Polycythemia - Treatment

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What is the treatment for polycythemia?

The treatment for polycythemia is generally dependent on the cause.

In polycythemia vera or other primary polycythemia syndromes, the treatment options are more specific. Phlebotomy (drawing blood or blood letting) is the most essential part of the treatment. The recommended hematocrit of less than 45 in men and less than 42 in women is the goal of phlebotomy.

Several medications have been considered in conjunction with phlebotomy to suppress the abnormal production of red blood cells. Most of these chemotherapeutic drugs have been linked with side effects and their use has been controversial and limited.

The medication hydroxyurea (Hydrea) has been recommended for some patients with primary polycythemia and higher risk of blood clot formation due to high blood viscosity. The factors favoring treatment with hydroxyurea are age greater than 70, platelet count greater than 1.5 million, and general cardiovascular risk factors.

Aspirin and other anti-platelet agents (dipyridamole) may also be beneficial in patients with polycythemia by reducing clotting complications, unless the patient has a history of bleeding problems.

In patients with secondary polycythemia, the goal is to treat the underlying condition. For example, in patients with lung or heart disease with hypoxia, appropriate management of these conditions along with oxygen supplementation is generally advised.

Return to Polycythemia (High Red Blood Cell Count)

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Comment from: scm, 55-64 Male (Patient) Published: May 30

I was detected as having polycythemia vera (PV) about 9/10 months ago and the hemoglobin count had gone up to 21.9. I had to go for phlebotomy about 9 times almost in continued succession and another time after 4 months as hematocrit level went to 45.5. As an Indian maybe the upper limits the doctors check here are far lower i.e. 12-16 for hemoglobin and 41-45 for hematocrit. Due to the treatment with hydroxyurea capsules and blood thinning tablets I am giving blood only when higher levels are breached. However on phlebotomy there is severe weakness and debility. This makes even, walking a problem due to continued pain in all joints. This has also caused sexual debility. I have heard of Levical, an herbal drug made in Belgium. Reported to be an effective controller of blood parameters.

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