3a Riba dosage?

Hi Everyone,

I'm wondering what the Riba dosage is for other 3a's and how you are tolerating it.

I'm a 3a and started treatment 2 months ago.
My Dr. put me on Peginteron (.4 on the redipen) and 1000 mg of Riba per day. He said that my Geno would normally be prescribed 800 mg per day but he felt that the extra pill per day would increase my chances for success.

But I feel like it may have increased my side fx as well.

Things have gone better than I expected so far but I have one side effect in particular that is alarming me. If I exert myself in any way my heart rate goes way up and I often feel like I'll pass out or have a heart attack. I was in good shape before tx and I'm a 47 year old male 167 lbs.

At Week 4 my viral load went from 700,000 down to 16,300. and my hemo was around 11.7. My Dr said that although I'm not technically a "rapid" responder it was still good.

Any other 3a's out there think that it would help reduce my side fx if I went to 800 per day on the riba. My Dr wouldn't give me a straight answer and said that I had to make the decision myself. He said that he didn't have any hard data as to whether or not reducing Riba by 200 mg per day would make a big dif in my side fx.

Thanks!

[comeagain]

get a second opinion wheather to extend tx stop it and wait for better options.
Geno 3 is not at all like G1 due to whats considered rapid respons and non responding.
Find a good hepatologist that know geno 3 in your area people on this forum can prob. tip you about that.

[FlGuy]

167 lbs is 76 kg.  The normal weight based dose of riba is 13 to 15 mg per kg.  At your weight, you take about 13.1 mg per kg, at the lower end of the range.  I am also a 3a and, in retrospect, the reason for relapse (as assessed by a liverhead) was low riba (I did only 800) and duration, 24 weeks.  The second time, I did 1200 and 46 weeks.  However there are other variables that worked against me; age of 56 and early cirrhosis.  I'd suggest that you do not entertain riba reduction at this point, especially since you did not get to undetected yet.  Geno 3 is a tricky one to deal with.  Knowing what I know now and if I was where you are, I think about increasing riba and talking to the doc about possibly extending tx.
The meds are no fun, having to do a tx do-over is less fun.  Being aggressive now may have a payoff later on.  For me, the first tx of 24 was wasted effort.  If the doc and I were smarter we would have done serious hcv-kicking the first time and there would probably not have been a second time.  Don't relent.

[gauf]

If I calculated right, you had a 1.63 log drop at week 4. A 2 log drop would have been better, but certainly well enough to continue. I would stay on the 1000 riba at least until the 12 week test. Anemia causes the shortness of breath and just goes with the territory. Curb your activities and stay the course. I am a 3a as well and suffered the shortness of breath throughout 24 weeks. Also experienced the increased heart rate that does scare the hell out of ya! Get yourself a home blood pressure monitor and log the numbers and then discuss with your doc., let him make the call and good luck.

[tiedyd]

I am a 3a as well. I just (last friday) finished 24 weeks Tx.  My weight is about 185 and I was taking 1200 per day of Riba.  At my 4 week count for viral load it registered at <615.  I just had blood drawn today to check at end of Tx, don't have the numbers yet there.  My sides got gradually worse through Tx, and still seem to be increasing some even tho no meds since Friday.

I am not as informed as to dosage per weight, but I know that it seems that a high dose has knocked the virus out of me with a quickness. We will see how it goes over the next few months to see if I get SVR.

Good luck

[mar148]

Well I am 3 also, it is important with three's that you become undetected at week four, I not only wouldn't reduce the riba, I would extend treatment.  Just my non medical opinion.

[nygirl7]

Please don't let anyone "trick" you into reducing the riba for any reason.  It is CRUCIAL to your success.  Geno 3s don't have it as easy sometimes as you think - look at FLGuy and a couple of my other good pals on here. There is NO lucky geno just a geno with a little better odds.

I was technically a RVR at week 4 but then hit a plateau and did not get to UND until somewhere between week 12 and 24 so I treated for 72 weeks.  It is possible to get to SVR whether you are RVR or not.

Don't give up. Even if your hemo goes down there are drugs to fix that - don't let them reduce you!!!!!!!

Please also make sure you are GETTING A TEST MORE SENSITIVE THAN THE <615. That is a very old test and you don't want to have a 500 because then you are still very much in the game and not UND at all.

I would consider if I was you depending on when you get to UND really extending a bit too.

Good luck.

