If weight goes below 65Kg/143lb

Can I reduce my Riba to 800 from 1000mg. Just took my 15th shot today and on Neupogen since Wk 5 and Procrit
since wk 13. Dr had already asked to reduce to 800mg at 12wk when HGB reached 9.9. I am on PEGINTRON wkly.

[hero68]

I just got my wkly blood work it say HGB- 11.4 after last wk procrit, ANC- .97 and platelet 1.62 lakhs.

[desrt]

Sure, why not. Full dose riba is most important during early tx and as long as you're not geno 1, it probably won't matter now. I reduced from 1200 to 800 at week 19 (100 kg / geno 3) and had no problem sustaining a response.
How long have you been undetected?

[hero68]

Thanks for the quick response. My baseline VL was 2.35 Million, at wk4 it came down to 67 IU and at wk 12 UND. I started with 1200mg upto 4th wk and continued with 1000mg till date.
I am GT1

[jusjames]

look you are already getting rescue drugs why do you want to reduce ? just stick at it
you hgb is fine

[spectda]

I don't know why you would want to reduce either. I am doing everything I can to not reduce and because I can't get the procrit I have to reduce. My impression is that riba full dose riba was important throughout treatment. Why would treatment include procrit in first place if dose reducing was a good idea, obviously higher there are higher svr rates with procrit and full dose riba.

[desrt]

I assumed that being from S. Asia you might have a genotype other than 1. My bad.
You're still in the early part of tx, you started with a relatively high viral load, and were still detectible at week 4. As long as the Procrit keeps working, try to stay on the higher dosage of riba.

[hero68]

Thanks for the valuable advice. Well I will stick to my present dose of 1000mg. I am confuse & very fatigue nowdays. This forum has been helping me to stay positive with all wounderful people with lots of experiences and never hesitating attitude of giving a helping hand. Thanks again and may God bless us all.

[spectda]

800 mg would be weight based for you, but I would still stay at the higher dose as long as the doctor allows to increase your chance of svr.
Good luck - Dave

[portann]

Hi again,

800 mg is weight-based, according to:

http://www.rxlist.com/htmlchunks/rxlist_tablePopup.html:

Daily Dose REBETOL
Body weight kg (lbs):  
40-50 (87-111)  
800 mg/day  
51-60 (112-133)
800 mg/day

61-65 (134-144)
800 mg/day
.
66-75 (145-166)
1000mg/day

76-80 (167-177)
1000mg/day

81 – 85 (178-187)
1200 mg/day

86-105 (188-231)
1200 mg/day  
> 105 ( > 231)
1400 mg/day


As you can see, someone who weighs anywhere between 87 and 144 pounds is advised to take 800 mg of Rebetol, according to the table.

That's a range of 57 pounds!

I weighed 120 or less and my hemoglobin was mostly in the low tens (and for a while in the nines); nevertheless, my hepatologist had me stay on 1000 mg throughout.

I think I had some cardiac issues, though, directly related to the 17+ mg per kilo of riba I was taking. My heart pounded and raced a lot and we probably should have had a better look at that.

I can't say whether you should stay at the higher dose or not, but I advise that if you do, make sure your doc monitors you.

I hid some issues form my doc because I was overfocused (obsessed?) with avoiding dose-reduction and have no way of knowing whether reducing would have affected my current SVR. Within two weeks of stopping the riba, though, my pulse rate and blood pressure improved dramatically.

So stay focused, not obsessed!

Susan

[Gee704]

Thank you for your post.
If you lose weight during tx should your dosage be adjusted to your new weight or should you maintain your original dosage from the start of tx throughout tx regardless of weight loss?

[nygirl7]

No you should stay on whatever dosage you were originally prescribed - you don't want to dose reduce unless absolutely necessary. Why give the virus a chance to make a return? It's only half the job done to clear the virus - the other half is to make sure it does not come back...that your own immune system gets used to beating it down just in case you do have some left (remember Undetectible does not necessarily mean REALLY undetectible -  there is no way to test for that).

Almost all of us do lose a lot of weight on treamtent and do not reduce even if we are having bad hemo issues.  Just not worth the chance that it will effect something negatively.

[bowyer2002]

I have gone from 148lbs to 136lbs and have no reduction in Rx of 1000mg/day w/ hg at 9.4 to 10.5.

[hero68]

Thanks all for the experience thoughts shared. I am too sticking with my current dose of 1000mg although I have lost almost 16lbs from start of tx to now 142lbs. I am fighting hard with my sx with helper meds. For the time being it is fine.Let hope all goes fine till the end.
           Thanks again all the members. Without U all this forum would not have serve its purpose. Thanks & God bless us all.

[portann]

Best wishes on the journey ahead.

And don't be surprised if you pile on those pounds after you finish treating. Weight gain post-tx happens to many of us. It was a tough road back to return to my usual weight. It took me a year!

Hope to hear from you again soon,

Susan