600 mg Ribavirin and holding

Question

Week 6 triple tx with incivek.  und at week 4, but hgb dropped 15.3 to 11.4, so riba was reduced 1200 - 600; lab monday dropped hgb to 10.9.  Decision is to continue at 600 mg for 2 more weeks.  If drop below 10, then start procrit and slowly increase riba; if above 10, then stay the course.  My doc is very tuned into HEP C and HIV treatment protocols.  What he reading is that riba plays less of a role with triple tx; but it still does play a role.  What the min levels at this point are not known, but he is not ready to drop below 600.  

We discussed from all my forum friends and patients that we don't want to do anything to jeopardize SVR and he understands and supports that position; so today we stay the course and see the next lab results.

This is my second treatment with him and have done 2 biopsys.  Everyone is struggling to keep up with impact of the protease drugs on traditional treatments; the long term studies are just not out there yet.

As always, appreciate the forum; it is a wealth of information - good stories, sad stories, and just stories.  We have to become educated about the dragon, the tx, and especially the sx.

Today is birthday #55; doctor appointment and picked up another round of rx; had nuts for 2 pm 20 gram feeding.

Another day checked off the calendar.

Thanks

crossroadsec · Answer

Happy Birthday! And congrats on having found a Dr who is aware. My hgb dropped hard n fast n procrit was hard to come by w ins. Glad to hear you've found ur balance. I dropped RIBA also and w procrit got it back up. We're trying the juggling act w reduction n procrit to avoid another transfusion. Btw my drop came early too and at week 33 now? You're doing it!!! Yay you!
Karen :)

belle19 · Answer

happy birthday.  good luck with your UND and be good to yourself.  i hope you reach SVR.  belle

skiyaltr · Answer

I dropped from 15.3 to 13.9 at 2 week lab and then to 11.4 at the 4 week lab (it was actually 24 days, so short of 4 weeks; the slide was happening fast and the thought was at the next lab, if it dropped below 10 and we started down the procrit path it would take several weeks to get insurance approved, drugs started, and results. He has a big concern on loosing control of anemia. Me too!! I still have to function.

Advocate1955 · Answer

Happy birthday, and best wishes for continued UND and SVR.
Advocate1955

LookingForward12 · Answer

Happy Birthday to you!  I, too, find it interesting that your ribavarin has been reduced already. My hemoglobin is at 11.0 and no mention of dose reduction.

crigger · Answer

Yes I sent him a Email this AM. I told him I thought I need something.  An. Oxygen tank and a handicap sicker if nothing else.

stormy456 · Answer

Really?  My husband's doctor cut his Riba at 5 weeks (hgb 11.2)  to 800mg, and is probably just going to keep him there.  Husband was UND at Day 5 and week 3, so that may have had a role in the decision, but he believes it's OK to keep Riba reduced as it doesn't seem to affect SVR.  Every case is different, but you may want to check with him again if you were UND at week 4.

skiyaltr · Answer

Great news and thanks for information.  Congratulations on SVR.

crigger · Answer

Happy Birthday! Hopefully next year will be Better without Hep C. My Hgb is at 8,6 and the doc has yet to changes in my dose.

lapis · Answer

I did triple tx in a trial.  Out of 24 wks of tx, my Riba was at 600 for a total of 7 wks, and the first reduction came at wk 3.  It sounds like you and your doctor have a reasonable plan.  I worried about the Riba reductions too but am SVR for more than 2 years (3 year check in April).

UND at wk 4 is awesome!  Hang in there.

Lapis

skiyaltr · Answer

I have had three; the first one with a diff dr in 2000.  It didn't establish a good base line; next ones were 2004 and I believe 2008; both were stage 2 and minimal progression.  It has provided some options in treatment.  I opted for the first round since the next set of drugs were out several years and thought I could beat it with SOC.

1oftheclub222 · Answer

Just out of curiosity, you say that you had 2 biopsies...when were they and what were the results?  I am curious to see if there was progression and how long it took for that to happen...

And happy B'day!