MISSING DOSES OF RIB- GIPA AND OTHERS

HI GANG, I'm really worried and wanted your advice before i call my GI. i don't want him threatening me to take me off the meds. Here goes. I KEEP MISSING DOSES OF RIBIVARIAN!!! i take shot #4 this friday. and i have figured out i have missed 5 doses of ribavirion so far. Sometimes i fall asleep before i take it then take it in the morning and sometimes i just forget a morning dose and then take it as soon as i remember. ALL THIS FORGETTING HAS COST ME 5 DOSES. BRAIN FOG CITY!!!!!!! i'm afraid i'm ruining my chances of clearing or going to cause the virus to mutate or become tolerant to the copegus/riba. ANY ANSWERS/HELP OR ADVISE WELCOME, I ALREADY FEEL LIKE AN IDIOT SO STATEING THE OBVIOUS WILL NOT BE NESSESARY, NOT THAT ANY ONE HERE WOULD. YOUR ALL SO SWEET, AND I'M THANKFUL FOR YOU ALL IN MY LIFE!  THANKS, SANDI

[Galen]

OK, here's what you need to do.  You need to get either two alarm clocks or one that allows you to set two different times.  Put them with your meds and NOT near your bed where you can hit the off button without disturbing yourself.  Make sure the alarms are loud enough to awaken you and get your attention.  If that doesn't work, there are services that you can pay to call you to remind you.

[Sioux]

Hi, I have to use those medicine containers to remember, you know with the 7 days of the week on them. I have 2 for my riba one for AM and one for PM. I also use 2 others for other meds that I take. you might want to try that too. Good luck !!!

[LvdByGod]

thanks for the good tip. i wonder if anyone could comment on the damage that this may have done to svr possibility?

[layla]

Is there soemhting you do every day at the same time, like brushing your teeth? Put the piils near your toothbrush. I put my morning pills near my coffe pot. I never miss that. I think Galens idea is the most trustworth. LL

[OkieJim]

Yeh the <B>FOG STRIKE ANOTHER ONE </B>
Make sure you let your doc know. Galen has a good idea. Or maybe try dosing earlier. I use 8AM and 8PM. I go to bed at 8:30. This seems to work for me. Sorry for the fog but good also to still hear from you. I miss Myrtles. I think she has been really having a hard time or stopped TX due to SX.
God Bess you and keep on fighting.

[LvdByGod]

thanks for the advise on how not to forget. does anyone know if this will ruin my chances for svr? and i hope MYRTLES will come back soon. sandi

[OkieJim]

I wish I knew for sure Sandi. I just don't. I know that what I read before starting was that the riba did not work on its own. The interferon worked but not as successful as combo therapy. I sure hope someone out there can say for sure. Since you have just started I think talking to DR. and gettting on schedule with make it work. I pray that the bad things you are thinking of won't happen. God is with us and listening I will say a prayer for you.

[raheem]

Take them in the morning when you get up and take them at night before you go to bed.

[landfill]

My dr says riba builds up slowly and depletes slowly.  The half life in your body is 2 weeks.  It isn't critical that it be taken precisely on schedule.  He reduced my riba from 1200mg to 800mg for 10 wks, then 1000mg for 6 wks then back to 1200mg because of anemia that wouldn't come under control.  I protested loudly that he was selling me out.  He said that there's some research suggesting that getting 85% of the optimal riba total over the whole tx is about the same as 100%.  If it falls below that, the chance of relapse rises rapidly.  So I think that if you get the right amount every day the exact timing isn't important.  I was undetectable at 4 wks post-tx and I'm getting the 12 wk test Wednesday.

This isn't true of inf.  It's important that you stay on schedule.

[Eyedeas]

My doc said that if you took 8% of the meds, 80% of the time it should be effective, assuming you were going to respond.  I really doubt that missing 5 doses will have done any real damage.  Double check with your doctor, but I'm sure that's what he'll tell you.  Hang tough!

Kim

[LvdByGod]

i have missed 5 half days worth of dosing. that is, for 5 of the days this month i have only taken 600mg. as opossed to the 1200mg i am suppose to be on. also,i just talked to the pharmisist that said antivirals not taken right can cause the virus to become resistant.she said this in general of antivirals and antibiotics. oh please someone debunk this. sandi

[Revenire]

Missing a dose, here and there, won't ruin the chances. Isn't the rule 80% of the meds, 80% of the time?