[GoodByeHepC]

Thanks to all of you for your insight.
I really do appreciate the info and encouragement.

I'll keep up the 1000 mg. It's what my Dr preferred anyway.

onward...

:)

[comeagain]

I´m one month ahead of you taking fix nr 13 thirsday. I went from 3.8 milj to less then 15iu after 4 weeks.They haven`t been doing many vl test before week 12 until resently for geno 2 and 3s. I have about the same ribadose as you 1200mg but I am 10kg heavier.
Anyway my nurse told me that my 4week result  was quite common among  relapsers.
and she also added that there must bee a reason why I relapsed.
So I´m not comfortable with that result, and I´m gonna extend to 48 weeks but  my nurse couldent give me any odds or warranties for SVR.
You seems to bee a slower responder then me thats why I suggested a second opinion
depending of your livercondition to either extend or stop and hope that telepravir will work on geno 2 and 3 and bee available in a near future.
I wount say you couldn´t bee SVR on 24 weeks this HCV dont seem to play bye the book all the time, some people who had the odds against them pull through some times, and some that have the odds in favor dont. Its a hard dicision to make and you can only make it your self. Getting a sec. op. though,could maybee help.
ps I´m on my sec tx relapsed on my first. Take care and God bless

[CockSparrow]

Hi GoodByeHepC
I am a G3 2 time non responder, not even had the joy of relapse – yet.
If I had had your 4 Week PCR result I would be considering increasing my riba dose to 1200 mg and increasing the Treatment length to 48 weeks. G3 non RVRs are not that easy to treat.

Here is a thread on G3s where I posted the Accelerate and other studies SVR G2&3 Stats.
http://www.medhelp.org/posts/show/457864?post_id=post_2610609

Here they are again with only the 24 week G3 figures.

Below is what the Accelerate study has to say.

Methods
We randomly assigned 1469 patients with HCV genotype 2 or 3 to receive 180 μg of peginterferon alfa-2a weekly, plus 800 mg of ribavirin daily, for either 16 or 24 weeks. A sustained virologic response was defined as an undetectable serum HCV RNA level (<50 IU per milliliter) 24 weeks after the end of treatment.

Results
The study failed to demonstrate that the 16-week regimen was noninferior to the 24-week regimen.
The sustained virologic response rate was significantly lower in patients treated for 16 weeks than in patients treated for 24 weeks (62% vs. 70%; odds ratio for 16 weeks vs. 24 weeks, 0.67; 95% confidence interval, 0.54 to 0.84; P<0.001).
In addition, the rate of relapse (a detectable HCV RNA level during follow-up in patients who had undetectable HCV RNA at the end of treatment) was significantly greater in the 16-week group (31%, vs. 18% in the 24-week group; P400,000–800,000...32/46........(70%)
>800,000................138/232.....(59%)

Cirrhosis or Bridging Fibrosis pretreatment
No...........................207/294....(70%)
Yes.........................37/75........(49%)

Liver Steatosis at Baseline
No..........................102/143.....(71%)
Yes........................60/109.......(55%)

Rapid virologic response
Yes.........................187/219....(85%)
No..........................57/145......(39%)


Whats clear is that G3s who RVR are dead easy to treat. Not the case for non RVRs

However G3s have several negative predicts at baseline. These are;
• HVL
• Steatosis
• Fibrosis Stage

For G2s only F3-4 Fibrosis stage produces slightly lower SVR rate. The Canadian Power study which showed G3s had reduced SVR rates occurred when F2 and above with F4 having particularly bad SVR rates.

http://www.hivandhepatitis.com/2007icr/aasld/docs/110907_c.html

Power Study Stats
Baseline..G3 (n=389)
HVL........65
LVL.........76
F0 - F1....80
F2...........68
F3...........71
F4...........47

• Numerically, more genotype 3 than genotype 2 patients had high viral load (HVL; 49% vs 44%) and advanced fibrosis or cirrhosis (stage F3-F4) (40% vs 33%).
• Genotype 3 patients had lower SVR rates than genotype 2 patients (72% vs 79%; P = 0.04), attributable to a lower end-of-treatment response rate (77% vs 86%, P = 0.01);
• Relapse rates in genotype 2 and genotype 3 patients were identical (7%).
• An inverse relationship was observed between SVR and fibrosis score in genotype 3 patients.
• Less than 50% of genotype 3 patients with cirrhosis attained SVR.

