Think I missed a dose...not sure

Good Morning,
     Guys I think that I might have missed (forgotten) my Thursday morning dose of pills.  Took my evening dose however.  Should I take an extra pill for the next two days?  Not really sure what I should do here.  I take 800 mgs of riba.  Two in the morning and two in the evening.  So for the next two days should I just take one pill in the afternoon between my morning and evening dose?  Little frustrated here.  I looked at the Thursday evening side of my pill box to get my pills only to notice that the Thursday morning side lid was still closed.  Low and behold...guess what?  I saw pills.  I could have sworn though that I took them.  Don't want to overdose...Yikes!!!  On my pill box I always leave the lid open of the day showing myself that I have taken them, and once the pill box is empty then I replenish it with the pills close all the lids and start over again.  Day/time taken....leave lid open...

I would call my Dr., but because she only practices on Tuesday she's not in the office.    Little stressed here...Take care....

In Him,
Rick  

[stangshelly]

I don't think you should dose more just continue on your regular course, I believe it states in the literature about if you miss a dose. Just stay on the same 2 in am 2 in pm course. I take 3 in am 2 in pm , I think over the course of the 50 weeks I missed a dose here or there. Best wishes:) shelly

[ladybug52]

Dear Friend!
I missed a dose and posted the same question! Everyone's concensus was don't worry about it. My dr. office finally called me too and said one dose doesn't matter, don't take extra meds to catch up.

Hope you are feeling well. I have been meaning to write you. I got a spam e-mail that had this is in the subject line: Pansy......Now is the time
It scared me to death! I thought "Oh no, Pansy has taken a turn for the worse!" I was sick. Then I opened it up and it was about investing in stocks!!! I was so mad!

Have a great day! Got our income tax refund last night, both girls are home for the weekend, Taylor baby here too, I'm doing the happy dance!
You're in my prayers
Janice

[honey11]

Yes,,,I think during my tx,,,I missed one dose and it drove me crazy lol  But you are good and no need to make it up,,,just carry on!

[nygirl7]

The doctors say no - just continue onwards on a regular schedule.

It's really really important that you take the meds on time and schedule - I used to take mine with breakfast and dinner (also to absorb them with the fat content because we should always take with some fat to bind the molecules).  I wouldn't let myself eat until I took them so it became a real habit to always take them.

That worked better for me even than the pillbox with the AM/PM boxes because I could always forget to look at THAT.  But...even sick I always knew when it was breakfast (cause I want my coffee) or dinner (because everyone else still wantead to eat).

7am and 7pm for me.  It worked great.

[Tater-ToT]

Hi Rick,
I think many of us have done that, or "WONDERED" IF we did that... I agree with the others... (My Doc told me that too) so, I wouldn't make up the dose, but just take your next schedualed dose!

Those pill boxes helped some... but Unless I actually left the little flaps OPEN I would get confused.

I would leave my pillbox on my nightstand with a water carafe, On Fridays I would fill my box (Shot Day) & each dose I would leave the flap open as I continued all week long... & that way all I had to do was LOOK Over & see if the am or pm flap was open for that day...

I tried to get into a routine that before my feet hit the floor in the am, I took them, & the last thing when my feet came back off that floor at night I would take them... but that meathod still was NOT flawless... (Sometimes I would forget to fill the pill box on Fridays) & it would mess me all up!

Hang In There!
;)

[rosebud57]

just the other day i did the OCD checking thing. and thought i had taken my meds and they were still in box.  every now and then i think i grab them out of the wrong day. i am not always refilling on the same day shame on me. but i did figure out that i had refilled box and took tuesdays meds on wednesday evening. gets hard to remember these (simple) things.

[Myown]

The pill box they gave us with the meds you can take apart. I did my first pills and shot on a Friday, so Friday is where Monday would be . Fri,sat,sun,mon,tues,wed, thurs. On Thurs night after I take my riba, I refill for the week again. If I would have left it the Mon-Sunday, that would have confused me as the week passed by, being my brain is beyond foggie these days.

