Aa
importance of HCV meds on time?
I was wondering if if anyone know with peginterferon and rebatol how important is
to take them on time.
I' m supposed to take rebatol every day and nite at 9.30
but sometimes I take 'em an hour late...is it a big deal?
to take them on time.
I' m supposed to take rebatol every day and nite at 9.30
but sometimes I take 'em an hour late...is it a big deal?
Regarding "rates" -- what I meant to say is that some of the numbers are different in the German study but overall both studies support each other.
I agree that consenss interferon (consensus) should be on the table as a first treatment for geno 1's, especially those with a number of pre-tx negative predictive factors. Why more studies haven't been done by it's manufacturer leads me to some very paranoid conspiracy theories akin to a collusion among drug companies to "split the pie." i.e. BIG DRUG COMPANIES TO LITTLE DRUG COMPANY: Give us first shot at tx and all the big bucks and we'll give you the leftovers. LOL.
Re: European response versus American, it's a fascinating subject and I wouldn't be suprised if living here (enviromental) is as important as genetic. But still, the numbers aren't drasticlly different and we can stil extrapolate from the European studies. Japan is a different animal with a distinct different ancestry so that may be comparing apples to oranges.
-- Jim
I agree that consenss interferon (consensus) should be on the table as a first treatment for geno 1's, especially those with a number of pre-tx negative predictive factors. Why more studies haven't been done by it's manufacturer leads me to some very paranoid conspiracy theories akin to a collusion among drug companies to "split the pie." i.e. BIG DRUG COMPANIES TO LITTLE DRUG COMPANY: Give us first shot at tx and all the big bucks and we'll give you the leftovers. LOL.
Re: European response versus American, it's a fascinating subject and I wouldn't be suprised if living here (enviromental) is as important as genetic. But still, the numbers aren't drasticlly different and we can stil extrapolate from the European studies. Japan is a different animal with a distinct different ancestry so that may be comparing apples to oranges.
-- Jim
I would have done consensus interferon, had I known it was even superior in geno 1 response.
to your last question, I noticed that quoting of those studies "out" there also, but, I have found the confirmation "here" also.
I do agree that if I was looking to grasp at any straw, I would use whatever study in whatever boondock country I could find. As a matter of fact, I did. But that study was confirmed over here also.
The US has unique creatures, as seen by the last national elections.
It might not be the meds or the virus, but maybe we have mutated from our original ancestors. It is just reassuring to see the confirmation with us, that is all.
Did you mean to say the SVR rates?
to your last question, I noticed that quoting of those studies "out" there also, but, I have found the confirmation "here" also.
I do agree that if I was looking to grasp at any straw, I would use whatever study in whatever boondock country I could find. As a matter of fact, I did. But that study was confirmed over here also.
The US has unique creatures, as seen by the last national elections.
It might not be the meds or the virus, but maybe we have mutated from our original ancestors. It is just reassuring to see the confirmation with us, that is all.
Did you mean to say the SVR rates?
LOL. You are one persistent lady. :) THE RELAPSE RATES WERE IDENTICAL WITH THE SHORT-COURSE VERUS LONG COURSE IN THOSE THAT WERE NON-DETECTIBLE AT WEEK 4. Forgive the "shouting" but it gets frustrating to see you continually miquote the study which by your own admission you haven't read in it's entirety. It was the Italian Study in answer to your question.
Regarding the mentioned German study -- the rates were somewhat different but so was the drug -- they used Pegasys verus Peg Intron for the Italian. They also found that for geno 3's, pre-tx viral load played a factor.
Not just from these studies, but from other reading and discussions, I've come to the unprofessional conclusion that overall Peg Intron is the better drug for most of us. I'm taking Pegasys like most of us because that's what my medical team recommended.
One quesiton. Why is it that every study that goes against what you appear to believe must be "repeated" in America by "independent" researchers but you often refer to studies supporting your opinions that don't meet this criteria. :)
Well, turns out my derm appointment isn't for two hours -- I am truly losing my mind from these drugs.
All the best.
-- Jim
Regarding the mentioned German study -- the rates were somewhat different but so was the drug -- they used Pegasys verus Peg Intron for the Italian. They also found that for geno 3's, pre-tx viral load played a factor.
