What to do about a missed dose?

[roaming]

Hubby realized yesterday that he missed tues. night dose of riba. We think the coordinator told him at the beginning that if that happens just to continue as normal and not to worry about it. I have heard some of you make it up by taking extra. Is that what your dr told you to do? I told hubby that and he took an extra one last night. Probably wont today because today is shot day.

[sfbaygirl]

I missed a few doses and made them up early in tx. I took one extra a day. On vacation (after 12 week PCR) I missed my morning dose and didnt' make it up. I never asked the dr. about this, so you should check with them, but I had no problems with making them up, except when I took 4 instead of three. That hit me a bit hard!

[NYgirl]

Roaming

Since it's so far afterwards...just take the regular dosage today.

When I was new I went out and bought an AM/PM pill container so I couldn't forget.  It's very crucial not to miss any of the meds - especially in the beginning.  With the riba, once you've been on it for a while you build up the serum level we've been talking about so it's not as bad as missing the shot - but in the beginning...it's the most important thing you can do.

I'd advise you to get the pill container ASAP so you can't forget.  Make  a sign and put it on the fridge or something...that's one place that everyone always seems to have to go every day a couple of times, LOL.

[GrandOak]

Given what I've heard on Riba, I would recommend consulting with doc before making up missing dose.

The PI for CoPegus reads that if you miss a does "and remember the SAME DAY, take the missed dose as soon as you remeber. If the WHOLE DAY HAS PASSED, ask your healthcare provider what to do. Do not take 2 doses at the same time".

For Rebetol, I could not find any similar there, but it does have a disclaimer that there is "limited experience with overdosing".

[NYgirl]

Rebetol IS Riba.

Same same.  Don't make it up at this late point - there is no sense - none at all.

And taking ANY EXTRA riba can lead to WORSE complications with Anemia.  Plus at this point it just doesn't make any sense to take it at all.  He should already have TAKEN another dose by now - one in AM and one in PM so the meds are ALREADY on board.

[jmjm530]

Whenever I thought I missed a riba dose I always made it up by either doubling up the next time, or spreading the missed dose over the next day or so. My rationale was that riba has a very long half life, building up its level in serum over time -- and therefore the timing of the dose is less important than maintaining full dose.

But as GrandOak states, the standard protocol is to just let the missed dose go and I imagine most doctors would tell you the same thing.

All the best.

-- Jim

[roaming]

thank you all for your response. Like I said it was yesterday morning (wed) that he realized that he forgot to take it tues. night. He already takes 7 a day now. 4 in the morning and 3 at night. He took an extra one last night and seemed to feel it with in a half an hour. I felt so bad for him. And the thought of anemia went though my mind also because he has dropped to 10.8 and feels like **** now. He will do 23 tonight of 48. It is starting to get to him.

[Dale_Ray]

I haven't missed a dose that I am aware of and aware being the key phrase but my doctor told me the same as your husbands. Just pick it up at the next dose and don't worry about what you have missed. I double dosed last week just before bed and that was an interesting night. I don't think I will do that again. The daily dosage container do help if you can remember what day it is or if it is am or pm. Good luck to you guys. Dale

[roaming]

I hate to say it but he has 2 of the daily dose containers, one for work and one for home. It may have been brain fog. He remembers telling himself to go get it that night and that was it.

[cajunlady]

I would not panic over the missed dose.  I thought I missed a dose right at the beginning of tx and like you I saw that some of the people here would make them up.  I did not make up my dose and I still was UND at 12 weeks.  And, I just missed another one the other night, just fell asleep and did not get up til morning.  I just continued with doseage the next morning.  Thats twice now, and all is fine.  I figured it was hard enough to keep the cbc's in check and I did not want to add to that by an increase in dose.  Doctor said, that what I did was just fine, but try not to miss.

Oh!  I have one of the cases to hold my pills.  Sometimes, I think brain fog takes over and we just don't remember.

He should be fine, but it would not hurt to let the doctor know and get his feedback. I'm sure he will say things are okay.

