Discussion Forums > Thalassemia Major

Liver levels and exjade

<< < (3/5) > >>

Hamdan:
Hi All,
Please I am still waiting for an answer to my question, another very important question is, I heard about Ferriprox and Kelfer so we can make a combination with Desgeral but my wife has Hep-C and we are afraid to take any of it with Desfiral because of liver function increasing, so can she takes Ferriprox Or Kelfer with Desferal???? her Ferritine levels now are 4400 and I am so scared, please answer ASAP.
Thanks
Hamdan

Andy Battaglia:
Hi Hamdan,

With her ferritin above 4000, combination chelation is appropriate. She can use desferal with either oral chelator. I don't like the halfway measure with Exjade. Again, patients are being made secondary to cost. If she can take full dose of Ferriprox along with 4 days of desferal each week, she would see good improvement. If she must take only half a dose of Exjade, I would suggest desferal 5 days a week.
Both are safe to use by patients with Hep C, as long as the regular monitoring of kidney and liver levels is maintained. I would also suggest using herbs like nigella and milk thistle to send the Hep C into remission. And she should drink tea with every meal.

Poirot:

--- Quote from: Hamdan on October 05, 2013, 02:11:09 PM ---Hi All,
Please I am still waiting for an answer to my question, another very important question is, I heard about Ferriprox and Kelfer so we can make a combination with Desgeral but my wife has Hep-C and we are afraid to take any of it with Desfiral because of liver function increasing, so can she takes Ferriprox Or Kelfer with Desferal???? her Ferritine levels now are 4400 and I am so scared, please answer ASAP.
Thanks
Hamdan


--- End quote ---

Dear Hamdan,

Sorry for the delay in replying - I do not see this board on a daily basis and email to me works faster.

RE: Ferriprox/Kelfer - there are absolutely no problems in taking it with Hep C -  I can say this from my personal experience and the experience of other thals + hep c on kelfer. Only thing to keep in mind is to EASE into the dosage for Kelfer and not start off with the full dosage immediately (max dosage that can be taken is 75mg/kg, although recent tests indicate that even 100mg/kg is well tolerated) - and that not everyone is suited for Kelfer. 1-2% of the patients report neutropenia, in which case the kelfer has to be stopped for 30-45 days. Then restart with a much lower dosage - if neutropenia recurs, then kelfer is not suited for you. Start off with 15-25mg/kg of body weight, and then keep increasing the dosage on a weekly/fortnightly basis until you hit the correct dosage levels. The daily dosage needs to be broken up and taken equally 3 times a day - 4 times a day, if you can really space yourself. Kelfer does not affect liver function, and will not raise the liver enzyme levels.

And, combination therapy with Desferal will also help, as the two drugs act on different organs when they start off - Kelfer on heart iron, Desferal on liver iron.

With Ferritin levels over 4,000, an aggresive chelation therapy is indicated.

Good luck.

Poirot

Hamdan:
Hi Andy and Poirot,
Thank you so very much for your great advises and I really appreciate that so much, one more question until we go to check with my wife’s Dr, next month can we just use Desferal 7 Days a week? my wife now on Desferal 2000mg daily and sometimes 1500mg daily for 12Hours, can that work to get her Ferritin down? and how long it could take? honestly my wife was not comfortable to use Kelfer with Hep C  but since you said ok I showed her your msg and she wants to consult her Dr first next month, my question as above is "is it OK to use Desferal only 2000mg daily for 12Hours to lower firritin levels from 4400 to normal below 1000? and how long this could take?
Thanks
Hamdan

Poirot:

--- Quote from: Hamdan on October 07, 2013, 02:40:43 PM ---Hi Andy and Poirot,
Thank you so very much for your great advises and I really appreciate that so much, one more question until we go to check with my wife’s Dr, next month can we just use Desferal 7 Days a week? my wife now on Desferal 2000mg daily and sometimes 1500mg daily for 12Hours, can that work to get her Ferritin down? and how long it could take? honestly my wife was not comfortable to use Kelfer with Hep C  but since you said ok I showed her your msg and she wants to consult her Dr first next month, my question as above is "is it OK to use Desferal only 2000mg daily for 12Hours to lower firritin levels from 4400 to normal below 1000? and how long this could take?
Thanks
Hamdan


--- End quote ---


Prima facie, I would say that the dosage of 2gms Desferal a day is too low, even if given over 12 hours a day to bring down the Iron levels. You have not mentioned her body weight or the number of transfusions she takes per month - but, I am guessing that 2gms/day is just about a maintenance dose. Her iron may increase at that dosage. If she weighs more than 50kgs, I would increase that dosage to 3gms/day immediately.

Please consult your doctor immediately - corrective action is required urgently - longer she delays, the more the risk of organ damage and worse. Don't want to scare you, but a Ferritin level of 4400 is not good.

Best of luck,

Poirot

Navigation

[0] Message Index

[#] Next page

[*] Previous page