However the following makes it difficult to draw too many conclusions, even if it does give a hint.
• Baseline viral load and fibrosis scores were available for
• 72% of genotype 2 patients and
• 37% of genotype 3 patients.

Now there are studies that support the above findings on poor G3 response rates

Exploring differences in response to treatment with peginterferon alpha 2a (40kD) and ribavirin in chronic hepatitis C between genotypes 2 and 3. Journal of Viral Hepatitis, 2007 doi:10.1111/j.1365-2893.2007.00889.x

This was also a Canadian study that produced strikingly similar results to the Power study. However G3 F4 only had a 17% SVR rate in this study.

There is an Indian/Pakistani study that had G3 SVR when detectable at 4 weeks of;
>50IU 44% SVR and >600IU 33%.SVR

For G3s non RVR makes us quite difficult to treat as the SVR rates are <40-45% for G3s and the higher the VL detected the lower the SVR rate.

All the Best
CS

[CockSparrow]

The post mess up the stats so i'll try again. I'll work it out one day.

Now for the Accelerate Stats

Per Protocol Analysis
…….........16Wk........24Wk
G3............65%.........,71%

Modified ITT Analysis
….............16Wk........24Wk
G3............62%..........66%

G3 On Treatment response.

24 Weeks
RVR rate, 59% (219/369)
EVR rate, 85% (314/369)
EOT VR , 80% (296/369)
SVR rate, 66% (244/369)

So how did the various G3 subgroups go.

Pretreatment HCV RNA level
Less Than 400,000..74/91........(81%)
400,000–800,000.....32/46........(70%)
Greater 800,000......138/232.....(59%)

Cirrhosis or Bridging Fibrosis pretreatment
No...........................207/294....(70%)
Yes..........................37/75........(49%)

Liver Steatosis at Baseline
No............................102/143.....(71%)
Yes...........................60/109.......(55%)

Rapid virologic response
Yes...........................187/219....(85%)
No.............................57/145......(39%)

[gauf]

Thanks for this. It is obvious to me why I relapsed given I have cirrhosis and steatosis and a high VL. With only a test at 12 week mark showing UND <50 last treatment, I guess the odds are not great for SVR.

[GoodByeHepC]

Comeagain,

Thanks for your input. I do appreciate your advice.
I have a pretty good Dr. - I'm in New York City and he only handles Hep patients. I feel lucky in that regard because I know that some less populated areas it's hard to find a well informed specialist.
That said, My logic at this point in time, is that I only have two options:
- Continue treatment and hope that my results are good.
- Stop treatment and wait for the technology to advance.

I actually waited for several years in the hopes that VX950 might offer another option. But I was paying out of pocket for health insurance  and realized that I may not be able to afford to continue. So, I decided to treat because if I have to give up my Health insurance after paying out of pocket for 5 years and never took advantage of treatment I would regret never having tried.

My biopsy in 2004 showed only a stage 1 fibrosis and a slightly fatty liver. I am very healthy otherwise. I don't use drugs, I rarely used alcohol (don't at all now that I'm on treatment), and I don't smoke anything. But I am 47 years old and all things considered this may be my only shot at this.

My heartfelt thanks for your info and help.

[GoodByeHepC]

CockSparrow,

Wow!
Thanks for all the data. I have to admit that it sort of makes my head spin but I'm going to go over it and try to assimilate the info.

I'm beginning to wonder if - in addition to maximizing the Riba - I should also increase the peginteron dosage.

Right now I'm using the Redipen 120mcg / 0.5ml
I was instructed to set it for .4ml which is about 75% of the full dosage in the Redipen.

Considering that I was just short of reaching UND at week 4 I can't help wonder if the higher dosage might have put me over the top.  ...probably would have made me sicker too I imagine.

I'll be checking in with my Dr to get my 8 week hemo and liver functions.
I'll see what he says.

Thanks

[dranurag]

I am only on intron without riba as my doctor said it was causing deposits of iron in my liver leading to further damage. any clues?

[CockSparrow]

It comes as a bit of a shock to find out that some G3s arent as easy to Tx as we are told dont it.

You can download the Accelerate study from www.nejm.org. they have a free 21 day trial offer. If you have problems finding it you can PM me with you email addy and i'll send it to you if you like. Bear in mind that Accelerate used Pegasys, but the PegIntron stats are strikingly similar. The 2 drugs are different though.

At the risk of giving medical advice I would set the dial to max, so long as my whites were not too low.