How are you doing, and how is hubby handling tx.  It is not easy, by all means.  Where is he with the shots.  I do 34/48 tomorrow night.  Getting Close, Getting Close.  Can't wait.

I wish you and your husband the best.

Lanette

[NYgirl]

He can tell the difference of taking an extra Riba?????

Than for God's sake DONT!  I mean really - since it says not to make it up, I surely wouldn't if especially he is having such an incredibly strong reaction as that!

I can't even TELL I take them at all, except for the not being able to sleep and the sides - and I'm so glad to be down one pill a day now after 48 weeks...and I can't even tell, its just the thought!

I don't know how he will manage the anemia if he feels that bad over one lousy Riba.  PLEASE don't let him take ANY more than he HAS to or you are going to be run absolutely ragged.  And you are too good a wife and too loving for that.

Riba doesn't generally cause problems like that as far as i  know, in fact I started them in advance of the shot and the doctor told me aside from being a bit speedy at night I wouldn't have any problem whatsoever.

so be careful not to let him take anymore than he needs!!!!!!!!

ARGH!

[Dale_Ray]

Poor guy! I can relate though. I gave my wife a present of a 200lb baby when I started treatment and now she follows me around did you take this, where is you syringe, why are you scratching yourself, your pants are on backwards. Without good women where would we slobs be? Get a sling shot and wait for him to yawn:) Dale

[GrandOak]

I understand that Rebetol is Riba, so is Copegus.  Those are the brand names Schering and Roche, respectively, have place upon their version of Ribavirin.

As for myself, I actually use a generic version of Riba from a different pharmacutical company, whose name I do not have at hand right now.

But I compare and reference the PI for Rebetol and Copegus when looking for information pertaining to Ribavirin as the information I found on line for both of them was the most complete.

[roaming]

Thank you all for your comments. And yes he does feel an effect from the riba. He just took his regular nightly dose about a 1/2 hour ago and he says he is starting to feel it. I read most of the comments to him from here and I think it does make him feel not so alone. But I still can't get him to come here and read for himself. In all honesty, he is not much of a reader unless he has to or it is a motorcycle magazine.

Dale - he definitely got a chuckle out of your comments.
Cajunlady - I can't believe you are that far. It seems only like a little while ago you were have problems with the anemia and I believe ringing in the ears. (I hope all of that is better) Thanks for asking about him. He does 23 tonight out of 48. So almost half way there.

Oh one more question that I didn't see and answer to. Has anyone had problems with dry eyes. Talking to him again tonight he says it is only one and almost feels more like pink eye. I hope it is just dry eye and he didn't pick something up.
Hope everyone is doing go and feeling better.

[Kalio1]

I hate that stupid dry eyes thing! Drives me nuts, I love to read and it really gets in the way. I had some sucess with those eye moistening products but ask the pharmacist which ones are the best, some arent that great I hear. I did go see a eye doc and he gave me some super duper drops that help some the OTC stuff worked about as well I think. He said the IFN is the cause of the dry eye problem and it causes what he called "little holes" in your eye, which is why they are dry, maybe he should see an eye doctor to get a good look at his eyes and make sure al is well.My opthamologist said they DO go away when the IFN is stopped. Too much dry eye isnt good so he needs to use something to keep them moist.
High five your husband for me! He is almost half way through now that is great! It will be over before you know it! He is so luky to have such a caring sweet wife.

[roaming]

thanks for the post. To the drug store again. I went today for the malox/benedryll but forgot the eye moisturizer. I was wondering if the otc stuff was ok. Thanks again for the reply.

[OnAPrettyPoison]

I got dry eyes on treatment myself.  First the eye doctor had me using "Systane" and after awhile I had to graduate to the prescription drops Restasis.  They do work great, single dose vials, real portable!  The dryness of EVERYWHERE on the body, especially skin and eyes is from the interferon.  Hope he does okay!  You just keep reading to him.

Dale Ray, you are a hoot!