Hepatitis C Treatment and Anemia

Hepatitis C Treatment and Anemia
Understanding Hemoglobin and Procrit / Epogen

Why Your Body Needs Hemoglobin

Just like a car, your body needs fuel to run. Hemoglobin, or Hb, is important
because it transports oxygen to your blood to all parts of your body. Think of the
oxygen carried by hemoglobin as the fuel your body needs to stay alive and run
efficiently.

Hemoglobin is a substance found in your red blood cells. Although other
substances in your body, such as water and plasma, also carry oxygen,
hemoglobin is unique because it can carry four times as much oxygen
throughout the body.

How Hemoglobin Fuels Your Body

Because hemoglobin contains iron, it is an excellent vehicle for transporting
oxygen and carbon dioxide. When red blood cells fill the air sacs of your lungs,
they take up oxygen. The hemoglobin in the red cells combines with the oxygen
to form a compound called oxyhemoglobin. When the red cells travel through
the rest of your body, they give up the oxygen to the tissues. In the tissues,
hemoglobin takes up carbon dioxide and releases it in the air sacs of the lungs.
The carbon dioxide is then exhaled.

What Causes Anemia

Anemia develops from abnormally low levels of red blood cells or hemoglobin.
A severely anemic person’s blood cannot carry enough oxygen to meet the needs
of the body tissues. As a result, over time the person becomes tired physically
and mentally. When on interferon and ribavirin treatment for hepatitis C, a
reduction in hemoglobin very commonly occurs and in most cases, is managed at
levels below the normal laboratory ranges, returning to normal after treatment is
completed or stopped. Anemia is an expected side effect of treatment with
interferon and ribavirin.

In addition to anemia caused by interferon and ribavirin, anemia can be caused
by kidney disease, lack of vitamin B12 in your diet, lack of folic acid in your diet,
an inherited blood disorder such as sickle cell anemia, blood loss from an injury
or accident, gastrointestinal bleeding, lack of iron.



1

---

Symptoms of Anemia

Have you ever held your breath for longer than a minute? Do you remember
how tired you were afterward? With anemia, you would feel tired all the time.
Even extra sleep will not help an anemic person feel better. If you are anemic,
you may experience:
• Extreme fatigue and weakness
• Feeling tired
Take Charge of Your Health
• Difficulty sleeping

• Difficult thinking clearly
During your hepatitis C
• Headache
treatment period, you will have
• Dizziness or fainting
your blood drawn on a regular
• Paleness
basis to check many lab values,

including hemoglobin. It is
Treatment for Anemia
important to have the labs

drawn when instructed to do so
Your doctor will monitor your anemia by looking
by your doctor’s office.
at your blood test results. It is not uncommon for

hemoglobin values less than normal to be followed Plan and limit activities to save
closely without any change in medication or other
energy and prevent fatigue.
treatments. However, there may be a time when

your doctor discusses a separate treatment called
Ask family and friends to pitch
PROCRIT or EPOGEN for the anemia and the side in with things like child care,
effects you are experiencing.
shopping, house cleaning or
driving.


PROCRIT or EPOGEN is identical to erythropoietin Make sure you have a
(e-RITH-ro-POI-e-tin), the substance your kidneys
nutritionally balanced diet and
normally make. It stimulates your bone marrow
are drinking plenty of water.
to make new red blood cells. As a result, more red
blood cells can carry oxygen to the body, which
may increase your energy level and provide relief from the symptoms of anemia,
such as fatigue and shortness of breath.

PROCRIT or EPOGEN is available only by prescription. It is an injection given
underneath the skin like the injection of interferon you are already receiving.
Your doctor will tell you what dosage is right for you.

Precautions

Before administering this medication, tell your doctor or pharmacist if you are
allergic to epoetin, human albumin, or any other drugs. Always tell your doctor
and pharmacist what prescription and nonprescription medications you are
taking, including vitamins.

2

---

Administering Your Medication

Store the medication in the refrigerator. Do not allow medication
to freeze. Take your next dose from the refrigerator 1 hour before
using it; place it in a clean, dry area to allow it to warm to room
temperature. Avoid shaking the vial. Use a vial only once, and do not reenter a
needle into a vial. Discard unused portions and outdated medication.

Before you administer your medication, look at the solution closely. It should be
clear and free of floating material. Observe the solution container to make sure
there are no leaks. Do not use the solution if it is discolored, if it contains
particles, or if the container leaks. Use a new solution and contact the pharmacy
to report the damaged one.

It is important that you use your medication exactly as directed. Do not change
your dosing schedule without talking to your doctor’s office. Do not stop your
therapy on your own because your ability to continue interferon and ribavirin
could be hampered. Call the doctor if you have any questions or concerns.

Side Effects

Side effects are uncommon but they can occur. Procrit or Epogen sometimes
causes a flu-like reaction with chills, shivering, sweating, muscle aches, and bone
aches. These effects may appear 1-2 hours after an injection and usually go away
within 12 hours. They may go away during treatment as your body adapts to the
medication. However, tell your doctor if any of these problems continues or
worsens. Your doctor should carefully monitor your blood pressure and
hemoglobin for rapid increases, which should be avoided.

Complete Product Information is available from your pharmacist. The
information will provide you with a complete list of possible side effects and
other details concerning the medication you have been prescribed.

Results of Medication

This medication is intended to help your body make red blood cells. It is not
effective in all patients when prescribed for anemia, even when taken as directed.
Your doctor will monitor the success of the medication in terms of increasing
hemoglobin levels and improved quality of life relating to the symptoms of
anemia you are experiencing.

3

---