Start Tx on Nov.07

[kickboxingmom]

Can I ask a few questions ? Thank you all ahead of time.Caremark delivered my meds package today.Dr.Appt.Nov. 07, 3:30 p.m.Caremark called yesterday and said my insurance would not cover Ribavirin so they gave me the generic Ribashere.Then the paper work says, generic name: ribavirin.2 tablets in the morning, three in the evening.200mg.That's 1000 mg a day.I weigh 103.Bottle reads Ribashere
Peg-Intron Redipen Generic Name:Peginterferon Alpha-2b.Inject 0.4ML (64MCG), once weekly.
Dr. is going to show me how to inject and all the other stuff I need to know.My husband is on on Humira for the past 3 yrs. so shots no problem.?????
My question.Does this dosage and medication sound correct ?
Thanks again, Tammy
Also, should I ask about pre-dosing riba ?

[kickboxingmom]

The box the Redipen comes in reads,
Peginterferon alfa-2b
PegIntron
Redipen
80 mcg/ 0.5 mL
Thank You,
Tammy

[Isobella]

I can't address the redipen issue because mine is alfa-2a, 180mcg/0.5mL---but I just wanted to suggest taking the riba 3 in the a.m and 2 in the p.m. because it my affect your sleep and that way you are getting the bigger dose earlier in the day.

Good luck to you, Tammy.  I wish you kind sides and an easy ride :-)

Isobella

[desrt]

I'd say that's plenty of riba for your weight. If your RBC drops too quickly, you'll have some slack to drop a pill until you can get some epo. You might want to go back in the archives and do some reading on those who've done .5 instead of .4 on their redipens.

[can-do-man]

I would go with the .5 but thats just my thoughts. Redipens are easy to use. Heres a video on those for future use if you need it... Best to you

http://www.pegintron.com/peg/application?namespace=main&event=content_display&event_input=redipen_how_to_use#

cando

[portann]

I'm on 1000 ribavirin and am 125 - 130. Can't really comment intelligently on redipen or dosing or pre-dosing.

Do want to say, though, that like you, I was told to take my two pills in the morning and three in the evening. This works fine for me.

Also, my doctor put me on a schedule of ten and fourteen hours apart instead of twelve and twelve to even out the ribavirin in my bloodstream. That is, I  take 400 at nine every morning and 600 at 7 every evening. Not a big deal but just the way I was told to do it to kep the dosage steady.

Good luck.

[Rockerforlife]

ISNT the redipen dose kinda low?...mine was 1.5mcg.your is 80mcg??

[kickboxingmom]

Thank you to All for responding.
Isobella, That makes sense with the 3 pills in the morning.I have trouble sleeping anyway's.Thanks for that. Good idea !

desrt, Thank you I will read and read.I'm unsure of Redipen, that's why I'm asking before I go to my appt., on the 7th.

Trinity4,Thank you for the words of encouragement.Dr. said, not to take any meds till I see him but I remember reading post after post about pre-dosing.

can-do-man, I will ask my Dr. about the dose and Thank you  for the link and the nice words.I'll watch afterwhile.

portann, Thank you for your kind words.I guess I'll be like you and do what my Dr. says.I was thinkink Riba at 5 and 5.I'm unsure.Thanks for your advice.

Rockerforlife, That's why I'm asking, Im confused.I remember at a prior appt., doc said, 800 mg of Interferon.I just don't want it to be to low.
Hey, Congratulations on your start date, Nov. 07.That's the same as me.Also, for getting into the trial you wanted.Yea for you.

I mean that guy's, Thank you for responding.I love having information under my belt before appointments.i love the look on Dr's face when we say something they don't expect it.They look at you, then smile.

The Ribasphere tablets I have are blue oval Tablets.One side 3RP, the other side 200.
At first Caremark was sending a pack they said that included one horse pill Ribavirin that had all 5 doses in it.That is until ins. said generic.
Thanks again, Tammy        Spelling of Riba is : Ribasphere

[zazza]

You weigh 47 kilo. You should have at least 1.5 microgram PegIntron per kilo, which means 70.5 mcg. If you have an 80 mcg readipen and only take 0.4 ml that means 64 mcg. That is not enough for you. You need to take the full readipen of 0.5 ml, in which case you will get the full 80 mcg which is sufficient for your weight.

When it comes to ribavirin you want at least between 13 and 15 milligram per kilo. 1000 mg would mean 21 mg per kilo with your weight, which is quite a strong dose. Usually no less than 800 mg is prescribed, which in your case would mean 17 mg per kilo. A nice dose, can't see why you would need more than that.

Can you discuss the above with your doctor? In any case, I think you should be reluctant to take less than the 80 mcg PegIntron. The normal dosage if you weigh less than 65 kilo is 80 mcg. Can't understand why you would be prescribed less than that.

[Proactive]

As always Za, your math is perfect!! But it appears Tammy's doc is prescribing per the Peg-intron package insert..(See table 6)
87lbs.-111lbs. ---64 mcg/wk..which as you state is a 4ml dose from an 80mcg pen (#4 setting)---agree though, I'd push for the 5ml full 80mcg dose...
And again right, that is a pretty stout dose of ribavirin (same as mine and bill's was)---which I think is great and as mentioned gives some wiggle room to lower if hgb drops to hard...