Not just from these studies, but from other reading and discussions, I've come to the unprofessional conclusion that overall Peg Intron is the better drug for most of us. I'm taking Pegasys like most of us because that's what my medical team recommended.
One quesiton. Why is it that every study that goes against what you appear to believe must be "repeated" in America by "independent" researchers but you often refer to studies supporting your opinions that don't meet this criteria. :)
Well, turns out my derm appointment isn't for two hours -- I am truly losing my mind from these drugs.
All the best.
-- Jim
You can find a snippet of the Deutchlander Study here and probably more detail elsewhere. http://www.hcvadvocate.org/news/newsRev/2005/HJR-2.14.html
which was the study with the 12 wks v 24 for geno 2-3? That was the one with the higher relapse rate after 6 mo post tx.
These results seem different...still...no american subjects.
These results seem different...still...no american subjects.
I take a daily pill called aciflex now. It's really for acid reflex I think. It helps with the nausea. Also, I got a syrup called Ginger Wonder from the health food store. A spoon of that once in a while seems to maybe help, too. Between these two, I have little problems. Thought it might help. Good luck.
BTW - Others have said ginger may be a bad idea. As it turns out, the Dr office that was quoted as saying it's a problem, is the very office that told me to take it (though not the specific product I'm using) - so I don't worry. I only use it once in a while.
BTW - Others have said ginger may be a bad idea. As it turns out, the Dr office that was quoted as saying it's a problem, is the very office that told me to take it (though not the specific product I'm using) - so I don't worry. I only use it once in a while.
I try to take them 12 hours apart religiously but on Saturday sometimes I just don't wake UP until like noon ... no matter what I do, alarm clocks everything. Can't do it.
So then it's more like 8 hours apart cause I try to take them with meals too - even if I can't EAT with a smoothy (as I learned in here) or something.
You do the best you can. Sometimes I'm nauseaus and worry I'll just throw them up so i wait. Not much I can do about THAT either.
I'm glad it's just really a matter of getting them in there. Saturday's for ME are just too rough to worry about 12/12 at this point (wk 5/48) arleady!
So then it's more like 8 hours apart cause I try to take them with meals too - even if I can't EAT with a smoothy (as I learned in here) or something.
You do the best you can. Sometimes I'm nauseaus and worry I'll just throw them up so i wait. Not much I can do about THAT either.
I'm glad it's just really a matter of getting them in there. Saturday's for ME are just too rough to worry about 12/12 at this point (wk 5/48) arleady!
Yeah, I started munching the gravel too, whan I saw how it helped the chickens. Works pretty well, but I always regret that second cup of java now!
I always tried to take my riba exact time everyday,,,,I pretty much did everything by the book to give me best shot at SVR.
Lauren,,,So glad you checked in and wow! Do you ever have alot on your plate....Take care and try to slow down your pace while on tx,,,,You are at the halfway mark and try to do the bare necessities or get some help while moving. Best Wishes!
Lauren,,,So glad you checked in and wow! Do you ever have alot on your plate....Take care and try to slow down your pace while on tx,,,,You are at the halfway mark and try to do the bare necessities or get some help while moving. Best Wishes!
Cleansliness. Maybe that explains the last week's exile to the doghouse. Toonie? Hmmmm..... cartoon maybe?
Ah. I see now. Gravol - not the same, is it?
Ah. I see now. Gravol - not the same, is it?
yes, cleanliness is next to godliness, whatever that means lol
a toonie is part of the Canadian currency, it is a 2 dollar coin...a loonie is a 1 dollar coin! there are no paper currencies here under 5 dollars...
very pretty money too...the loonies are brass in colour and the toonies are brass in the middle and silver surrounds it...
*gimme da cash dip*
a toonie is part of the Canadian currency, it is a 2 dollar coin...a loonie is a 1 dollar coin! there are no paper currencies here under 5 dollars...
very pretty money too...the loonies are brass in colour and the toonies are brass in the middle and silver surrounds it...
*gimme da cash dip*
Just to expand on what Goofy said, my understanding is that it's the serum ribavirin level that determines the efficacy of treatment.