You may be responding slowly but all is not lost, you can still beat it.
You wont be jogging too much though. you will have to watch your Hgb if you take extra RBV.

Make sure you get a 12 week PCR and idealy an 8 week one.

All the Best
CS

[CockSparrow]

Comeagian - get a second opinion wheather to extend tx stop it and wait for better options.
Geno 3 is not at all like G1 due to whats considered rapid respons and non responding.
Find a good hepatologist that know geno 3 in your area people on this forum can prob. tip you about that.

I dont agree with that. If your response is looks more like a typical G1 response then thats the path we should be going down.
Remenber G3s are only easy to Tx because we have a high RVR rate.

I believe we should be Txed based on our response rather than by our Geno.
This would make no difference to the way most are treated but would catch slow responders of any geno.

CS

[CockSparrow]

GoodByeHepC - Considering that I was just short of reaching UND at week 4 I can't help wonder if the higher dosage might have put me over the top.

Just to mention you didnt just miss RVR you missed it by heaps. And yes the extra Peg may have made a difference. But you have to be able to tolerate it. Now its time to talk to your doc about how you can turn it around.

CS

[CockSparrow]

I would not be doing what you are. Non Peg IFN TIW has next to no chance of working and if its being used as maintenance that dont work either.

I would be looking at how to reduce my iron levels then Tx-ing again, but much harder.

I cant see where your docs are going with your Tx.
CS

[Lady Lauri]

CS, your awesome on those studies! Helped me  alot during tx!

Goodbye....didn't see it above, but have you had EKG, etc. before tx? Probably should have them do that to be on the safe side.
2b  & also had shortness of breath bad (1st side to leave me tho and I smoke!) and a LOT of heart palpitaions. As Gauf said, scares you. But with the check up before hand, helped me to not worry as much.

Be well, LL

[dranurag]

I have become UND again with just standard interferon without anything else. Now I am stopping it after 6 months. Let us see if and when the virus comes back. My iron levels came back to normal after stopping peg and riba and are still normal.

[CockSparrow]

It'll be back
It wasnt the Peg that raised your iron.
Actually it may have a bit not sure what liver cells do when then they die as far as releasing any stored iron goes.

I had high iron too Tx btw
CS

[dranurag]

I understand it was riba and that is why they have stopped it. Now they want me to take standard interferon 3 miu 3 times aweek for many many years --may be life long. Any comments?

[CockSparrow]

Its called maintenance therapy and the studies done on it surprised everyone by proving that lowering your ALTs did not stop disease progression. In other words it doesnt work.

So I wouldnt do it. In your shoes and i kinda am, i would be looking at lowering hepatic iron and trying to work out the reason for your slow response.

Then I would hit it with everything I could throw at it. NPIA could well be a part of that approach.

Long term Interferon use carries certain risks.
You could end up with any number of AI issues.

Question your Docs make and sure you understand what they are trying to achieve.

All the Best
CS

[CockSparrow]

Here are couple of links on HALT-C.
It used Pegasys but Conventional IFN will make no difference.

http://www.nih.gov/news/pr/nov2007/niddk-06.htm
http://www.hivandhepatitis.com/2007icr/aasld/docs/111607_a.html

CS

[BelB64]

I wonder what the numbers would have been like if everything was equal between the 2s and 3s. Since the 3s had on average higher VLs and more fibrosis and cirrhosis than the 2s, wouldn't it make sense that there was a higher SVR outcome for the 2s?  

If I'm reading this correctly the 3s had 5% more HVL patients and 7% more liver damaged patients than the 2s and ended up with 7% less SVRs.

It also appears that low viral load is the best predictor as again if I'm reading this correctly 81% of those under 400,000 RNA and 70% of those between 400000 and 800000 got to SVR.  66% overall is not as high as we'd like but still MUCH better than 1's. Hopefully when teleprevir and alinia become available they will increase the percentages of svrs dramatically

[mar148]

There is a higher SVR outcome for 2 but 3 is not far behind.  It is still the second best genotype to have in terms of SVR outcome than 2, not quite as good but still pretty good by any disease standard.

[meki]

"I believe we should be Txed based on our response rather than by our Geno.
This would make no difference to the way most are treated but would catch slow responders of any geno. "

Agreed.

