Aa
Lower dose of Ribasphere on 9th week.
My husband's Dr. lowered his does from 1400mg a day to 1200. Also he takes a injection every Friday. Has anyone ever had the dose lowered? My husband had some bad side effects a few days ago due to a flu virus. But the blood test today was good and my husband is a better.. He shows no signs of hep c. So the Dr thought maybe he would lower the dose for a week to see how things go. My husband is a little unsure, but will do it. The Dr said he thinks my husband will only have to take the meds for 24 weeks.
I'm afraid I do not quite follow the reason for your husband's Riba dose reduction if his labs were OK. Flu-like symptoms are are the most common side effect of HCV meds. But then there is probably a huge chunk of medical info we do not have. If you do not do so already you may want to obtain copies of your husband's lab results. It really helps with specificity. I am guessing the first thing your brother asks about is exact lab values rather than the nurse's general interpretations.
As Will said being UND at week 4 is a great sign though :)
As Will said being UND at week 4 is a great sign though :)
At 210 lbs. unless he is suffering from relatively severe "hemolytic anemia from the medications or a rash that is deemed dangeous he should be taking the full dose 1200mg Riba.
Best ..
Will
ps .. His UND. status at the 4 week mark is a significant predictor of overall success
Best ..
Will
ps .. His UND. status at the 4 week mark is a significant predictor of overall success
Besides taking 1200 mg of Ribasphere. He takes a injections of pegintron. once a week. He was told after about 4 weeks that the hep c was not showing up. He's weight when starting was about 240 now it's about 210.
I'm getting a little concerned after ready all these comments.
My brother is a internist in WI. I think i may have him talk to one of
his dr's that specialize in this.
Thanks for all the advice
I'm getting a little concerned after ready all these comments.
My brother is a internist in WI. I think i may have him talk to one of
his dr's that specialize in this.
Thanks for all the advice
Hi, again: here is the url for an article which talks more about this stuff:
http://www.hivandhepatitis.com/hepatitis-c/hepatitis-c-topics/hcv-treatment/3583-easl-ribavirin-dose-reduction-and-epo-both-work-for-managing-anemia-in-patients-using-boceprevir
I did notice the riba-reduction I mentioned, was only intended for people experiencing hemolytic anemia, due to Triple Therapy, with a Protease Inhibitor.
If your husband is doing SOC (standard Interferon/ribaviran Treatment, used for genotype 2 {and sometmes 3})) then this same article did mention that riba-reduction is NOT recommneded
http://www.hivandhepatitis.com/hepatitis-c/hepatitis-c-topics/hcv-treatment/3583-easl-ribavirin-dose-reduction-and-epo-both-work-for-managing-anemia-in-patients-using-boceprevir
I did notice the riba-reduction I mentioned, was only intended for people experiencing hemolytic anemia, due to Triple Therapy, with a Protease Inhibitor.
If your husband is doing SOC (standard Interferon/ribaviran Treatment, used for genotype 2 {and sometmes 3})) then this same article did mention that riba-reduction is NOT recommneded
I'm not sure what your husbands' weight is: I started out with 1,200 mgs, and I am guessing 1,400 is for someone over 200 lbs, maybe big and tall. I know they have a weight chart for ribasphere dosage, out here.
There is some new material that came out, in March of 2012, which had stats that suggested Riba-reductuion didn't ultimately effect a persons chance of SVR, if the riba was reduced, once a person was Undetected.
1,200 mgs is still a hefty dose of riba, but make sure you contact the Treating Doctor, and ask him his reason for the reduction. I've only heard of riba-reduction, apropo of low HGB.
Perhaps your Husband does have low HGB (hemogloblin), are you keeping copies of all his labs? There are many experts on here, who can help with reading labs, but they will need to know the exact #'s, so I always make copies of all my labs.
My ribasphere was reduced, at 19 weeks, due to hemolytic anemia, with my # at 9.1 (the reduction was from 1,200 mgs, to 800 mgs) My anemia set in at 8 weeks, so if your Hubs is doing Triple Tx, his "Flu" may have actually been a drop in HGB. Hemolytic anemia causes all kinds of dreadful side effects, but the true test for me was, can I get up the 6 stairs to my front porch, without getting out of breath.
I hope you get this straightened out as soon as possible, and congrats on your husbands Undetected status : )
There is some new material that came out, in March of 2012, which had stats that suggested Riba-reductuion didn't ultimately effect a persons chance of SVR, if the riba was reduced, once a person was Undetected.
1,200 mgs is still a hefty dose of riba, but make sure you contact the Treating Doctor, and ask him his reason for the reduction. I've only heard of riba-reduction, apropo of low HGB.