[LvdByGod]

p.s. i promise to be good from now on!!! (with doseing). i'm looking into finding an alarm/pillcase to wear arround my neck at all times. pharmasist says check with sharper image. going there now. thanks again for help you guys. you are all in my prayers. sandi

[jamit_a]

HI THERE,

I USE A PILL CONTAINER ALSO BECAUSE, I WAS DOUBLING MY DOSES of Co-peg. hehehehehe! I thought I didn't take it, and take it again ooooops!:-) so now I use the 7 day pill container it works great especialy if you have brain fog!!!!

Good luck and be up front with your GI.

jamit_a

[LvdByGod]

AWHILE AGO I POSTED ON YOUR STATS FORM SOME ADDED INFO ABOUT ME. I WONDER WHAT I DID WRONG. MY NAME IS NOT BLUE YET. ARE YOU JUST BEHIND OR DID I DO SOMETHING WRONG? PLEASE LET ME KNOW. O.K.? I'M 4/24 PEGYSUS/COPEG THIS FRIDAY. ONE MONTH DOWN 5 TO GO, HOPEFULLY. THANKS,  SANDI

[sugie]

Thanks for the input when I really needed it! Finally got my guts under control, I hope. Doing another antibiotic that agrees with me, or doesn't make me barf. I missed some riba, throwed it up. Also, missed my shot night. Did my shot this morning. So far, so good. The drug info. in the box says if a missed dose is within two days, take it and then resume regular schedule. So, mine was 36 hrs late and I guess I'm ok to go back to regular shot time this coming weekend. I hope I feel better soon. It was a rough weekend.I have had a feeling or a lump in my throat since I took the first antibiotic. Could this be a problem with my throat or thyroid maybe? It feels wierd. This happen to anyone on TX or taking an antibiotic? Also, never had reaction to any drug before, cuz of the TX or immune system I assume. Anyway just wanted to check in and say thanks again. It does help to know I'm not really alone in the fight.

[Indiana]

It's all fine to try to be "nice" about this stuff, but this is serious business we're talking about. Early in your tx it is VERY important that you do NOT miss doses of anything. Failure to follow the dosing regimine is the single biggest reason that people fail at this....at least the biggest reason that you can do something about. With the pill reminder container it's not that hard. Set your time for the pills...7-8 AM and 7-8 PM.....and stick to it like glue. It's NOT that hard. Sure, things will happen and delays will happen but if you want to succeed at this then DO THE MEDS!! The early weeks are the most critical of all. You simply MUST focus on doing ALL the meds as close to on time as possible. Later on it becomes less critical.
Sorry if this comes off as a bit harsh but you all need to hear it and take it to heart. It's fine to be nice but I think the truth outweighs nice sometimes............

[cindee]

I was much closer to the end when my hubby and I were going to the beach...4hr. drive. My liver doc said I could lay off the rib while @ the beach....but I kept on taking them. I probably have missed 5 pills during tx due to brain fog...I found 3 in my nite coat pocket one time....never knew when I missed those!!!! HUGS @ PRAYERS TO ALL! ~Cindee~

[oldhippiechick67]

I can empathize with the situation of missing a dose...argh.  Brain fog indeedy. But the pill box with AM and PM pills has helped me a lot! I usually take my AM with bkft, and PM before going to bed. The alarm clock is a good idea. I know I have seen a watch that you can set to remind you to take pills, but I cant remember where. Dang it.  If you can take the missed ones as soon as you remember and take the next dose at least 6 hrs later, maybe you wont have so many gaps.  But anyways, I think you will be okay if you get back on track SOON! The 2's and 3's can get by on 800mg per day.  I am taking 1000mg a day and I weight 160. Do you weigh more than me?  Erin PA hopefully will comment on your dilemma.  If you think of taking your pills say when you get home from work, set the oven timer for 3 hrs later.  Good luck hon!  OHC

[LvdByGod]

WELL,I just bought a 49.00$ reminder keychain with medicine container. with multi alarms set. this should do it as long as i remember to wear it! ;) thanks for the encouraging news about the 80/80 rule. do you know where i could read about this info online? i will still talk to my dr. i feel less afraid that he will take me off based on your responces. thanks again, faithful friends. sandi

[LvdByGod]

I AM 265LBS. A BIGGY! SO I DO NEED ALL OF IT I THINK.

