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Procrit and anemia, again!

Procrit and anemia, again!

I bet you guys are sick of me asking questions about Procrit and anemia, but here goes:  husband Geno 3, week 16/24.  4 & 12wk PCR UND. Beginning hgb was 13.3.  After 5 weeks of tx hgb was 7.4. Riba was stopped for 3 weeks. During that time he was started on weekly Procrit of 40,000IU.  When his hgb got back up to 11.6 he was started back on his full 1000mg Riba dose.  Since that time his hgb has dropped about 1/2 point per week.  It leveled off at 9.0 for the last 2-3 weeks.  His doc wanted him to double up on the Procrit, doing two shots per week of 40,000IU.  Husband resisted this at first because he's sick of injecting himself (he's just sick of the whole thing, period).  He asked about a one pill Riba reduction instead.  Doc said one pill wouldn't make a difference and if they were to reduce it should be to 600mg/day.  Bottom line is, I think they butted heads (I wasn't there, 1st appt I missed) and the doc told him to "do whatever he wanted" and walked out of the room.  This is just par for the course with this doc. Every time we go in he never knows what the Riba dose is or anything else.  He has the chart right there in front of him and he wrote the Rx...shouldn't he know that??!!  Anyway, after talking it through husband and I decided he would go ahead with the double dose of Procrit and a one pill Riba reduction.  This week he did Procrit on Mon/Thurs and reduced the Riba beginning Tuesday.  Yesterday's lab work shows his hgb at 8.0.  My question is, will the increase in Procrit still take 2-3 weeks to work even though he's already been taking it for two months?
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Avatar_n_tn
Read my post and replies 'Informed advice on procrit dosing needed' placed yesterday.
During my my last treatment 48 weeks with double procrit at cerain points the procrit never was effective at any dose and we had to reduce and periodically cease the riba.
I am now re-treating and caught in the same syndrome.
Extreme sensitivity to haemolytic anemia caused by ribavirin means that procrit simply does not work for everyone.I have endured hgb of 7.5 and felt like hell and I am headed there again by the look of it.
On the bright side the build up of ribavirin in the system may,repeat may, mean that a low dose i.e 600 mg can still be helpful.
Riba is most important in the early stages of getting to und,and your husbands treatment is still likely to succeed.
I would not blame the doctor for not remembering the individual doses of all his patients and his responses seem reasonable.
Complete the treatment by balancing increased procrit with reduced riba.
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Avatar_f_tn
Thank you.  I read your post and I hope you start feeling better soon.  I hope you don't back down to 7.5, that is just miserable.

I don't mean to blame the doctor, but it has been a frustrating experience.  Not once have they received any of the blood work and called us to express concern over the dropping numbers.  We have always been the ones to call them and then they sound surprised by the whole thing even though they get the same lab reports we do, probably sooner then we do.  

Good luck to you.
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