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Ribaviron absorption and dietary fiber
I know when I first started tx and asked for advice, lots of people told me to drink lots of water, have fat with my Riba, and either I read it elsewhere, or a few people here told me to not have much fiber at the same time I took my Riba. I can't find anything lately... especially my brain, so if anybody on here knows where I got this from, I would really appreciate it if you would remind me!
(:-)
(:-)
Yes, this is true. Precise mechanisms of action for both interferon and ribavirin are unknown.
thanks,
best part in all of this is that in the little pamphlets that come with the meds it says
something like the exact actions of ribavirin and peg against hcv are unknown.
got to keep myself reminding of that once in a while.
best part in all of this is that in the little pamphlets that come with the meds it says
something like the exact actions of ribavirin and peg against hcv are unknown.
got to keep myself reminding of that once in a while.
obviously many people react very differently to the meds
anemia is a sx of riba but not everyone gets anemic
and not everyone who gets anemic SVRs
from my observation people with an intial rapid hgb drop are more likely to require
rescue drugs
i had a 2.6g drop hgb so far and it happend slowly despite increased dosages
just to make something clear , i am not blindly and rectlessly overdosing
instead i early on did small incremental increases with tightly monitored weekly
CBCs. You really can`t do much more short of getting the serum test.
You know how much I like to do tests...
Now , what does it all mean , only time will tell but I do see a lot of slow responders
despite rapid hgb drop.
I decided to go up on my riba dosing (at least in the beginning) because I see studies
for geno 1 that showed better SVR rates.
how about riba with scrambled eggs in the am. It has fat and protein and no fiber.
anemia is a sx of riba but not everyone gets anemic
and not everyone who gets anemic SVRs
from my observation people with an intial rapid hgb drop are more likely to require
rescue drugs
i had a 2.6g drop hgb so far and it happend slowly despite increased dosages
just to make something clear , i am not blindly and rectlessly overdosing
instead i early on did small incremental increases with tightly monitored weekly
CBCs. You really can`t do much more short of getting the serum test.
You know how much I like to do tests...
Now , what does it all mean , only time will tell but I do see a lot of slow responders
despite rapid hgb drop.
I decided to go up on my riba dosing (at least in the beginning) because I see studies
for geno 1 that showed better SVR rates.
how about riba with scrambled eggs in the am. It has fat and protein and no fiber.
Personally I would never just start taking extra meds. I would find a qualified hepatologist to treat me and help find the right dose, and monitor for safety if I was in the situation of needing to treat again. "
This was way back right after the Swedish study was done so I read it and listened to someone. It was the lesson that taught me 'one study does not the truth make' and the reason I try to point out to people to make sure they are listening to their doctor and not making things up as they go. For my weight I should have had 800 but I begged up to 1,000. I should have left it at that 1200 - 1600 a day was just WAY too much and didn't accomplish anything that the 1,000 would have.
Lesson hard learned!
This was way back right after the Swedish study was done so I read it and listened to someone. It was the lesson that taught me 'one study does not the truth make' and the reason I try to point out to people to make sure they are listening to their doctor and not making things up as they go. For my weight I should have had 800 but I begged up to 1,000. I should have left it at that 1200 - 1600 a day was just WAY too much and didn't accomplish anything that the 1,000 would have.
Lesson hard learned!
Thanks for the laugh!
It's nice to know we have our humor to keep us going.
BTW...My Riba is about right!
It's nice to know we have our humor to keep us going.
BTW...My Riba is about right!
flguy: great list. I must be in good shape for my next round - according to the list I'm already at the right dose and I haven't even taken my first pill..
bali: on a practical level, best approach at the moment might be to have a vial drawn and stored at -80 while you look for a lab. Here's a recent French paper that compared assays across three labs:
http://www.ncbi.nlm.nih.gov/pubmed/19412142
Their sample collection was:
"After 15 minutes of centrifugation of blood samples at
1733g and 4C, serum was aliquoted and stored at -80C in
brown 1.5 mL polypropylene tubes until analysis."
so basically draw a couple of ml, spin and freeze.
I think Mike's suggestion is a good one : once you've collected your vials contact studies that have done serum rbv concentration (there are lots) and look for a local lab. University hospitals are a good bet.
From that free-access Morello'08 review linked above,
http://www.ncbi.nlm.nih.gov/pubmed/18931138
it looks like the window between not-enough and too-much is pretty narrow:
"what is the therapeutic range for ribavirin? The chances of response increase with greater ribavirin plasma concentrations. According to all studies reviewed, we propose a target concentration of at least 2–2.5 mg/L to maximize the achievement of SVR. Unfortunately, ribavirin plasma concentrations gt 2.5 mg/L are associated with significant rates of haemolytic anaemia"
bali: on a practical level, best approach at the moment might be to have a vial drawn and stored at -80 while you look for a lab. Here's a recent French paper that compared assays across three labs:
http://www.ncbi.nlm.nih.gov/pubmed/19412142
Their sample collection was:
"After 15 minutes of centrifugation of blood samples at
1733g and 4C, serum was aliquoted and stored at -80C in
brown 1.5 mL polypropylene tubes until analysis."
so basically draw a couple of ml, spin and freeze.