Perhaps your Husband does have low HGB (hemogloblin), are you keeping copies of all his labs? There are many experts on here, who can help with reading labs, but they will need to know the exact #'s, so I always make copies of all my labs.
My ribasphere was reduced, at 19 weeks, due to hemolytic anemia, with my # at 9.1 (the reduction was from 1,200 mgs, to 800 mgs) My anemia set in at 8 weeks, so if your Hubs is doing Triple Tx, his "Flu" may have actually been a drop in HGB. Hemolytic anemia causes all kinds of dreadful side effects, but the true test for me was, can I get up the 6 stairs to my front porch, without getting out of breath.
I hope you get this straightened out as soon as possible, and congrats on your husbands Undetected status : )
Which drug regimen is your husband on?
I am assuming Interferon, Riba, and Incivek?
At what week did he become Undetectable? 4 weeks? or 8 weeks?
I agree with what Will said above, lowering Riba for anemia but not other side effects.
If your husband is not anemic but he was having other side effects, flu like symptoms, or even the flu, I do not know why the doctor lowered his Riba dose. Instead of lowing the Riba dose, the doctor should treat the side effects (if they can be treated). The worst sides can be treated with prescription medications (nausea, vomiting, rash, itching, diarrhea, neutropenia, severe anemia). The rest of the side effects we just ride out or take some tylenol. .
I am a little unclear what, exactly, the doctor hoped to accomplish by lowering the dose. You said, "The blood test today was good and my husband is a better.. He shows no signs of hep c. So the Dr thought maybe he would lower the dose for a week to see how things go."
What was the docs reason for lowering the dose? Ribavirin is weight based so if his weight says he should be on 1400 a day, then that is what he should be on (unless he develops hemolytic anemia). To me, it sounds like the doc is tinkering with the med dosage and thinks that because your husband is currently Undetectable that your husband no longer needs 1400 mg a day. If that is the case, and it was me, I would be alarmed that the doctor does not know the recommended Hep C med regimen protocol.
Just because your husband is not showing Hep C in his blood does not mean the Hep C is gone. There are people on this forum who have been Undetectable since week 4 and then showed virus at week 16 or 18. There is also a person on the forum who had been Undetectable at week 4 and all the way through treatment and then relapsed after finishing treatment.
Personally, if it was me, I would be very, very reluctant to lower my Riba dose. Why take the chance.
I am assuming Interferon, Riba, and Incivek?
At what week did he become Undetectable? 4 weeks? or 8 weeks?
I agree with what Will said above, lowering Riba for anemia but not other side effects.
If your husband is not anemic but he was having other side effects, flu like symptoms, or even the flu, I do not know why the doctor lowered his Riba dose. Instead of lowing the Riba dose, the doctor should treat the side effects (if they can be treated). The worst sides can be treated with prescription medications (nausea, vomiting, rash, itching, diarrhea, neutropenia, severe anemia). The rest of the side effects we just ride out or take some tylenol. .
I am a little unclear what, exactly, the doctor hoped to accomplish by lowering the dose. You said, "The blood test today was good and my husband is a better.. He shows no signs of hep c. So the Dr thought maybe he would lower the dose for a week to see how things go."
What was the docs reason for lowering the dose? Ribavirin is weight based so if his weight says he should be on 1400 a day, then that is what he should be on (unless he develops hemolytic anemia). To me, it sounds like the doc is tinkering with the med dosage and thinks that because your husband is currently Undetectable that your husband no longer needs 1400 mg a day. If that is the case, and it was me, I would be alarmed that the doctor does not know the recommended Hep C med regimen protocol.
Just because your husband is not showing Hep C in his blood does not mean the Hep C is gone. There are people on this forum who have been Undetectable since week 4 and then showed virus at week 16 or 18. There is also a person on the forum who had been Undetectable at week 4 and all the way through treatment and then relapsed after finishing treatment.
Personally, if it was me, I would be very, very reluctant to lower my Riba dose. Why take the chance.
Hi there..
The dose of Riba is usually only lowered if one is has moderate or severe "hemolytic anemia" (HGB below 10) caused in part by Riba.
There would be no ther reason to lower the dose ,especially early on.
Congrats to him being Undetected for virus currently.
What week is he in?
Will
The dose of Riba is usually only lowered if one is has moderate or severe "hemolytic anemia" (HGB below 10) caused in part by Riba.
There would be no ther reason to lower the dose ,especially early on.
Congrats to him being Undetected for virus currently.
What week is he in?
Will
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