i have a concern for meds being (peg and riba)decreased

[missy60051]

HI,
I've had a rough time for the last 15 weeks with sx.  Recently my riba was dropped to 800mg. and my pegasys has been degreased to 135mcg.  INterferon was dropped for the purpose to ease my pain and ribe because of hemoglobin dropped to 9.2.
The problem is I'm concerned with reaching svr.  My weight is between 135-140.
My pain did ease and my appetite increased enormously.  I've put on 7 lbs in one week.  I'm just concerned on the strength of meds doing mre justice.  I don't have Dr.s appt anytime soon and I thought maybe someone has experienced this or has knowledge on this subject.
Missy

[ladybug52]

Are you still an undetermined genotype? Sorry if you've already posted concerning any of this, but bear with me, I'm old, and didn't have a good memory to start.
Did your Dr. not want to try procrit for the drop in Hgb? Did they not want to prescribe pain meds to help with tx? I remember you asking before about what any of us used for pain.
When is your next pcr? what are the results of your earlier pcr's?
I know that you are doing appropriate dosage of riba for your weight, <65kg is 800mg, and at 140 you are at 63.6kg's.
So you meet that criteria. But do geno 1's go higher with the riba dosage? If they are txing you like a geno 1. I really don't know the dosage standard for anything but my weight and genotype. And have no idea for undetermined genotype.
Where's Jim??

BUG

[purplecat]

You've done the very important 12weeks at full dose? I have same questions as ladybug except if treated for geno 1 riba dose is normally 1000mg for your weight.  So if 800 is lower dose they are treating 48 weeks? How long have you been doing lower dose and are they checking blood weekly, to see if HGB rises.  Why no rescue drugs?  Are you UND and if so at what week?  Lowering dose can possibly lower chance of SVR.  How much depends and your answers.  IF UND early and lower dose only 1 or 2 weeks then only slightly.  This is something you have to discuss with your Doctor. If your doctor isn't making any sense, possibly you should seek another hepatologist opinion.  A few who have posted here did change and continued treatment with better managed care.  Orphanedhawk might comment on her situation, she changed Dr's.

My Hep Dr's are doing everything possible to treat my sides in every way so I do not have to lower dose. I've had more issues than carter has pills. Lowering dose is usually 2nd to last resort, last resort is having to discontinue treatment due to uncontrolable serious situation.  

Take care, hope things get under control so you can continue.  

[nygirl7]

Wondering why the doc wouldn't prescribe procrit instead of dropping the meds which is as you know usually the LAST resort and only done if absolutely positively needed.

Figure it this way I guess - it's better to have the meds decreased and be able to continue onwards to the 48 week mark than to have to quit at week 12.

At least you did them until week 12 right? Still, I'd be asking the doctor why he was taking chances with my SVR by doing so instead of trying to get the Procrit to work it through.

[missy60051]

to start I'm undetermined genotype,but am being treated as genotype 1.  The Dr. and NP wanted to try the decrease in riba before the procrit.  They stated that would be last resort.  I had test yesterday done ,so all I have to do is go up the street and pick them up.  I'm sure it'll be much better because I feel 100% better.  I'm just worried of the decrease interfering with me continuing to be UND and my chances of SVR.
Missy

[missy60051]

In the mean time every 2 weeks I get blood test to make sure I'm ok.

[missy60051]

so basically I have a legitimate reason for concern of the decrease interfering with my chances of SVR.

[missy60051]

Yes, I did clear.  I also asked about procrit,but they wanted to wait and see and
that would be last resort.
I just picked up labs.  I don't have a copy of my last,but I do know hemoglobin was 9.2.
Albumin            3.0
AST                39
TOTAL PROTEIN       5.9
WBC                2.1
RBC                3.8
HGB               10.0
HCT                30.
RDW                 15.9
PLT                66
SEGS               45
MONO               11

MISSY

[ladybug52]

I guess I always thought that when you decrease dosage, you decrease your chances, but I'm not your dr.
Lots of people do continue und with  a lower dosage,
Orphan Hawk is one. But she was given rescue meds to help her low Anc. Does your dr believe that Procrit is worse than maintaining optimum dosage, or carries some risk? I was happy to have the procrit rather than decreasing meds, or feeling so wiped out.
BUT, I always say it's up to the person on tx to make the choice that is right for them.
Good luck, I'm sure you're going to be OK, as long as you're getting the UND'S, it's all good.
Hugs, sounds like you need a hug,
Bug

[indyjo]

Hi Missy - Long time reader, but I rarely post. I was in the IDEAL study and had meds lowered because of low Hgb and platelets (no rescue drugs with study). I cleared at 12 weeks. I relapsed or had a break through..whatever it's called, between week 24 and 48 (did all 48 weeks). I was relieved to have dose lowered. Here I am now doing 72 weeks at increased dosages of each med. My NP is willing to prescribe to assist in sx management. She is working on Procrit for me now even though my Hgb is higher than 10. She anticipates that I will need it. I am taking pain meds, sleep meds, Provigal, and ADs. I feel that the Procrit and any other medicine that helps manage the sides is the FIRST line of defense. Course I might have relapsed even without the reduction. Who knows? But I am going down fighting tooth and nail this time around. Good luck with whatever you and your doc decide.