telaprevir patient counceling information

7/31/2019 TELAPREVIR Patient Counceling Information

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Esther Soler Climent. B-Nursing.Hepatology Unit. HGTiP. Badalona.

Barcelona. [email protected]
mailto:[email protected]:[email protected]


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THE FIRST 4 WEEKS. At week 4, you will have a blood test to measure

the amount of virus in your blood.

If the virus is undetectable means that you areresponding really well, so you have many options to

cure (SVR). However, it takes some time to completethe treatment.

If the virus is still detectable with a low amount, thenews may not be bad depending on what happensin week 12.

However, if the quantity of virus in the blood isabove a certain level, your doctor may recommendstopping treatment you are taking for hepatitis C.

Esther Soler Climent. CTN


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THE FIRST 12 WEEKS.

At week 12, you will have another blood test to

measure the amount of virus in blood.

Continue treatment.

Depending on your response in the first 12

weeks you should stop or continue treatmentonly with peginterferon alpha and ribavirin foranother 12 or 36 weeks.



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This medicine may affect other medicines and

other medicines may affect it. Inform theteam of health to visit if you are taking orhave recently taken other medicines,

including those not prescribed.



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Telaprevir should always be taken with foodbecause it is important to achieve appropriatelevels of medication in your body.

Example of food that can be taken to improvelevels of the drug:Whole milk, chocolate biscuits, toast withbutter and jam, toast with cream cheese,

chocolate, nuts, cheese, dried fruit, olives, etc...



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No, not reduce your dose.

No, the tablets should be swallowed whole.

Do not chew, break or dissolve before swallowing.Tell your doctor if you have trouble swallowingtablets whole.


Can you chew, dissolve or break the

tablets ?


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If you find that you skipped a dose in ashorter period of 4 hours:Take the prescribed dose with foodimmediately.

If you find deque have missed a doseafter 4 hours:Skip the missed dose.Resume treatment with the nextscheduled dose, without double dose tomake up the missed.



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The pills should be stored in their originalpackaging, which must be kept tightly closedto protect from moisture.

The pack contains a bag of desiccant to keepthe tablets dry. Do not remove the desiccantfrom the container.



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Keep out of reach and sight of children.

Telaprevir not use after the expiration date

on the carton after EXP. The expiry date isthe last day of that month.

Medicines should not be disposed of viawastewater or household waste. Ask your

pharmacist how to dispose medcatenos anddo not need. This will help to protect theenvironment.



11/42Esther Soler Climent. CTN


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Precautions in pregnancy .

As Telaprevir be administered in combination withRibavirin and ribavirin can cause considerable

damage to the fetus, all patients are women ormen, must take special precautions to avoidpregnancy. Any method of contraception can fail,so you and your partner will have to use at leasttwo effective contraception during and aftertreatment with Telaprevir.

Women of childbearing age and their malepartners.

The anticoceptivo hormone may not be reliableduring treatment. Therefore, you and your partnershould use two barrier methods of contraceptionduring treatment with Telaprevir and up to twomonths after completion.



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Some patients may feel faint or visualdisturbances during treatment. Do not drive

or operate machinery if you experiencethese conditions during treatment withTelaprevir.

This medicine contains 2.3 milligrams ofsodium per tablet which should beconsidered in the treatment of patients withlow sodium diets. Tell your doctor if you

should be careful about salt intake and adiet low in sodium.



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Patients taking this treatment often sufferfrom itchy skin rashes. Typically, the rash ismild or moderate. Rarely, patients mayexperience other symptoms, which may be

a sign of a severe rash.

Your doctor should check your rash todetermine the best treatment. Your doctormay interrupt treatment and treatmentshould not be restarted if stopped.



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If the rash worsens, or

If you develop other symptoms with the rash: Fever

Fatigue

Swelling of the face

Swollen lymph nodes, or if your rash isspreading and has cold sores.



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Fainting

Painful swelling of the joints, mostcommonly of the feet (gout).

Vision problems.

Bleeding from the anus.

Swelling of the face.



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Low number of red blood cells (anemia)

Nausea, diarrhea and vomiting.

Inflammation of the veins of the rectumor anus (hemorrhoids), discomfort inthe anus or rectum.

Rash and itching of the skin



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What I can do to preventand control the most

common side effects?



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Perfumed products Bubble bath Soap, particularly perfumed soaps. Soap-free cleansing bars, these can be drying

and potentially irritating. Lanolin-based creams, lotions, ointments etc. Anything that you think you might be allergic

to. (common allergy-causing agents;detergents, plants, pets, harsh chemicals in

household cleaning products, rubber gloves,jewelry, feathers, grass and pollen, artificialfingernails and adhesive).



