Aa
reduction
is it normal for them to reduce the ribavirin? anyone please help me be ok with this...
I'm lol at how fast everyone jumped to reassure you. Many of us have been there and cleared the virus. It was scary to me! xo Karen:)
maybe not available to me cause im on medecaid. my doc hasn't even mentioned it. she insists there is nothing I can take! am so frustrated....wanna remain undetectable....
Thank you for your concern :-)
I know, or I should say, we -my hepatologist and me- already know it.
There are a couple of fatcs though that are also important to consider: firstly, the country were I am presently living do not allow the use of bone marrow stimulating drugs whilst in hep C treatment. Secondly, the treatment is working. "Is not recommended", "generally prohibited" are not absolute controindications. My doctor has treated more than 2000 hep C patients so far, double or triple tx. He has quite an insight of effects, side effects and reactions and he says that to develop a drug resistence is unlikely. I went so far to stop Victrelis altogether, having blood test twice a week, slowly increasing it to the actual 3 X 3. I am feeling well, my blood results are ok and my viral load dropped from 960000 to 291 @ week 8. It is not exciting? :-) I look forward to next test.
There is a topic of mine on this argoment somewhere :-)
I know, or I should say, we -my hepatologist and me- already know it.
There are a couple of fatcs though that are also important to consider: firstly, the country were I am presently living do not allow the use of bone marrow stimulating drugs whilst in hep C treatment. Secondly, the treatment is working. "Is not recommended", "generally prohibited" are not absolute controindications. My doctor has treated more than 2000 hep C patients so far, double or triple tx. He has quite an insight of effects, side effects and reactions and he says that to develop a drug resistence is unlikely. I went so far to stop Victrelis altogether, having blood test twice a week, slowly increasing it to the actual 3 X 3. I am feeling well, my blood results are ok and my viral load dropped from 960000 to 291 @ week 8. It is not exciting? :-) I look forward to next test.
There is a topic of mine on this argoment somewhere :-)
8.2.2 Anemia and Hemoglobin Analyses
In Phase 2-3 studies, anemia was managed with RBV dose reductions in accordance with approved RBV labeling. If RBV was permanently discontinued for anemia, telaprevir/placebo had to be permanently discontinued as well. Erythropoiesis-stimulating agents (ESAs) were prohibited from most studies, and their use was reported in only 1.0% and 0.8% of T12/PR and Pbo/PR subjects, respectively
Although premature discontinuation of RBV was associated with a decrease in SVR, RBV dose reductions and interruptions did not appear to adversely affect SVR rates.
8.2.2.2 Treatment and Management of Anemia
During the telaprevir clinical program, hemoglobin was monitored and RBV reduced in accordance with PEG-IFN/RBV prescribing information. If ribavirin was permanently discontinued for the management of anemia, telaprevir was also to be permanently discontinued. If telaprevir was discontinued for anemia, patients may have continued treatment with peginterferon alfa and ribavirin. Ribavirin could be restarted per the dosing modification guidelines for ribavirin. The dose of telaprevir could not be reduced and telaprevir could not be restarted if discontinued. In the telaprevir clinical program, erythropoietin stimulating agent (ESA) use was generally prohibited.
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/AntiviralDrugsAdvisoryCommittee/UCM252562
In Phase 2-3 studies, anemia was managed with RBV dose reductions in accordance with approved RBV labeling. If RBV was permanently discontinued for anemia, telaprevir/placebo had to be permanently discontinued as well. Erythropoiesis-stimulating agents (ESAs) were prohibited from most studies, and their use was reported in only 1.0% and 0.8% of T12/PR and Pbo/PR subjects, respectively
Although premature discontinuation of RBV was associated with a decrease in SVR, RBV dose reductions and interruptions did not appear to adversely affect SVR rates.
8.2.2.2 Treatment and Management of Anemia
During the telaprevir clinical program, hemoglobin was monitored and RBV reduced in accordance with PEG-IFN/RBV prescribing information. If ribavirin was permanently discontinued for the management of anemia, telaprevir was also to be permanently discontinued. If telaprevir was discontinued for anemia, patients may have continued treatment with peginterferon alfa and ribavirin. Ribavirin could be restarted per the dosing modification guidelines for ribavirin. The dose of telaprevir could not be reduced and telaprevir could not be restarted if discontinued. In the telaprevir clinical program, erythropoietin stimulating agent (ESA) use was generally prohibited.
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/AntiviralDrugsAdvisoryCommittee/UCM252562
"My hepatologist also reduced Beceprevir"
Dose Modification
Dose reduction of Victrelis is not recommended.
If a patient has a serious adverse reaction potentially related to peginterferon alfa and/or ribavirin, the peginterferon alfa and/or ribavirin dose should be reduced or discontinued. Refer to the peginterferon alfa and ribavirin Package Inserts for additional information about how to reduce and/or discontinue the peginterferon alfa and/or ribavirin dose
http://www.drugs.com/pro/victrelis.html
Dose Modification
Dose reduction of Victrelis is not recommended.
If a patient has a serious adverse reaction potentially related to peginterferon alfa and/or ribavirin, the peginterferon alfa and/or ribavirin dose should be reduced or discontinued. Refer to the peginterferon alfa and ribavirin Package Inserts for additional information about how to reduce and/or discontinue the peginterferon alfa and/or ribavirin dose
http://www.drugs.com/pro/victrelis.html
I think this is pretty normal. I am back to 800 mg of Riba after 6 weeks. My hepatologist also reduced Beceprevir, I am taking now 1800 mg (3 X 3).
Be confident, stay focused.
Best of all.
Laurie
Be confident, stay focused.
Best of all.
Laurie
Yes, it is totally normal to reduce the Ribavirin. Hubby's was reduced and held at 600 for him. Even his Pegasys shot has been reduced as well. The only thing they didn't reduce is his Incivek, but they added in Procrit, Nuepogen, and now another one for his platelets.
I can't wait for him to finish up his Incivek so maybe his CBC will stay up!
I can't wait for him to finish up his Incivek so maybe his CBC will stay up!
So you are only taking 400 mg per day? Can you not get Procrit to help with the anemia? What dosage were you on in the beginning before your Dr reduced? Sorry i dont remember your history.
You should rest if you're anemic, listen to your body. Hopefully your hgb will increase and they can bump your riba up again next week.
thank you...am so scared. im down to one and one. wanna go full force but don't seem to have the fortitude to eat.
It is not unusual for treating doctors to reduce ribavirin when a persons hgb drops on treatment and they become anemic.
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