drug abuse and unintended overdose of lorazepam and valoron. There was a history of drug abuse.

Addiction relapse: Patient 297 a 35 year-old man discontinued IFN treatment after 6 months due to relapse of heroin abuse.

Cardiovascular Adverse Events
Myocardial infarction, septal, age undetermined, cardiomyopathy, severe depression of left ventricular systolic function: Patient 053 was a 53 year old man on PEG-IFN 1 pg/kg for 1 year. He became symptomatic and was diagnosed in the post IFN-treatment period.

Additional evidence of association of ischemic events with IFN consists of one case of myocardial infarction in study C97-058-01 (a PK study), two cases of retinal ischemia in the phase 3 study (see "Ophthalmic" narratives below), and post-marketing reports of ischemic colitis associated with interferon alfa-2b.

Renal Adverse Events
Nephrotic syndrome, interstitial nephritis: Patient 087 was a 42 year old man who completed 1 year's treatment with PEG-IFN 0.5 f_r.g/kg. Dramatic increase in body weight and edema were first noted 1 month after the end of IFN treatment. At 3 months post-treatment heavy proteinuria (6g/24 hrs) was documented with normal urine microscopy, hematology and clinical chemistries. At 4 months post- treatment interstitial nephritis was diagnosed on renal biopsy (focal segmental glomerulosclerosis was included in the differential diagnosis) and corticosteroid treatment was begun for the nephrotic syndrome.


Hematologic Adverse Events
Autoimmune thrombocytopenia: Patient 0002 was a 58 year-old man who received PEG-IFN 1 .O yglkg for 16 weeks. IFN was stopped when the platelet count dropped to 65x10' from 370x10' at baseline. Other hematology parameters including bone marrow aspirate were normal. Anti-platelet glycoprotein Ilb/llla was negative at baseline and elevated during treatment. Increased gingival bleeding was the only clinical manifestation of the cytopenia. Platelet count normalized on corticosteroid treatment. After several months of treatment corticosteroids were tapered off without recurrence of thrombocytopenia.

Autoimmune thrombocytopenia, epistaxis: Patient 157 was a 59 year-old woman who received PEG-IFN 1 .O pg/kg for 3 months. While on study, Parkinson's disease, gastritis, anxiety, and flu-like syndrome were diagnosed and were treated with biperiden, madopar, famotidine, acetaminophen, and a benzodiazepine. IFN was discontinued due to severe thrombocytopenia (27 xl 0'). Anti-platelet glycoprotein la/lla and ANA became weakly positive whereas they were negative at baseline. Bone marrow was not examined. Corticosteroid treatment was deemed unnecessary. Three months after discontinuation of IFN the platelet count was 102 xl 0'.

Ophthalmic Adverse Events
Retinal ischemia, decreased visual Acuity, cotton wool spots: Patient 021 was a 58 year-old man on IFN for 3 months. At 4 weeks of treatment he began to complain of decreased vision at night that progressively grew worse. There was no history of diabetes or cardiovascular disease. Ophthalmologic exam at 3 months showed cotton wool spots in the right eye and microvacular ischemia was documented by angiography. IFN was stopped and ophthalmologic changes were reported to be normal 8 weeks later.

Retinal vein thrombosis, vision disorder: Patient 361 was a 48 year-old woman on IFN for 7 months. Evaluation for scotomas in the right eye revealed a thrombosis of the upper temporal pole of the retinal vein with no involvement of the central vein.

Endocrine Adverse Events
Autoimmune thyroiditis mya/gia,asthenia: Patient 049 was a 30 year-old man, on PEG-INF 1.5 f_rg/kg for 3 months. He developed asthenia, diarrhea, headaches, myalgia, low TSH, elevated T3 and T4 and positive anti-peroxidase antibodies. IFN was discontinued and carbimazole treatment was begun.

lnfections
Because of the bone marrow suppressive effect of interferons alfa, serious infections were reviewed for unusual clinical manifestations or outcomes. The following events were described. Two cases of pneumonias presumed to be bacterial; one case of each of the following: appendicitis; peri-appendiceal abscess with peritonitis; retrouterine abscess in the presence of an IUD; oral abscess following dental extractions; labial abscess associated with controlled diabetes; tonsillitis presumed to be bacterial; erysipelas originating from a wound in the popliteal fossa; aseptic meningitis. The adverse events were not associated with clinically significant decreases in neutrophil counts and patients appeared to recover with treatment. An unusual finding was the presence (in patient 206 on PEG-IFN 0.5 yglkg) of necrotizing epithelioid granulomas in the post-treatment liver biopsy. A diagnosis of mycobacterium infection was considered but was not confirmed.

Neuroloqic Adverse Events
Left-sided facial paralysis associated with neutropenia and thrombocytopenia: Patient 022 was a 62 year-old man on PEG-IFN 1 .O pg/kg for 3 months. Bell's palsy developed while WBC was 0.81 x10' and the platelet count was 81 x10'. Paralysis and cytopenias resolved after discontinuation of IFN. Left-sided facial paralysis: Patient 347 was a 53 year-old woman on PEG-IFN 1 ug/kg for two months and a history of diabetes. Severe Bell's palsy developed, IFN was stopped and corticosteroids begun; 15 weeks later mild facial drooping remained.

