Aa
Lowering doses, labs
Hi All.
To brief: Pegasy/Riba doses just lowered from:
Peg: 180mg to 135mg.
Riba: 800mg to 600mg
In 'only' week 6
In a trial, no rescue drugs. Higer doses had me 100% bedridden (?)
After reviewing all labs, sides, type2b, etc. Dr. decided to lower.
Shands app. yesterday. I am UND, RVR at 4 weeks. Not 'allowed' to tell me but 'overheard' I was at 2 weeks (?) and getting the best response, etc. New plan in tx is........
Doing this dose a couple more weeks, watching labs. Than probably lower to 90mg Peg.
His goal....to keep some of these drugs in me, stave off anemia (getting taken off tx) for at least 10 more weeks, reaching 16.
I am very comfortable with Shands and my Dr. and he is quite secure in just getting me to 16 weeks and I will reach SVR. Said my labs 'holding up okay'. Of course if doing well, I will do more weeks.
I don't know the 'labs' too well yet. learning. Posting what I think is needed for an opinion.
Whatever is dropping......can it stabilize out, get better with just lowering dose's?
RBC. Start 4.46... wk4 3.50
Hgb: " " 13.9 wk4 11.3
HCT " " 42.3 " " 33.0
PLT " " 204 " " 197
WBC " " 6.1 " " 4.0
Neuts " " 4.2 " " 2.3
AST " " 46 " " 28
ALT " " 59 " " 19
Alb " " 4.3 " " 4.1
T Bili " " 0.4 " " 0.6
(What are neuts??)
VL load at start of tx was 1,550,000
I don't know these to well, but don't see anything that would make me 'drop to my knee's', as happened 2 weeks ago.??
Any opinions helpful, thanks.
LL
To brief: Pegasy/Riba doses just lowered from:
Peg: 180mg to 135mg.
Riba: 800mg to 600mg
In 'only' week 6
In a trial, no rescue drugs. Higer doses had me 100% bedridden (?)
After reviewing all labs, sides, type2b, etc. Dr. decided to lower.
Shands app. yesterday. I am UND, RVR at 4 weeks. Not 'allowed' to tell me but 'overheard' I was at 2 weeks (?) and getting the best response, etc. New plan in tx is........
Doing this dose a couple more weeks, watching labs. Than probably lower to 90mg Peg.
His goal....to keep some of these drugs in me, stave off anemia (getting taken off tx) for at least 10 more weeks, reaching 16.
I am very comfortable with Shands and my Dr. and he is quite secure in just getting me to 16 weeks and I will reach SVR. Said my labs 'holding up okay'. Of course if doing well, I will do more weeks.
I don't know the 'labs' too well yet. learning. Posting what I think is needed for an opinion.
Whatever is dropping......can it stabilize out, get better with just lowering dose's?
RBC. Start 4.46... wk4 3.50
Hgb: " " 13.9 wk4 11.3
HCT " " 42.3 " " 33.0
PLT " " 204 " " 197
WBC " " 6.1 " " 4.0
Neuts " " 4.2 " " 2.3
AST " " 46 " " 28
ALT " " 59 " " 19
Alb " " 4.3 " " 4.1
T Bili " " 0.4 " " 0.6
(What are neuts??)
VL load at start of tx was 1,550,000
I don't know these to well, but don't see anything that would make me 'drop to my knee's', as happened 2 weeks ago.??
Any opinions helpful, thanks.
LL
Hemoglobin is measured in gram per deciliter (g/dl). Normal values for women are 12.1 to 15.1 g/dl.
For geno 1 a desirable weight dosing of ribavirin is often stated as 13-15 mg/kg. For geno 2 and 3 a fixed dose has in the past been the most common: 800 mg/day for everybody. Today weight based dosing is often recommended even for these genos. I have seen the figure > or = 12 mg/kg mentioned for geno 2 and 3. Ribavirin's most important chore is to prevent relapse.
For geno 1 a desirable weight dosing of ribavirin is often stated as 13-15 mg/kg. For geno 2 and 3 a fixed dose has in the past been the most common: 800 mg/day for everybody. Today weight based dosing is often recommended even for these genos. I have seen the figure > or = 12 mg/kg mentioned for geno 2 and 3. Ribavirin's most important chore is to prevent relapse.
( I gotta know where the name came from? If I put it IN the post...it blanks out C*CK! :}
" I wouldn’t mind betting that LLs serum concentration of Riba would be quite high".