Pull apart your pill box and line it up with the first day of the week being the shot night since that is when you started the riba too.

Most of us started tx at the end of the week so the end of the week should be first in line of days of the week.

Maybe you are doing that, I don't know, but with it like this, its so easy.

[bobbyullc]

think of it this way. if you tx for 48 weeks you will take 1344 pills. do you think taking only 1322 will make a diferance? good to ask but try and not get too worked over the small stuff. only 800 riba? how much do you weigh. are you geno 2?

[giddyup]

Once I forgot if I took my dose so I took another then I forgot again so I took another.Boy did I get sick Off all that ribba!

[AMERIBOI2003]

Thanks guys for your responses.  I feel better now!!!  I have just decided that should I have any of my pills left over to save them for our next Halloween night, and pass them out on a platter with the rest of the goodies!!!!    LOLOLOLOL....Could you imagine????  

In Him,
Rick

[jmjm530]

MO: The NP said if I wanted I can take all 5 riba at once as long as my stomach tolerates it.
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Actually, she may be wrong according to newer findings by the Sweedish researcher Lindahl regarding the saturable nature of ribavirin.

What Lindahl found is that Higher ribavirin doses are associated with a lower bioavailability and therefore recommended 3X a day dosing for those on high dose ribavirin (HDV) which I believed was defined as over 2000 mg/day.

That doesn't mean that ribavirin has to be dosed every 12 hours, but what it does suggest is that spacing the doses apart will insure more ribavirin gets into your blood serum than if you take all the ribavirin in one gulp, at least at higher doses.

Would the example above of 5 pills (1000mg) be enough to decrease biovailablity? Not sure on that one, but it certainly might to some degree. And would a very high fat meal mediate this somewhat? Not even sure if that has been studied.  BTW in defense of your NP, these findings were relatively recent and not too many U.S. doctors appear to be following the Sweedish studies.

As mentioned earlier, I often took my two daily doses of ribavirin (3 pills each) as close as 3-4 hours apart.

-- Jim

[jmjm530]

MO: The pill box they gave us with the meds you can take apart.
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LOL. Well, you're certainly better organized and having a better time of tx than I had. I still find sections of those pill boxes (probably 3 or 4 I bought on treatment) under the couch or somewhere. LOL.

The best method I had -- when I was at my absolute worst -- was to write every pill/shot in a dated log book. My mind was so bad at that point that I made it a habit not to take the pill out of the container unless I had both the pills, log book and pen out at the same time. The pill went down with one hand while almost simultaneously writing it down with the other. Still, once the phone rang during the process and I got confused whether I took the pill or not !!! Later on, I just ended up taking the riba with my two meals and it became habit. But for those better organized, and less less apt to lose/misplace the boxes, the pill box system seems to be a good one.

-- J

[Pdilly]

Funny Jim
I agree I have forgotten 2 or maybe 3 doses (see I don't even know) in 6 months.  If it was not for those pill boxes I would totally loose it.

[Myown]

The pill went down with one hand while almost simultaneously writing it down with the other. Still, once the phone rang during the process and I got confused whether I took the pill or not !!!
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lol!!What you experienced is exactly what all of women go thru with menopause,so the tx on top of menopause is a double whammy for the mind. I hate having both cloud my mind. I really don't know how people work durring tx because of how it effects your memory.

But as far as the pill box, well what actually happened with me was I didn't realize the pill box came apart and I was trying to take the flaps off figuring I could switch them. And while trying to rip the things off thats when the box fell apart and I said to my husband 'see if you can start Friday as the first day of the week, cuz otherwise I am DEFINITELY going to overdose or underdose.  So now thats why I have my neatly organized pill box.

If I left it as the Monday to Friday set up, I'd be in trouble. I started out with the pen and notebook too. Wrote everything down. Vitamins, what time I took them, pills shots, how I felt that day,if I was constipated, stress level notes. Oh please I was nuts. Finally I said 'that's it.'

