Pegasys & Hydrea

[russkatt]

I am wondering if anyone is taking both in combination? I am not getting the results from PEG and I don't want to increase my dose above 115 mcgs. I asked my doctor if we could try a small dose of Hydrea maybe 500 twice a week to see if this will lower my HCT so I can go more than 2 months without a phlebotomy.

[hunter5582]

While combining Pegasys with hydroxyurea might occasionally be done, there are risks to this approach. here is the drug interaction from ePocrates.

Monitor/Modify Tx hydroxyurea + peginterferon alfa 2a monitor CBC: combo may incr. risk of myelosuppression; may incr. risk of cutaneous vasculitic toxicities in myeloproliferative disorder pts (additive effects; mechanism unknown)

Additional Considerations peginterferon alfa 2a in Pegasys when used to treat HCV, caution advised w/ narrow therapeutic index drugs extensively metabolized in the liver; viral eradication may improve hepatic metabolic function, decr. levels, efficacy of concomitant drugs.

Note that hydroxyurea is a narrow therapeutic index drug.

It would be best to discuss this with a MPN Specialist.

[russkatt in reply to hunter5582]

Thanks! I will go into to it with my MPN specialist. Lots to consider.

[eladhil]

hey,I am taking peg 45 every 18 days and h.u 3gm a week. It work well and my numbers are o.k

[dbus1417]

I am taking both with no adverse effects. Although my mpn doc has indicated that as the pegasys takes effect we will drop the HU in the near future. I started at 1000 mg HU daily but as my numbers keep improving we are reducing the HU.

90 mcg pegasys weekly

500 mg HU daily currently

If my numbers are good enough next appt, we will drop HU altogether.

[russkatt]

Thank you for the info much appreciated.

[Minify]

Some folks need higher doses of Pegasys. I did not respond until I reached 180, and now all of my labs are normal and I feel great. During the 6 months of slow titrating and waiting for the Peg kick in, I asked about adding Hydrea, but my doctors felt it was best to stick with one drug as long as I was tolerating it and we could manage blood counts with phlebotomy. I did need 2 phlebotomies during that wait period.

I’m glad I stuck with the low and slow approach with Pegasys, and glad that I didn’t add Hydrea.

[russkatt in reply to Minify]

That is really good to hear. I might just try a little higher dose and see if that does the trick. Thanks for the reply!