In Sweeden, they actually measure the serum ribavirin level through special blood tests not available here. Using those results, several studies have shown a direct correlation between serum ribavirin levels, anemia and SVR. So in this sense, anemia becomes a positive predictor for SVR.
It takes about 2 to 4 weeks to reach maximum serum riba level with a constant daily dose. (And conversely about the same time for serum levels (and Hgb) to drop if riba dosage is reduced.) With such a long half life, the timing of the dose each day becomes inconsequential, or so I am led to believe by those that should be in the know.
As Goofy says, taking your ribavirin with a good meal is more important than spacing it 12 hours apart. In fact, studies suggest that the the bioavailibility of ribavirin can be increased up to 70% if taken with a high fat meal. And while the clinical significance of this has not yet been studied, where I come out is to take my riba with the two biggest meals of the day, regardless of what time I eat them.
-- Jim
In Sweeden, they actually measure the serum ribavirin level through special blood tests not available here. Using those results, several studies have shown a direct correlation between serum ribavirin levels, anemia and SVR. So in this sense, anemia becomes a positive predictor for SVR.
It takes about 2 to 4 weeks to reach maximum serum riba level with a constant daily dose. (And conversely about the same time for serum levels (and Hgb) to drop if riba dosage is reduced.) With such a long half life, the timing of the dose each day becomes inconsequential, or so I am led to believe by those that should be in the know.
As Goofy says, taking your ribavirin with a good meal is more important than spacing it 12 hours apart. In fact, studies suggest that the the bioavailibility of ribavirin can be increased up to 70% if taken with a high fat meal. And while the clinical significance of this has not yet been studied, where I come out is to take my riba with the two biggest meals of the day, regardless of what time I eat them.
-- Jim
My feeling, and that of my treatment nurse, is that a good meal is more important than the 12 hour cycle. I don't worry about moving an hour or so one way or the other. Based on some discussions here, I'm probably a bit more dilligent now, in my 6th week (hey, look at that - time to carve another notch in the thigh), than I was earlier. I actually now believe timing is more important in the first few weeks as you're building your serum levels.
On the peg, again my personal feeling, and to some degree corraborated by the nurse, is that not everyone can matabolize at the same rate. So while reasonably even spacing throughout the tx is sensible, an hour or so here and there doesn't make a hoot. One hour is less than 6/10ths of one percent of a week - we can't all be calibrated that closely - can we?
These are just my thoughts.
Hi Ina. How ya feeling? Seems that for every 10 hour dosing we'd need a 14 (or at least a couple 13s) to get back on track, yah?
On the peg, again my personal feeling, and to some degree corraborated by the nurse, is that not everyone can matabolize at the same rate. So while reasonably even spacing throughout the tx is sensible, an hour or so here and there doesn't make a hoot. One hour is less than 6/10ths of one percent of a week - we can't all be calibrated that closely - can we?
These are just my thoughts.
Hi Ina. How ya feeling? Seems that for every 10 hour dosing we'd need a 14 (or at least a couple 13s) to get back on track, yah?
To those of you who suffer from the "I know I am gonna heave and never do" syndrome, here's what I take....
It's called Gravol...I think it is the Canadian equivelant for a motion sickness pill in the states...It's a wonder drug!
I have had nausea off and on for a couple years, always thought it was from a nervous stomache...But now, like every ache and pain I have, it HAS to be HCV related!!...lol
I started taking Gravol only a few weeks ago...It was given to me in the Hospital when I had my bx, it was mixed in the demerol shot...The Nurse said it helps with the vomiting some people get when given opiates...So I bought some and it works! It's incredible, it works in just a few minutes, very safe, liver friendly...
Which reminds me, I have to go out to the pharmacy and get some more...I am going to a George Jones concert tonight and do not want to puke on the possum!!
*good gut dip*
It's called Gravol...I think it is the Canadian equivelant for a motion sickness pill in the states...It's a wonder drug!