[mar148]

From what I read the genotypes are very different to how they replicate  and react to interferon/riba type medication.  To ignore genotype would be ignoring an important part of the treatment strategy.  Genotypes do have very different treatment outcomes and their reaction to medication and what is means to treatment success varies greatly.   While we all might have/had hepc on this website, the genotype makes it a little different for each of us in terms of treatment and the reaction the body has to the disease.  (i.e., type 3 has more fatty liver, type 2 some say have slower liver disease progression.....)

I am not sure why someone want to ignore genotype?  Is there are reason you would want to interpret the facts that way that I am missing?

[zazza]

The reason is that geno 2's and 3's who are not RVR are usually undertreated because of their genotype. By looking at time of response rather than genotype these non-RVR's would get at least the same chance as geno 1's.

It does not mean we should in fact ignore genotype, since genotype as you say tells us a lot about the probability of RVR, of fatty liver, etc. But once tx'ing, the on-tx response tells us more.

[mar148]

I agree completely that once treatment begins you look at response and determine course of action.  But if a type 1 was not RVR that does not mean they would go 72 weeks verses 48, but look at how many logs they dropped and look at their week 12 response, which hopefully is undetected.  So by type of genotype the week four response means different things and different courses of action.  So no, your reaction to treatment is a critical component in strategy while going through it, but even then it means different things by genotype and with different statistical outcomes of success by genotype.

Treatment is part science, part art and knowledge of the disease factprs (VL, age, race... weight) treatment response and genotype.

[GoodByeHepC]

So which of thee two drugs actually eliminates the Virus?

It was my understanding that Interferon was the main drug and the Riba prevented the virus from reconstituting.

After reading this thread I'm thinking that my Dr. should have ticked up my peginteron one tick. (700,000 starting and 16,300 @ week 4)
My injections are set to .4 there are two more ticks - the max is .5
I can't help but think that if my dosage were one tick higher I would have been UND @ week 4.

I'll be speaking with him tomorrow. I think He's going to put me on Procrit due to the results of my last blood work.

thanks

[comeagain]

We are all in away labrats still, particullary g 2, 3.
Acc to zazza and I´m sure she have studies to back that up with geno 1 that are UND at week 12 has 80% chanses of SVR.  How much can you trust a study  was some of them UND earlier weeks and what other parameters like weight time of infection lengt of infec. rase , sex iron in the blood did they had and of cource vl, grade and state of liver damage and all the other aspect not even thought of so much of yet like lifestile digestivsytem how well its functioning etc.
Theres been a big differens last 10 years in curing HCV.
Why are geno 1a more difficult to treat the 1b, 3 more then 2.
And if a g1 have 80% chance SVR  with 48 w tx why shouldnt a geno 3.
That hasen´t been checked up yet I´m in a study for that at the precent.
It seems (my conclution) that the best for all Genos is to bee UND at weck 2 as the vertex paitent seems to be its an interesting subject though and we all have much more to learn.
And as I`ve sad in another tread I dont think its harmles for many to tx to long so shortening the treatment by hitting it fast and hard could be a goal to work after, just my thoughts I´m not a doc

[zazza]

With your weight of 76 kilo you would be dosed with 120 mcg PegIntron, i e the entire Redipen 120 mcg/0.5 ml, if you were a geno 1. What is your neutrophil count (ANC)? This is what may be affected by raising the interferon.

I agree with CockSparrow: "At the risk of giving medical advice I would set the dial to max, so long as my whites were not too low."

Why would your doctor put you on Procrit if your hemoglobin is 11.9? Or has your hgb become lower still? I was of the impression that Procrit is usually not used until 10, or at least 11.

[zazza]

A geno 1 RVR has better odds of SVR than a geno 3 non-RVR. Interesting, hey?

I am a geno 1. Having a low baseline viral load I was going to tx for only 24 weeks if RVR, which is becoming the norm in Europe for LVL. If I had been UND by week 12, I would have tx'ed 48 weeks. Since I was a slow responder, UND between week 12 and 24, I tx'ed 72 weeks.

Why are geno 3's not given the same chance as I got? They are taken off treatment if detectable at week 12.

[CockSparrow]

Comeagain - Why are geno 1a more difficult to treat the 1b, 3 more then 2.
And if a g1 have 80% chance SVR  with 48 w tx why shouldnt a geno 3.
That hasen´t been checked up yet I´m in a study for that at the precent.

Yes it has. Study 5 (NV15942) in the pegasys insert.
http://www.natap.org/2007/DDW/DDW_01.htm

Now this this the study that recommended 24 weeks even for Pegintron.
Now the SVR rates were not that different regardless of the arm you were in.
The relapse rates were lower in the 48 wk WBR arm.

