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TOPIC: Raised bilirubin and Ribovirin

Raised bilirubin and Ribovirin 5 years 6 months ago #13530

  • Sundance
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I decided to add Ribovirin for the last 4 weeks of 24 weeks Harvoni treatment. My first week blood test with Ribovirin my Bilirubin has gone from 14 to 28, my FBC is normal. I am taken 1200 mg as the packs only come in 200mg. Has anyone else have similar experience. I am thinking of dropping down to 1000mg as my weight is 66kg so 400mg in morning and 600 at night.
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Raised bilirubin and Ribovirin 5 years 6 months ago #13534

  • Gaj
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Hi Sundance,

Not a doc so please check with yours but my bilirubin jumped 50% within two weeks of starting riba and returned to previous level over next four weeks (Didn't test at one week so may have been higher). I understand this is due to the increased RBC hemolysis caused by the riba initially. 1000mg is usually the recommended dose for someone of 66kg, do you know why you were put on the higher dose?
G3a since '78 - Dx '12 - F4 (2xHCC)
24wk Tx - PEG/Riba/Dac 2013 relapsed
24wk Tx - Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx - 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 - 22/06/17 UND
SRV12 - 27/07/17 UND
SVR24 - 26/10/17 UND
:cheer: :cheer: :cheer:
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Raised bilirubin and Ribovirin 5 years 6 months ago #13536

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The Meds came In 200mg capsules, so it was either 400mg morning and 600 mg night or 600 mg morning and night, I decided to do equal doses morning and night. I am feeling well, although the insomnia has returned but I was only intending on taking Ribovirin for 4 weeks so that is something I can cope with. I will get another test this week.
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Raised bilirubin and Ribovirin 5 years 6 months ago #13537

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  1. You are taking too much Ribavirin. The correct dose for your weight is either 800 mg or 1000 mg total each day in 2 divided doses (this assumes you have normal renal function. I suggest reducing the dose immediately.
  2. Ribavirin can cause a haemolytic anaemia - haemolytic means that red cells "explode"
  3. When red cells break down they release stuff that becomes bilirubin
YMMV
Last Edit: 5 years 6 months ago by DrJames.
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Raised bilirubin and Ribovirin 5 years 6 months ago #13582

  • Price
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Ribavirin is supposed to sensitize you to whatever you're taking with it. So it makes sense to take it at the start of treatment or predose with it but taking it at the end of treatment has never worked.

Adding Ribavirin to Harvoni for Hepatitis C Increases Side Effects But Not Efficacy

www.hivandhepatitis.com/hcv-treatment/ap...cts-but-not-efficacy
Last Edit: 5 years 6 months ago by Price.
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Raised bilirubin and Ribovirin 5 years 6 months ago #13583

Too late for me,
I've already done my first 12 weeks with Ribavirin , Sofosbuvir & Ledisbovir .
Then I've continued with just the Sofosbuvir & Ledisbovir .
Must admit that the RIBA has some very bad side effects.
At 4 weeks PCR <12 detected
At 12 weeks PCR undetected .
1 week left for my 24 week PCR .
AUSTRALIAN
HCV Genotype 1a
2003 Relapsed Peg Interferon / Ribavirin
Pre treatment VL 2,000,000
ALT 65, AST 42, ALP 111, GGT 56
Bridging F3-4
Treatment -24 weeks - Sof , Led with 12 weeks Riba.
4 weeks VL <12 Detected ALP 89 , GGT 21 , ALT 17 , AST14
12 weeks VL Undetected ALP 96, GGT 22, ALT 20, AST 20
24 weeks VL Undetected ALP 83, GGT 20, ALT 21, AST 14
EOT 6th April 2016
SVR 5 weeks VL Undetected ALP 81, GGT 31, ALT 22, AST 20
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