Oculomotor nerve paralysis, diplopia: Patient 577 was a 48 year-old man with insulin-controlled diabetes. IFN treatment was discontinued after 5 months because of double vision, and drooping left eyelid. Partial oculomotor nerve palsy was attributed to vasculitis caused by diabetes or IFN.

Hearing loss: Patient 068 was a 36 year-old woman who completed 1 year treatment with PEG-IFN 1.5 yglkg. The patient complained of hearing loss and an audiogram showed a bilateral 30% loss of hearing (30 dB in the 1000 and 2000 Hz frequencies) that remained stable on continued IFN treatment.

Dermatologic Adverse Events
Psoriasis aggravated: Patient 149 was a 37 year-old woman on IFN for 3 weeks and a history of mild psoriasis controlled with topical coal extract. The patient developed a severe flare of psoriasis affecting the extremities and associated with arthralgias and eye irritation. IFN was stopped and cyclosporine and calcipotriene were required to control the psoriasis. Exacerbations of psoriasis recurred in the post-treatment period.

Generalized urticaria: Patient 318 was a 54 year-old woman on PEG-IFN 0.5 pg/kg who developed injection site erythema after the third dose. With the fourth dose the patient developed urticaria that began at the injection site and became generalized. IFN was discontinued and the patient was treated with corticosteroids.

Autoimmune Adverse Events
Systemic lupus erythematosus-like syndrome, Patient 327 was a 71 year-old woman who completed a 1 year course of PEG-IFN 1.5 ug/kg. Six weeks post- treatment the patient developed dyspnea, fever, and thoracic pain. Pericarditis with effusion and pleurisy were diagnosed and diclofenac was administered. GI bleeding occurred, was attributed to diclofenac and was treated with transfusion. A respiratory infection was treated with a cepahalosporin. Serologic testing was positive at high titer for ANA, DS-DNA, TPO, and for thyroid, spleen, thymus, and smooth muscle. No treatment for the autoimmune disorder was considered necessary. To the SLE case should be added the following autoimmune adverse events described above: aggravated psoriasis, thyroiditis, thrombocytopenia, and nephritis. In addition ulcerative colitis (presenting with fever, abdominal pain, and bloody diarrhea) has been associated with interferon alfa by postmarketing adverse event reports."
(33/2-38/8)
Side Effects of this Medicine
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

More common
Black, tarry stools; bleeding gums; blood in urine or stools; chest pain ; cough or hoarseness; difficult or labored breathing; fever or chills; lower back or side pain; painful or difficult urination; pale skin; pinpoint red spots on skin; shortness of breath; sores, ulcers, or white spots in mouth; tightness in chest; troubled breathing with exertion ; unusual bleeding or bruising; unusual tiredness or weakness; wheezing


Along with its needed effects, a medicine may cause some unwanted effects. The following side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

More common
Acid or sour stomach; belching; discouragement; dizziness; feeling sad or empty; feeling unusually cold; heartburn; indigestion ; irritability; itching skin; lack of appetite; loss of interest or pleasure; lack or loss of strength ; shivering; stomach discomfort, upset, or pain; tiredness; trouble concentrating; trouble sleeping


Less common
Change in taste; cough; crying; depersonalization; difficulty in moving; dysphoria; euphoria; fatigue; fever; gastrointestinal effects; headache; insomnia; joint pain; mental depression; muscle aching or cramping; muscle pains or stiffness ; nervousness; pain or tenderness around eyes and cheekbones; paranoia; quick to react or overreact emotionally; rapidly changing moods; rash; shortness of breath; stuffy or runny nose; swollen joints; vomiting


Rare
Itching, redness, or swelling of eyes; skin rash or irritation

Answer 2

I did the course of peg-interferon and Ribavivarin. I got severe side effects that included, anemia, severe weight loss, depression, muscle pains, and on and on. I was so pugnacious and nasty I lost many friends. No matter how understanding someone professes to be (a spouse or a friend) watch out. You go through an incredible personality change. Injecting is horrible. It's like being a junky looking for a place to put the needlle. I was subject to infection and my skin dried up. I got horrible psoriasis. My hair fell out. When you inject it's like giving yourself the flu every week. You are out of commission for two days and then sick the rest of the week. Just when you start to feel better you have to make yourself sick again. I am genotype 1. the treatment has a 40-50% Mine did not succeed so I suffered for ten months. My aunt went through the treatment at the same time. Her doctor did not treat the side effects which include psychosis. She committed sucide by jumping off a bridge. My advice is to wait for a better treatment than peg-interferon and ribavivarin. If that's not possible make sure your doctor gives you sleeping pills and ant-depressants and monitors and treats all the side effects immediately. They can be very severe. My aunt was very petite, 125 pounds. I am 6 foot 3 and 240 pounds. The doctors gave us the same dosage. You need to make sure that the doctors monitor your side effects and if they are too much for you, stop the treatment.