I have had nausea off and on for a couple years, always thought it was from a nervous stomache...But now, like every ache and pain I have, it HAS to be HCV related!!...lol
I started taking Gravol only a few weeks ago...It was given to me in the Hospital when I had my bx, it was mixed in the demerol shot...The Nurse said it helps with the vomiting some people get when given opiates...So I bought some and it works! It's incredible, it works in just a few minutes, very safe, liver friendly...
Which reminds me, I have to go out to the pharmacy and get some more...I am going to a George Jones concert tonight and do not want to puke on the possum!!
*good gut dip*
I am seriously starting to worry about you sir! You have gone from goofy to out right goofiest!!! eating gravel, sheesh! L'goof is gonna think that eating dirt is okay and how the heck is his mother gonna keep him clean!!!
*dip a roonie*
Just my toonies worth...(oh forgot, you may not know what toonies are)
*dip a roonie*
Just my toonies worth...(oh forgot, you may not know what toonies are)
It's nice to hear from you. Moving is a big undertaking when all is normal so I imagine it's especially so during tx. But I figure you are up to it. I wish you good luck with your PCR. Take care of yourself. Mike
Hi all you lovely people,
I have missed you all, but have not had time to even read, let alone post. I recently bought a house and moved (Rev, I know you said not to while on tx, but the right place came along, and I had to go for it.), I am on 24/48, and awaiting the 24 week pcr results. (45 yo F, Geno 1B, 647,000 vl) I have so much going on- a four year old, FT job, moving, etc... but I thank God I am managing! I miss you all dearly. I want you to know I'm still around. Will be back in commission soon.
Lauren
I have missed you all, but have not had time to even read, let alone post. I recently bought a house and moved (Rev, I know you said not to while on tx, but the right place came along, and I had to go for it.), I am on 24/48, and awaiting the 24 week pcr results. (45 yo F, Geno 1B, 647,000 vl) I have so much going on- a four year old, FT job, moving, etc... but I thank God I am managing! I miss you all dearly. I want you to know I'm still around. Will be back in commission soon.
Lauren
You should try and take the Peg shot the day it is scheduled.
Ribavirin, however has a very long half-life, so the trick really is just to get your daily dose in whenever you can. I was told by two NP's, one doctor and one riba researcher that the timing of the ribavirin didn't matter as long as you get the proper dose down the hatch every day.
Personally, I take my ribavirin with my two largest meals, which some studies suggest helps with riba absorption. Sometimes that means I take them 8 hours apart and sometimes that means as little as four hours apart. I was actually told by my doc that I could take all six pills at once if I wanted. However, the one or two times I did so (by accident) I got a bit too much of a "rush".
-- Jim
Ribavirin, however has a very long half-life, so the trick really is just to get your daily dose in whenever you can. I was told by two NP's, one doctor and one riba researcher that the timing of the ribavirin didn't matter as long as you get the proper dose down the hatch every day.
Personally, I take my ribavirin with my two largest meals, which some studies suggest helps with riba absorption. Sometimes that means I take them 8 hours apart and sometimes that means as little as four hours apart. I was actually told by my doc that I could take all six pills at once if I wanted. However, the one or two times I did so (by accident) I got a bit too much of a "rush".
-- Jim
I think 12 hour intervals would be best, but due to brain fog and changing sleep habits( I am on full time disability since week 10 ),it hasn't worked that way for me. I haven't missed a dose but have been more than 1 hour off on quite a few occassions.
I tried to do the 9AM and 9PM, but I sometimes do 7:30 - 8PM and 8:30 - 9:30 AM or somewhere in between. There have been a two times where I was about 8AM and 11:30 PM. Once I was 7:30 AM and the next was at 1 in the morning. I was clear at 4 weeks and 12 weeks. I am now at week 21/48 and my ALT is lower than it was at 12 weeks, my next viral load is at week 24.
Good Luck
I tried to do the 9AM and 9PM, but I sometimes do 7:30 - 8PM and 8:30 - 9:30 AM or somewhere in between. There have been a two times where I was about 8AM and 11:30 PM. Once I was 7:30 AM and the next was at 1 in the morning. I was clear at 4 weeks and 12 weeks. I am now at week 21/48 and my ALT is lower than it was at 12 weeks, my next viral load is at week 24.
Good Luck
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