Pegintron has never been had multinational studies comparing 24 wks v 48wks for G2/3.
Win-R doesnt count as it was a clinical trial Only dione in the US and had really high drop out rates.
http://www.natap.org/2006/DDW/DDW_24.htm
The was a similar study done in Canada.

There have been several G3 studies that have tXed for 48 weeks but these tended to be for specific reasons such as steatosis..
This is changing with several studies using either Peg looking at comparing 48 wks with 24 wks including the one you are in.

G3s who dont RVR have lousy SVR rates.
G3s who RVR are dead easy to treat and have excellent SVR rates.
But all genos have excellent SVR rates when RVR.

CS

[comeagain]

Cocksparrow-G3s who dont RVR have lousy SVR rates
dhttp://www.natap.org/2007/DDW/DDW_01.htmo Do you call 76% lousy thats with the higher doses 48w acc to that study
BTW is it over with pinkeye

[comeagain]

I think its odd when i lock at many studies so small nr of people involved.

And not enough thoroughly facts like for instance when they say RVR 4 w responder.
were they acctually 2w responders they mented, them who made it all the way,you dont know couse they did´t  tock any 1w or 2w vl testes.
And SVR rate among so called RVR wasn`t 100% it could have been them who was UND after w 2 that didn`t made it.  I think many peoble shout halleluja a little bit to early when they get their 4w testes.  Some have even not precice enough testes, and thats couse they missinformed due to not thoroughly studies.
That test cost 250 dollars in Sweden to get. With all the new tecknik data I think its a shame they hasn`t come up with much more presice figures long time agoo.
My hepdoc use to say you can allways find a study that contradict another.

[comeagain]

I didn´t mean they have unpresice testes because of missinformation ( or maybee they do) no I think its cheepnes. I meant that some people get overtrilled over 4w result and later find theme selfes in a chock of dissapointment.

[GoodByeHepC]

Thanks Zazza & FIGuy,

My hemo was at 11.9 at 4 weeks.
I just did my 8 week and my hemo is still going down. It's at 10.4
I think he is trying to keep it from getting dangerously low. I've complained about very high heart rate and I'm sure he doesn't want to take any chances. So I may be on Procrit for a while if my insurance aproves it. He wants to avoide reducing Riba (as everyone here agreed)

RE my interferon dosage:
I asked him why my peginteron was set to .4ml and he seemed quite sure that it was the right dosage for my body weight (76 kg).
He called back later after checking my records and said that my body weight is right on the cusp of the dosage recommendations (As FIGuy pointed out) Meaning that I probably could have bumped it up to .45.
I'm sure he is trying to balance sx with results.
I asked him if my chances of being UND at week 4 would have been better if my dosage was slightly higher and he insisted that it would not have made a difference. I don't buy that.
I've decided to bump my dosage to .45 for the next two weeks 11 & 12 in the hopes that I'll be UND for my 12 week tests.

I don't know what my neutrophil count is. My conversation with Dr was over the phone and was mainly about the Procrit.

I agree with you about the miss-information that is circulating about g3s.
I've learned significantly more on this website than I have from my own Dr.

Thanks very much for your insight.
It's Truly appreciated.

[CockSparrow]

Comeagain-G3s who dont RVR have lousy SVR rates
Do you call 76% lousy thats with the higher doses 48w acc to that study

I should have said with 24 weeks.
You would expect better results with 48 weeks

CS

[zazza]

Regarding dosage:
I gained weight during treatment so I asked my doc if my doses of ribavirin and PegIntron ought to be increased. My doc checked my bloodcounts, especially my neutrophil and white blood cell count, and then said if I hit 76 kilo I would go from 100 mcg which I was currently on to 120 mcg. 120 mcg is the standard dosing for 76 - 85 kilo.

So weighing 76 kilo I dosed 120 mcg/0.5 ml from week 41 to 72. No significant differences in side effects, no differences in blood counts. I never heard of bumping just one tick, didn't think they did that. I thought it was 120 mcg/0.5 ml or 120 mcg/0.4 ml. But I did see the extra mark at 0.45 ml though.

I like that your doctor wants to give you Procrit instead of reducing riba. Good thinking!

Have you talked to him about extending to 48 weeks since you were not UND at week 4?

"I've learned significantly more on this website than I have from my own Dr." So have I.

Good luck and hoping you get to UND real soon!