Peg-intron package insert dosages on pg 6
http://www.spfiles.com/pipeg-intron.pdf

[Proactive]

The redipens are pretty easy to use, a bit akward sometimes, but pretty straight froward...A tip from the peanut gallery, take the pen out of the fridge 15-20 mins prior to doing the shot, let it warm up to room temp...feels better going in...;^)
pro

[zazza]

I checked Schering-Ploughs prescribing information/product information, and there is a table nr. 6 which actually indicates 64 mcg PegIntron for a weight between 40 and 50 kg. This is confusing since they also state that PegIntron should be dosed at 1.5 mcg per kilo.

So this is probably where your dosage comes from, although it says that 800 mg ribavirin (Rebetol) is enough for your weight. I would be reluctant though to take less than 1.5 mcg PegIntron per kilo, but that is me. I would just take the full shot, I don't like being underarmed in this war.

Here is the link:

http://www.spfiles.com/pipeg-intron.pdf

Just to correct what I stated in my prior post, these are Schering-Plough's recommendations:

"PegIntron/REBETOL Combination Therapy: The recommended dose of PegIntron is
1.5 mcg/kg/week in combination with 800-1400 mg of REBETOL based on patient body weight."

40-50 kg: 64 mcg PegIntron
51-60 kg: 80 mcg PegIntron
61-75 kg: 96 mcg PegIntron
76-85 kg: 120 mcg PegIntron
86 kg and up: 150 mcg PegIntron

[zazza]

****, I managed to erase my first version of the above post. Seems you beat me to the bush.

[zazza]

Oh, you sensitive Americans and your censor! LOL! That is not even a swearword in Swedish!

[Proactive]

"Seems you beat me to the bush"......Believe it or not, I'm going to bit my tongue here and wait for goofy or flguy to comment further.......................;^)

[zazza]

For those that remember, when I weighed 74 kg and only got 100 mcg PegIntron, which means 1.35 mcg per kilo, I drank a h@ll of a lot of water, since 1 liter water equals 1 kilo, and this brought my weight up to 76 kilo, and I got my 120 mcg readipen. Told you I am crazy when it comes to this war, but I am SVR now!

[zazza]

I did have a feeling I should have checked that proverb! Seems I got it mixed up! Hmm, wonder if "bush" might mean the same in English as in Swedish, hmmm....

[kickboxingmom]

Thank you so very much for taking the time to explain all of that.I truely appreciate it.
Sure enough as I looked at the box it is an 0.5 Redipen.I'm to take 0.4 as stated on the box.
Yes, I will talk to my Dr. about the 0.5.If you guy's don't care I'll print out some of these facts and Refuse to take no less than the FULL 0.5.
Question- The Redipen isn't pre-loaded with just the 0.4 amount, is it ?
The box reads 0.5 Redipen.
Hoping I don't have a problem with that.I fought for almost a year to get those drugs in my refrigerator.
Again, Thank You SVR People.I wish I could give you's a hug.
I would have taken the 0.4 and who knows .Now I know what dose I should be taking to have a better chance to reach my goal.Thank You, Thank You, Tammy

[Proactive]

Maybe you'll get lucky and your doc will give you the Schering Plough kit..has a twice daily pillbox(a must have to keep track of your riba pills), a dvd showing you how to inject(I think someone posted a link to it for you), along with a few other goodies...If not, no big deal...
The redipen is preloaded with .5ml of solution and peginterferon in powder form, you simply kick it down and it mixes the solution for you. When you screw the needle on, the redipen automatically purges the air from the pen. On the end of the plunger, there is a dial marked .3,.4,.5 etc. and you turn and set it to your prescribed dose (think it limits how far the plunger goes down, thus giving you the proper amount of solution)...and your ready to go.

Best of luck Tammy, you'll do just fine...the process becomes second nature in a very short period of time...Actually, I found "shot day" to be my perkiest day of the week(did my shot at 6:00am) and would try to take advantage of the extra boost of energy..
Pro

[zazza]

Your pen is loaded with 0.5 ml and 80 mcg PegIntron. As Pro says, you are supposed to dial it to 0.4 and only take 64 mcg.

I remember trying to ask my doc why I only had a 100 mcg readipen when I weighed 74 kg, and 74 kg x 1.5 mcg = 111 mcg. He refused to answer and just said that according to the prescription information it was 100 mcg up until you reached 76 kilo. (He probably did not know the answer.)

I don't know why they say 1.5 mcg on the one hand, and on the other hand the prescription information is some kind of compromise. It's not like it is change, that should be rounded either up or down I would think. Beats me.

[redrodeo]

You'll be fine. Like everyone told you there is a little extra in the redipens if you feel so brave. I used the redipens and found them to be very easy to use. And the needles were so small that was a big plus. Now the drug kicked my a**. Personally if I could tolerate it I would do the extra for the first 4 wks. That rapid response seems to be the ticket.
Red

[kickboxingmom]

Your words have Helped so much.Thank You All very much.I feel so much better with everything.You guy's are something else.I don't think you guy's Realize sometime's How Much you help.
Thank You To All,
Tammy