I think Mike's suggestion is a good one : once you've collected your vials contact studies that have done serum rbv concentration (there are lots) and look for a local lab. University hospitals are a good bet.
From that free-access Morello'08 review linked above,
http://www.ncbi.nlm.nih.gov/pubmed/18931138
it looks like the window between not-enough and too-much is pretty narrow:
"what is the therapeutic range for ribavirin? The chances of response increase with greater ribavirin plasma concentrations. According to all studies reviewed, we propose a target concentration of at least 2–2.5 mg/L to maximize the achievement of SVR. Unfortunately, ribavirin plasma concentrations gt 2.5 mg/L are associated with significant rates of haemolytic anaemia"
Personally I would never just start taking extra meds. I would find a qualified hepatologist to treat me and help find the right dose, and monitor for safety if I was in the situation of needing to treat again.
sorry had to go
basically the subject had the test and it was a bit low so they increased the dose by 200 mg increments from 1000 to 1600 at which point anemia was experianced and the concentration level was suddenly good.
location of test? sweden
basically the subject had the test and it was a bit low so they increased the dose by 200 mg increments from 1000 to 1600 at which point anemia was experianced and the concentration level was suddenly good.
location of test? sweden
with the high dose you are on you will either have enough or you will never have enough if you know what i mean "
You do realize that taking all the riba in the world won't matter - your body can only handle a certain amount, get to a high concentration then it's all overboard and a waste of time. Once your hemo drops like mine did (six points in 10 days) you learn that really you are only sabotaging your treatment and it didn't matter AT ALL.
I wish I had listened to the doctors instead of one person on an internet forum. The incredible amounts of epogen I was on weekly to maintain the riba level put my life much more at risk than the liver damage and treatment.
It's amazing what stupid things people can do in the quest to be cured. Overdosing on medication is NOT the the way to go. It is dangerous.
You do realize that taking all the riba in the world won't matter - your body can only handle a certain amount, get to a high concentration then it's all overboard and a waste of time. Once your hemo drops like mine did (six points in 10 days) you learn that really you are only sabotaging your treatment and it didn't matter AT ALL.
I wish I had listened to the doctors instead of one person on an internet forum. The incredible amounts of epogen I was on weekly to maintain the riba level put my life much more at risk than the liver damage and treatment.
It's amazing what stupid things people can do in the quest to be cured. Overdosing on medication is NOT the the way to go. It is dangerous.
just been talking to the person who had the test very interesting to hear the course of action they took..
25 grams of fat in a small bag of peanuts. I am having one with each riba dose. It makes me kind of nauseous though!
In the absence of a readily available test for riba concentration you can evaluate yourself with a simple set of survey questions
Has your hemoglobin dropped more than 25% ?
Do you scream at family members without reason?
Do you talk to yourself and then forget what you said?
Have you misplaced anything in the last three days?
Have you found the missing item in a refrigerator?
Have you missed a medical appointment time by more than a day?
Has your family moved out of the house?
Have you been bitten by a mosquito that suddenly dies?
Have you gotten ready for work on a day off?
Does your tub require Draino more than once a week?
Do you itch like a heroin addict?
When you look in mirror do you say “Holy Shite”
More than 10 ‘Yes’ --- Riba is about right
Less than 8 ‘Yes’ --- Dose is right, you forget to take sometimes
Less than 6 ‘Yes’ --- You ain’t on treatment
Has your hemoglobin dropped more than 25% ?
Do you scream at family members without reason?
Do you talk to yourself and then forget what you said?
Have you misplaced anything in the last three days?
Have you found the missing item in a refrigerator?
Have you missed a medical appointment time by more than a day?
Has your family moved out of the house?
Have you been bitten by a mosquito that suddenly dies?
Have you gotten ready for work on a day off?
Does your tub require Draino more than once a week?
Do you itch like a heroin addict?
When you look in mirror do you say “Holy Shite”
More than 10 ‘Yes’ --- Riba is about right
Less than 8 ‘Yes’ --- Dose is right, you forget to take sometimes
Less than 6 ‘Yes’ --- You ain’t on treatment
i know where you can get a test , and i know someone who had one, but why bother it wont make it start working differently , its too late now really 6 wks in i would say,as the first 4 wks is when you need the impact, with the high dose you are on you will either have enough or you will never have enough if you know what i mean
Frequent monitoring may present a problem though depending on where you live and/or how much money you have.
Mike
Mike
Wow, a serum riba concentration test and the opportunity to view the Shroud of Turin.
Now that IS exciting.
Now that IS exciting.
I saw an article about ribavirin concentration authored by physicians at the following institution so maybe you could get tested there.
Department of Infectious Diseases, University of Turin, Turin, Italy
Department of Infectious Diseases, University of Turin, Turin, Italy
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