Answer 3

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RE:
Hep C Treatment, Anybody tell me ablout their side effects from it?
My best friend is to start treatment on ribavarin and interfelon. What side effects did you or loved ones have? I am worried about the side effects I have heard of, such as psychosis so on. Please elt me know your own experiences with it to pass on to a worried pal. Cheers

Answer 4

psychosis rarely happens now days because for one, she should be on a good antidepressant (at least a month prior to treatment because antidepressants take about a month to effect a person) she should also be on an antianxiety med such as buspar as well.

now, i had psychosis, but i was also taking a dose meant for my prechemo weight-but i was only 116 pounds!

You didnt say how long her treatment is, but if it is 6 months, I doubt she will have that sort of side effect, but if it is for 12 months, she may if she does not make sure all of her doctors are aware of the sides as well as what to look for.
Usually they will up the antidepressant or antianxiety meds or both.

The sides can hit really bad for some, mild for others and some even feel much better on the meds (i was one of the lucky ones)

I have found through my research that those that had more symptoms had an easier go of it, but then again, the more serious a person takes their treatment, the more apt they are to drinking enough water to keep the sides minimal.

She needs to suck or drink ice water-constantly. There is a mouth wash she will need (over the counter) forgot the name (sorry)
Her mouth will usually burn when she eats because her mouth will be dry. This makes food taste like crap. I found that the colder a food was, the more tolerable...that was basically either a very chilled sports drink or ensure, or my version of a very berry shake.

Other symptoms. Hair loss (not all of it however) I actually miss the days when I didn't have to shave my legs! lol

Sometimes a person will develope a rash at injection site-it will be "red and hot to the touch" which is normal, rash in the mouth (hot sauce seemed to make mine go away)
Her white and red cell counts will be affected, however, there are medications to help that as well....

The more positive she is( "Yeah, I'm gonna kick some HCV butt!" is a good one to tell oneself on treatment), the more water she drinks (as close to a gallon a day), and support are the three most important things I can tell you that she needs to do- this will ensure her adherance to the meds for the alotted treatment course.

Some doctors will okay the use of marijuana because marinol just doesn't help the mental side effects like the real thing. They may approve it, might write a prescription for it or tell you do what you think is best....

Infact, I tried it for about 2 months on chemo....it didnt help me gain weight (which is why I felt i needed it) however, when I quit, about a month later, that is when I had the psychosis, so, I think it helped with the mental sides as well (I was topped at the max on zoloft).

Tell her to hydrate for a few days before her first shot. The doctor will tell her to take a tylenol or advil (which ever he feels is right for your friend) about 20 minutes before the shot. Usually a hepper will feel slight to more prominent chills within a few hours.
She may get a fever, she may get a headache. The following day is usually the hardest as far as side effects, then it tapers off until its shot time again.

It's really not that hard to do, but then again, everyone is different and some have other diseases because of the actual hcv itself that may make treatment harder for some.

Thanks for asking and look out for signs leading up to psychosis....if you notice something strange "thats just not your friend"-chances are it's a mental issue.

Thanks again for being such a wonderful caring friend. You will make it easier for her, I have no questions about that!

Tell her I said kick some aS$!

HUGS to you both and Good LUCK to your friend for a successful treatment, sustained viral response and a cure!

Stormy SKY: lessoning the alt and ast levels is not keeping HCV from doing it's damage to the liver or any other organ. It simply means that it's lowered his enzymes. Your friend also must have genotype 1a or 1b. Treatment with interferon will give the liver a much needed break whether he responds or not, it will also keep liver cancer at bay a little longer as well. Again, milk thistle only affects the alt and ast levels, not virus levels. Aloe Vera juice? That does nothing but empty the pocket book. He's better off drinking pom juice or cranberry-less expensive. Seriously.

Last but not least, anything can cause a side effect. Everyone is different. Treatment is more like having the flu....if a person knows what they are getting into, take the right steps, treatment is fairly easy!
I no longer sleep ALL day and MOSt of the night! I can get up and go and stay awake all day long compaired to pre treating!
Psychosis and all, I'm glad I did it! Too many fear the side effects without knowing what it takes to keep them at bay!
Tell your friend the sooner he/she treats, the better! I'd be fearing what the HCV can do over what the medications have a possibility of doing! If he can't handle the sides, at least he tried!
Look for infergon...the latest with fewer sides!
Good Luck! :o)

UDIT: the article is from 1999!!! It is now 8 years later! Outdated information! We know more now than that in the year 1999!

Answer 5

The thyroid is a butterfly-shaped gland that sits low on the front of the neck. Your thyroid lies below your Adam’s apple, along the front of the windpipe. The thyroid has two side lobes, connected by a bridge (isthmus) in the middle. When the thyroid is its normal size, you’re unlikely to be able to feel it.
All types of hyperthyroidism are due to overproduction of thyroid hormones, but the condition can develop in several ways.
Thyroid hormone production can be suppressed or halted completely in these ways: https://tr.im/B4KYK

Answer 6

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Answer 7

1

Answer 8

pls click on-
http://http://www.medscape.com/viewarticle/416607_print
u'll find detail.