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Dry yourself by patting your skin with a soft towel, rather thanrubbing vigorously. Use mild, non-perfumed, non-deodorent soaps Or low allergy soap

of soap substitute - cream, cleaning gels. Take showers or short, cool baths instead of long, hot baths. Shaving for men - if dry skin reactions occurs on your face, skip a

couple of days (over a weekend?) to give your face a rest. Do not

use perfumed after-shave. Shaving for women - if after shaving your legs a rash appears do not

shave again until the skin has completely healed.

Wear cotton clothes where possible next to the skin, rather thanwool, synthetic fibers or rough clothing.

Wash clothes in mild detergent.



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Extreme weather conditions can worsen and

cause dry skin reactions (hot and sunny, coldand windy).

Wear gloves in cold weather.

Avoid sun exposure. Wear SPF 30 (or higher)sunblock and protective clothing.

Drink plenty of fluids keep your body well

hydrated. You should drink 2-3 quarts of non-alcoholic, non-caffienated beverages daily,unless you are instructed to restrict your fluidintake.



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Use moisturizers regularly. Moisturizers prevent water loss by

layering an oily substance over the skin to keep water in or byattracting water to the outer skin layer from the inner skinlayer.

Bath oils such as baby oil, mineral oil, Herbal Bath Oil,Lubriderm Bath Oil, or Neutrogena Body Oil can be applied toyour wet skin after you emerge from the bath or shower.

Always rinse and dry hands carefully, particularly after contact

with cleaning products. Wear rubber or vinyl gloves to protect hands, underneath

wear thin cotton gloves. Do not wear for long periods oftime. (Wash the cotton gloves frequently).



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You can moisturize with Vaseline or moisturizingcreams soluble in the lips and nasal mucosa.

Reinforce oral hygiene. If you have discomfort or painin the gums must make brushing teeth and to rinse ofchamomile, plantain or basil, often to avoid the

accumulation of food and bad taste. To this, add atablespoon of chamomile flowers or a spoonful ofchopped dried leaf and plantain or one tablespoon ofdried leaves and chopped basil in a cup of boilingwater, the dose is to mouthwash 4 times a day, to

improve. Avoid alcohol mouthwashes.

If you have dry mouth can chew gum or sugarlesscandy or pieces of fruit like pineapple or orange, theycan help produce more saliva.



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Maintain good oral hygiene - brush your teeth before and after each meal. Choose and prepare foods that look and smell good to you. Eat small, frequent meals. Use plastic utensils if food tastes like metal. Eat mints (or sugar-free mints), chew gum (or sugar-free gum) or chew ice to

mask the bitter or metallic taste. Substitute poultry, eggs, fish, peanut butter, beans and dairy products for red

meats. Marinate meats in sweet fruit juices, wines, salad dressing, barbeque sauce, or

sweet and sour sauces. Flavor foods with herbs, spices, sugar, lemon, and tasty sauces. Chilled or frozen food may be more acceptable than warm or hot food. Try tart foods such as oranges or lemonade (this may be painful if mouth sores

are present).

Avoid cigarette smoking. Eliminate bad odors. Eat in pleasant surroundings to better manage taste changes. Increase your fluid intake.



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There is no one magic solution for tastechanges that suits everyone. Finding foods

that taste appealing may be a process of trialand error. Some people who experience tastechanges avoid their

favorite foods to prevent the possibility of

spoiling them for the future.



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Try to eat small meals or snacks, every two to three hours,

instead of three large meals a day (become a grazer). Don'texpect to eat regular size meals.

Foods that are high in protein or calories are good snacks tohave handy. Examples include; milk shakes, cheese, fruits,peanut butter, nuts, crackers and juices.

Eat foods that are rich in calories and nutrients. Avoid low-calorie foods that fill you up, such as lettuce, broth and dietsoda.

When choosing beverages, select nutrient-dense fluids such asmilk, milk shakes, juice and punch-type drinks.

Avoid heavy meals, greasy or fried foods, and foods that causegas. Examples of gas-producing foods include: beans,cauliflower, broccoli, cabbage, and carbonated drinks.

Prepare food that is colorful and appealing to the eye.



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If you aren't eating much because your mouth isdry, try increasing your non-alcoholic fluid intaketo at least two liters per day; just make sure it isokay with your doctor to drink this much fluid.

Also limit the amount of food you drink withmeals. Liquids make you feel full. Save the liquidsfor between meals.

Avoid toothpaste and mouthwashes that contain

alcohol as this can cause further drying of yourmouth. To stimulate saliva, or to make your mouthmoist, try sucking on ice cubes, candies, or gum.



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Try artificial tears, available as either drops or

ointment. Ointments last longer, but arethicker and can cause blurred vision for ashort time after they were implemented in theeye.

Do not smoke. Avoid indirect consumption ofsnuff, direct wind and air conditioning.

Use a humidifier, especially in winter.