I told my husband if I die from this poison you can write in the book what day and time I died, other than that the notebook is going in the draw.

My husband knows (very obvious at this point) that I am very foggy from meds, which is a nice way of saying 'very stupid and forgetful', so he checks my pill box every night.

The NP said if I wanted I can take all 5 riba at once as long as my stomach tolerates it. She said a few of the patients started doing that and are fine. But I would rather split the day. Can't wait until this is over, although I should not complain because of the way some suffer with sx and are barely making it through the day.

see ya later. shot # 9 tonight!! yahooooo!!!! Wish it was 24 though.

[jmjm530]

Actually, the log is an excellent idea, and while I stopped noting my riba doses, I diligently recorded every injection of Peg, Procrit and B12, with date, dose and the exact location of the the injection znd sometimes with notes.  This came in very useful. I can still remember one or two times when I woke up in the middle of the night panicking that I forgot my injection a few days earlier, only to be reassured by the book that I did indeed do the injection in my left, upper abdomen.

-- J

[jmjm530]

I believe the package insert tells you just to forget it and move on -- but I always made up any perceived missed dose either at the next dossing or by dividing up the missed dose or the next couple of dosings. Depending on how much you take, if you double the next dose you may get a bit of a "rush", but if you spread it out over the next 2-3 dosings you probably won't. At least that's how it went down with me. Ribavirin has a very long half life -- 14 days I think -- so in theory, missing a dose should have almost no effect on serum ribavirin levels if you make it up within the next day or so.

[Myown]

I'm with you on this. Some things are just common sense to me. Common sense is sometimes not used at a doctors office. There has to be a 'peak' in any med and a 'drop'. I know they say riba builds up in the system, but as far as I am concerned there still has to be a peak and a valley that's why some get the jolt from the riba when they first take it and cannot sleep.

To me alot of this tx is based on guessing and we sometimes just have to follow what  feel after reading and asking alot of questions.

The medical world lost my full attention when they made the statement that anal sex is more apt to put you at risk and they assume vaginal sex is not a big risk.

Well whats the reason anal sex is 'high risk?" Tares. Tight=tare. IMO so many women whose husbands are carriers do not get infected because they are not "tight" cause they gave birth several times. Well what about the women who didn't give birth and if their husband is infected?

Plus to me it also means that the virus is transmitted from the mans body fluid because anal sex might make the 'receiver' tare and bleed, but the guy is not dripping blood from his penis, so then it has to be in body fluid IMO. As far as middle Eastern studies and the wives not having the virus but the husband does, did they examine the husbands girlfriend? Not to sound rude, but I wouldn't do a study based on a culture where there are 'arranged marriages.' Sex once a year to have a child, that does lower your risk factor. But thats just my opinion. And of course I think I'm right. lol

[ladybug52]

Is tare the same as tear? :) Since I have perfect spelling and English and never make typing errors, I wanted to give you a hard time. Take care. Did you see my post to you re: your prayers skills/talent/gift? It was awhile back on someone else's thread.
Bug

[Myown]

I'm an absolute horror at spelling,,,your supposed to cut me some slack! ha! I guess I am in the wheat and tare mind-set of the bible.

Ya know its funny and I can't totally blame the riba, but there are times I know I am not only spelling words wrong but "using the wrong words", little ones too, and my mind can't figure out is it the wrong word or is it my mind? Then after I hit post and read it, I say OMG what the heck did I type.

Do you remember that comedian Norm Crosby who used words wrong. I used to think he was funny, now I probably wouldn't get the joke cuz I use words wrong all the time now ha!

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I never saw the post you mentioned. Where?  

[ladybug52]

Community, bleeding cramps in stomach from Sfbaygirl. can definitey identify with that feeling of something not right but can't figure out what. I drove off w/o my debit card yesterday fro a drive thru. New I was missing something!

[Myown]

thanks bug, I didn't see it before. I answered you in the community. Its on pg 2.

[Cindy10]

I too use a log book for me and hubby, pain but neccessary. I could not keep track if we took them and when, so I write it down.