Thrombocytopenia ribavirin

Common side effects of peginterferon are given in Table 25-10. Common side effects of ribavirin are fatigue, flu-like symptoms, neutropenia, thrombocytopenia, and anemia. 

Peg Interferon Alfa 2b (PEG-Intron) [Antiviral/ Immunomodulator] WARNING Can cause or aggravate fatal or life-threatening neuropsychiatric, autoimmune, ischemic, and infectious disord s. Monitor pts closely Uses Rx Hep C Action Immune modulation Dose 1 mcg/kg/wk SQ 1.5 mcg/kg/wk combined w/ ribavirin Caution [C, X if used w/ ribavirin /-] w/ Hx psychiatric Contra Autoimmune H, decompensated Uvct Dz, hemoglobinopathy Disp Vials 50, 80, 120, 150 mcg/0.5 mL Redipen 50, 80,120,150 mcg/5 mL reconstitute w/ 0.7 mL w/ sterile water SE D ession, insomnia, suicidal behavior, GI upset, neutropenia, thrombocytopenia, alopecia, pruritus Interactions t Myelosuppression W/ antineoplastics t effects OF doxorubicin, theophylline t neurotox W7 vinblastine EMS See Peg Interf on Alfa-2a may cause flu-like Sxs... 

Sagir A, Wettstein M, Heintges T, Haussinger D. Autoimmune thrombocytopenia induced by PEG-IFN-alpha2b plus ribavirin in hepatitis C. Dig Dis Sci 2002 47(3) 562-3. 

A 54-year-old woman with chronic hepatitis C developed severe thrombocytopenia (16 x lO /l) after a single dose of peginterferon alfa-2a following treatment with peginterferon alfa-2b-I-ribavirin for 48 weeks an immunological mechanism was proposed [45 ]. 

Roomer R, Hansen BE, Janssen HL, de Knegt RJ. Thrombocytopenia and the risk of bleeding during treatment with peginterferon alfa and ribavirin for chronic hepatitis C. J Hepatol 2010 53 (3) 455-9. 

Kato H, Fujishiro T, Narita M. A case of severe thrombocytopenia in a patient with chronic hepatitis C caused by a single administration of pegylated interferon a 2a subsequent to 48 weeks of pegylated interferon a 2b plus ribavirin therapy. Intern Med 2010 49(16) 1741-4. 

Hematologic Factors that could help predict hematological abnormalities in patients with chronic hepatitis C taking pegylated interferon and ribavirin have been studied in 136 patients over 4 years, of whom 52 developed neutropenia (n = 28), anemia (30), or thrombocytopenia (11). Genotype 1, a history of hypertension, a low baseline platelet count, a low baseline hemoglobin, and a raised serum creatinine concentration were significant factors [31 ]. 

A meta-analysis examining the efficacy and safety of pegylated IFNa-2a- and IFNa-2b-ribavirin in children and adolescents with chronic hepatitis C revealed incidences of anaemia 11%, neutropenia 32%, leucopenia 52%, thrombocytopenia 5%, alopecia 13%, injection site erythema 27% and pruritus 10%. Discontinuation due to adverse events and viral breakthrough were each 4%. Small inhibitions of growth were seen during treatment [30 ]. 

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