---------------------------------------------------
Which would explain why I am feeling better with the 200mg less in Riba ?
Which I had done myself (I know.... I shouldn't have & didn't tell them......4 days before they said to! ) Than they also lowered Peg. to my surprise. But I had researched on all the weight based info. and had figured it was that kicking my butt more than the Peg.
Thus far, these dose's are much more doable.
-----------------------------------------------
"Which is what my “mg riba/kg” was."
-----------------------------------------------------
10.5 ? Your weight range is? and is that 'correct' level to have?
---------------------------------------------------------
2 'point' (wording?) .......................supposed to be 'log' drop, right?
Thanks, learning as I go.
LL
" I wouldn’t mind betting that LLs serum concentration of Riba would be quite high".
---------------------------------------------------
Which would explain why I am feeling better with the 200mg less in Riba ?
Which I had done myself (I know.... I shouldn't have & didn't tell them......4 days before they said to! ) Than they also lowered Peg. to my surprise. But I had researched on all the weight based info. and had figured it was that kicking my butt more than the Peg.
Thus far, these dose's are much more doable.
-----------------------------------------------
"Which is what my “mg riba/kg” was."
-----------------------------------------------------
10.5 ? Your weight range is? and is that 'correct' level to have?
---------------------------------------------------------
2 'point' (wording?) .......................supposed to be 'log' drop, right?
Thanks, learning as I go.
LL
Thought I'd share my hgb levels with you so you can compare:
baseline: 15.2
week 1: 14.1
week 2: 11.1
week 4: 10.9
week 9: 10.5
week 12: 11.5
week 15: 10.1
week 20: 11.1
week 24: 10.7
From week 2 my hgb has stayed between 10 and 11.5, with one dip in week 42 to 9.5 when my interferon dose was increased because of weight gain. I am now in week 52 of 72.
My dose of riba was at start of tx 14.9 mg/kg. Now it is 13.3 mg/kg. I take 1000 mg per day.
It seems like you got a good team of docs looking at your case. And what CS says is important, it would say more if the concentration of riba in the serum was measured, not just dose by weight.
baseline: 15.2
week 1: 14.1
week 2: 11.1
week 4: 10.9
week 9: 10.5
week 12: 11.5
week 15: 10.1
week 20: 11.1
week 24: 10.7
From week 2 my hgb has stayed between 10 and 11.5, with one dip in week 42 to 9.5 when my interferon dose was increased because of weight gain. I am now in week 52 of 72.
My dose of riba was at start of tx 14.9 mg/kg. Now it is 13.3 mg/kg. I take 1000 mg per day.
It seems like you got a good team of docs looking at your case. And what CS says is important, it would say more if the concentration of riba in the serum was measured, not just dose by weight.
LL - At 2 weeks my Hgb was 13.7, than 11.3 at 4 weeks, with that being over 2 'point' (wording?) drop in 2 weeks, couldn't they feel that I could drop 2 more in 2 more weeks......being below 10? Than.....'out of trial'
----------------------------------------------------
Its a little surprising if you were kicked out of the trial if you hgb dropped below 10. Roche recommend dropping a pill when it gets below 10 and keep dropping one till it hits 8.5.
Then you stop. At 8.5 you wouldnt be doing a lot of running - lol
So not sure why they would use a different protocol.
CS
----------------------------------------------------
Its a little surprising if you were kicked out of the trial if you hgb dropped below 10. Roche recommend dropping a pill when it gets below 10 and keep dropping one till it hits 8.5.
Then you stop. At 8.5 you wouldnt be doing a lot of running - lol
So not sure why they would use a different protocol.
CS
Zazza
LLs wiight is 57 kgs (apx) and the “mg riba/kg” is 14 with 800mg and 10.5 with 600. Which is what my “mg riba/kg” was. I wouldn’t mind betting that LLs serum concentration of Riba would be quite high. Its almost a pity we are not dosed this way.
LL
I would have trouble with 10-14 days in bed so don’t feel too bad about it. Its just interesting that your Docs dropped the Peg dose as well.
CS
LLs wiight is 57 kgs (apx) and the “mg riba/kg” is 14 with 800mg and 10.5 with 600. Which is what my “mg riba/kg” was. I wouldn’t mind betting that LLs serum concentration of Riba would be quite high. Its almost a pity we are not dosed this way.
LL
I would have trouble with 10-14 days in bed so don’t feel too bad about it. Its just interesting that your Docs dropped the Peg dose as well.
CS
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