About dosage and weight

[karley]

Hi everyone, I'm new to this forum. I'm so overwhelmed by the helpfulness and support and information. It helps so much--I read and read and feel such a connection. I can't even put it into words.

I have a big concern about my dosage that I'm hoping some of you could shed light on. I am geno1, week 32 of 48. Virus was negative at week 12.  I am female, 5'4," weigh 110. I was originally on 4 riba a day. It has been cut back to 3 for past 5 weeks. Have anemia and low white count. My IF was halted for one week and then back to half last week. Waiting for new lab reports. Also on ProCrit past three weeks.

My question is, I've heard that lower IF is OK, but that maintaining full riba is critical. I asked my NP about this and she said three is fine for my body weight.  Does anyone know a formula to calculate recommended dosage per body weight? I am so worried--5 weeks is a long time. Thanks to you all -- just from reading your responses I know how much help this will be.

[cindyazure]

ok but what is your weight?

[Martee]

I don't know what to say except that I have been on 600 mg of riba since day 1.
This Friday will be my 43rd week. My treatment is being extended to the end of June.
When I first began I started only with the shot for 3 weeks, and then I started 200 mg. of riba, and by the 6th week I was on 600 mg.
I weighed at that time l28. I went down to ll6 throughout the first few months of treatment, and now I'm back up to l20.
My doctor refused to put me on more than 600 mg. He said that was plenty for me.
At 7 weeks my PCR showed me as undetectable <50.
My PCRs have been undetectable since.
Tomorrow will be my next PCR (3rd)
I'm hoping that the results are still the same.
I was also on Procrit for about 2 months and then taken off.
I hope this helps you. :)

[madbyron]

Like Scott said, according at least to <a href="http://www.hivandhepatitis.com/2003icr/03_assld/docs/pegasys/102703_g.html">this study</a>, optimal ribavirin daily dosing by body weight for type 1s has been estimated to be >/= 13.75mg/Kg or 6.25mg/lb. The fact that you had been on the proper dosage for so long should give you some peace of mind. I doubt the reduced dose for 5 weeks will cause a problem--the missed pills (7 pills/week X 5 weeks = 35 pills) are only about 2.6% of your scheduled dosage. Talk to your doctor and nurse and encourage them to get you back on 800mg/day. 1000, which is generally the lower amount taken by type 1s, would probably be overkill. Alternating three and four pills every other day would just get you over the 13.75mg threshold, though in practice it might be kind of hard to keep track of. Go with four if you can. The procrit should help.

[cindyazure]

I'm at shot 40 also 5'4, 110 lbs.  Reduced in January from 1000mg. to 600.  My labs are still not coming back to normal levels so there must be plenty of toxic stuff still going on in my system to do the job.  I've read about tailored dosing for weight.  The 1000mg. felt like it was killing me and I can somewhat function at 600mg.  All I'm trying to do is complete my tx. whatever it takes.  What if I went up in dose and I was pulled off meds. again.  I think I'm fine where I'm at.  Good luck to you.

[karley]

cuteus -- yes, 3 mos is too long to worry...what stress! I read previously that you responded so hope all is still well.

Scott -- it's so helpful to know exactly what the formula is. Thanks!! Good information really feels empowering....

Cindyazure -- I know exactly what you mean--will do whatever it takes to finish. Your profile is amazingly similar to mine, even your body's reaction to full tx dose. Please continue to let me know how you're doing. Hang in there. I know exactly what you're going through.  Can't work full time anymore. Thanks to all and your in my prayers.

[karley]

madbyron--what great information. I plan to ask the NP about rotating 3-4 pills like you suggest. What you said about the reduction being only 2.6% of scheduled dose is a reassuring perspective. I am so overwhelmed at how generous everyone is with your time and energy to answer these questions. Hopefully I will learn enough information to be helpful to others someday soon. Thanks so much!!

martee -- your doctor's approach to tx dosage is so different from mine and I'm not familiar with it but the great news is that it's working. My prayers are with you tomorrow for good lab results. Thanks!!!

[cuteus]

Hello and welcome.

Lowering the riba seems to be the standard until the Procrit gets a chance to work.  Just don't let them forget to increase it once your RBC is normal.
I was lowered from 5 to 4 for 3 months!  Talk about worrying.  Once the Procrit stabilized the anemia, I had to remind my PA to increase it.  who knows what damage her brain fog caused my TX.

Stand by, this question pops in here often, and it gets answered to everyone's satisfaction.

Good luck