Blink more often purposely and relax theeyes.



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Should be included in the daily diet high fiberfoods like fruits, vegetables, bran, nuts andbread, among others, to prevent constipation.

In the case of hemorrhoids, it is essential topay attention to anal hygiene, cleaning theentire area carefully to avoid scratching orrubbing the hemorrhoid to help preventinfection.

Use soft toilet paper or cleaning anal bywarm bath.



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Change storage of items to reduce trips or reaching

Delegate when needed

Combine motions and activities and simplify details

Balance periods of rest and work

Rest before fatigue

Frequent, short rests are beneficial



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Decreased physical activity, which may be theresult of illness or of treatment, can lead totiredness and lack of energy.

Scientists have found that even healthy

athletes forced to spend extended periods inbed or sitting in chairs develop feelings ofanxiety, depression, weakness, fatigue, andnausea. Regular moderate exercise can

prevent these feelings, and help a person feelenergetic and stay active. Even duringtherapy, it is often possible to continueexercise.



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A good exercise plan starts slowly, allowing yourbody time to adjust.

It is important that you do something to exercisethe whole body on a regular basis. Regular meansevery day, or, at least every other day.

The right kind of exercise never makes you feelsore, stiff, or exhausted.

Any kind of exercise is O.K. Walking, stationarybike, or swimming (if the immune system is O.K.)are examples of types of exercise.



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Even more dangerous than doing no exerciseis exercising only occasionally and doing too

much, too fast.

If you experience soreness, stiffness,exhaustion, or feel out of breath as a result of

your exercise, you are overdoing it.



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Do not eat or exercise within 2 hours of bedtime Make the room dark If you have an electronic clock, or one with an

illuminated face, turn the face away from you. Use the bed only for sleeping (not for watching TV

or reading) Keep a consistent sleep schedule. Make sure you

go to bed each night and wake up each morning, atthe same time.

Minimize daytime naps. If you must take a nap, do

not sleep for more than an hour at a time. Longernaps will make you feel more tired, and maycontribute to sleep problems such as insomnia.



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If it's okay with your doctor, try some mild to moderate exercise during the

day. For example, take a twenty- minute walk most days of the week.

If you are drinking a lot of caffeine, try to slowly cut down and avoid drinking

caffeine in the evening.

If pain is causing difficulty sleeping, make sure you are taking prescribed

medications as recommended.

If your sleep problems are becuase you are worried or anxious about your health,

talk with your health care provider or social worker, and/or become involved with

a support group.

Try to listen to relaxing music or partake in activities that help you feel less tense

(i.e. singing, praying, cooking, painting, reading, etc.).

If you are feeling depressed, notify your health care provider.



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Behavioral - Cognitive Relaxation TechniquesThere are several relaxation techniques that

have been helpful in treating insomnia. Someof these can be done by one-self. Othersmay require a tape, CD or technician tofacilitate.



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Abdominal breathing is also known as diaphragmatic

breathing. The diaphragm is a large muscle located betweenthe chest and the abdomen. When it contracts it is forceddownward causing the abdomen to expand. This causes anegative pressure within the chest forcing air into the lungs.

The negative pressure also pulls blood into the chest

improving the venous return to the heart. This leads toimproved stamina in both disease and athletic activity. Likeblood, the flow of lymph, which is rich in immune cells, isalso improved.

By expanding the lung's air pockets and improving the flow ofblood and lymph, abdominal breathing also helps preventinfection of the lung and other tissues. But most of all it is anexcellent tool to stimulate the relaxation response thatresults in less tension and an overall sense of well being.



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Place one hand on your chest and the otheron your abdomen. When you take a deepbreath in, the hand on the abdomen shouldrise higher than the one on the chest. This

insures that the diaphragm is pulling air intothe bases of the lungs.

After exhaling through the mouth, take aslow deep breath in through your noseimagining that you are sucking in all the air in

the room and hold it for a count of 7 (or aslong as you are able, not exceeding 7)


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Slowly exhale through your mouth for a count of 8.As all the air is released with relaxation, gentlycontract your abdominal muscles to completelyevacuate the remaining air from the lungs. It isimportant to remember that we deepen respirations

not by inhaling more air but through completelyexhaling it.

Repeat the cycle four more times for a total of 5deep breaths and try to breathe at a rate of one breathevery 10 seconds (or 6 breaths per minute). At thisrate our heart rate variability increases which has apositive effect on cardiac health.


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In general, exhalation should be twice as longas inhalation. The use of the hands on thechest and abdomen are only needed to help

you train your breathing. Once you feelcomfortable with your ability to breathe intothe abdomen, they are no longer needed.



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If you have questions ask for information.

If you need to contact us:

+ 34 xxxxx

[email protected]

FAX: +34 xxxxx
mailto:[email protected]:[email protected]

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