[jamit_a]

Yeah, don't worry about it, you'll have plenty of other things to worry about! Or just do as I did, take the meds again when you think you for got to take them:-) hehehehehe the worst that could happen is your Red blood count will go down and you'll feel a bit weak!!! which we're all used to around here anyway right?

So hang in there and enjoy the ride!

Jamit_a

[layla]

I did the same thing in the beginning. Double riba rage!!!! lol I stopped doing that real quick. LL

[giddyup]

I went to work today without my ribba-woops.This is the first time I missed my morning dose.I figure after 8wks there is plenty of ribba in my blood to last a few hours. I also double dosed by accident[fog].That really gives ya the jitjit jitters.

[Is_This_Real?]

Sandi...

I realize that it is a scary and worrisome thought to think that you may have hurt your chances of success by "forgetting" to take <strong> SOME </strong> of your ribavirin doses.

However, I would not be too concerned over this (just try not to do it regularly).  I expect that most everyone here has heard of Dr. Ben Cecil, "The Hepatitis Doctor".  He uses an individualized protocal for treatment.

Although you have done it by accident, it sounds like you are almost using his protocal.  He says "Ribavirin does not cause the viral level to fall. It is the interferon that is the muscle drug. Ribavirin does not make a noresponder into a responder. What ribavirin does is greatly reduce the chance of relapse in patients who respond to interferon.

I use initially low doses of ribavirin, 600 mg per day, and most patients increase to 800-1,000 mg per day. I use 1,200 mg of ribavirin in hard to treat patients.  Patients with severe fibrosis or cirrhosis must be treated longer than patients with mild or moderate liver fibrosis to reduce the risk of relapse."

His website is full of useful information like this and can be found by clicking <a href="http://www.hepatitisdoctor.com"> on THIS link </a>.

[GI.PA]

There has been a lot of research into the dosage for Rib.  After the first few weeks, the drug reaches a steady state in the body.  This means that your body is breaking it down and taking it in at the same rate, so the level of drug in your body remains constant.  The pharm-D's that I have talked to about this say that the reason that Rib was divided into two doses a day is that it seems to be better tolerated (nasea, ect).  From what they so, there shouldnt be any difference between once daily (all your pills at the same time) or divided doses.

I am NOT saying that I reconmend this.  However, in my patients, I would rather them get all the dosage in in a 24 hours instead of missing doses.

GI.PA

[sugie]

another question????????Does anyone have the nasty habit of burping, no I mean an excessive burp. After water, food or nothing. Sounds almost like jessica simson. Is it a sign of something or just another gross side. My kids want it to go away. I don't really care, but I do try to muffle it in public.

[oldhippiechick67]

hey, yes I am behind, I guess you missed my posts about it, but my website had a little flaw...it only went to the C's.  I will try to get your name updated.  Anything else besides the week?  like your history, liver bx results, vl?  For about a week or so I didnt get any info forwarded to me from the site. But thats been fixed now.  Thx, OHC

[landfill]

If the lump in your throat doesn't go away soon, go to an otolaryngologist to see what's going on.  I started taking a new drug for diabetes 5 years ago and got a lump in my throat right away.  I dismissed it as a side effect.  Eighteen months later an oto said it was stage 4 tonsil cancer.  It looks like I'm going survive it after some mean surgery and radiation.  Please don't be preoccupied with hepatitis and ignore it.  I know you don't need more to fret about but I had to say it.

[landfill]

I just noticed that it was sugie that mentioned the lump.  Ignore it, lvdbygod.

[LvdByGod]

thanks all of you, and also indy. i know you are correct and that's why i was freaking out. there will be no more of this i pray. sandi

[MajNeni]

I think the burping is a nasty side effect... almost as bad as the explosions at the other end of the tract...
If your burping sometimes has bad taste, or biley stuff coming up, or you get heartburn (but didn't before tx,) you may have a problem with gastric reflux, that has happened to many people.
Tell your GI about that, he may want to give you a med to relieve this side.
So, are you able to continue tx?  Hope that recent episode is all behind you.  I had antibiotics 2x and hated their added sides.
Maj Neni

[Indiana]

Goo for you. I'm on your side here sweetie. I really want EVERYONE to succeed at this. Unfortunately, that cannot be. But if I see something that you can do to help yourself I'll be the first to tell you so. I kid around a lot to keep spirits up but I can get serious if I need to.
I'm done "spanking" you now. Hope you can get things on track now a focus on "the prize".
                                Your Buddy