Question for a friend of mine, REALLY!

[susan400]

I have a friend who has just started off on her first treatment. Now, as all of you know, I am not treating and I have been off of treatment for 1 year now.  This friend picked up her Ribavirin and had started taking it.  By the time that I spoke with her, she had been on treatment for one week.  She told me that she had been taking the Riba all at once.  I asked her..., what did her prescription bottle say on it?  She told me that it said take 5 Riba's a day, nothing about dividing the doses.  So, she'd been taking all 5 at once.

Has something changed recently with the way that doctors instruct their patients?  On ALL of my 10 Tx's, I was ALWAYS instructed to take the Riba in divided doses..., either 2 in the morning and 3 at night, or 3 in the morning and 2 at night..., it was my choice on whether I wanted to have my 3 in the A.M. or PM dose, but divided nonetheless.  Now, I'm wondering, if I'm telling her wrong when I told her to double check with her Dr. and Pharmacist on dividing the doses.  I was always told that you needed to divide them in order to keep an even level of the Riba in your system, AT LEAST at the very beginning when your waiting for it to build up in your system.  It was this way for me even as recent as last year when I was in the last trial.  

I'd appreciate some of your responses and let me know how your doctor instructed you.  I did get her to sign up here at Medhelp and I believe that she'd read your responses, even if she doesn't post.  I'm trying to be as supportive of a friend to her as I am able to and to provide her with as much accurate information as I can.  

Thanks, all.  

Susan400

[Lady Lauri]

Hi Susan!! Good to 'see' you.

Yep, same here. Taken in two doses. Many of us here got insomnia from it so we took the larger amounts in the am (3 am, 2 pm, etc.) I was 2 am, 1 pm by the end.

She needs to have her Dr. check this out more if he still feels 5 at once.

Hope all is well, LL

[frijole]

I agree with HCA.  Overall, the goal is for the ribavirin to reach a maximum serum level in the blood.  Once there, that level stays constant throughout treatment.  I took mine, split in the morning and evening.   When I missed a dose which was rare, I took additional pills to make up the missed dose.
frijole

[HCA]

The split dosing is purely to avoid tummy trouble as someone has already said.
Wolfing 'em all down at once won't make the slightest difference to the treatment or it's outcome.

[Isobella]

Sorry, Susan for my mis-information.  So much for my understanding, lol!

[Rockerforlife]

Ribavirin comes in 200 mg tablets or capsules. The approved dose of ribavirin when used with Pegasys is 1,000-1,200 mg (5-6 tablets) daily, split into a morning dose (2-3 tablets) and an evening dose (3 tablets). The actual dose is based on body weight: people who weigh less than 165 lbs. take 1,000 mg daily, and people who weigh 165 lbs. or more take 1,200 mg daily. People with genotype 2 or 3 only need 800 mg daily, split into a morning dose (2 tablets) and an evening dose (2 tablets), regardless of weight.

http://www.atdn.org/simple/riba.html

[lapis]

I was also told to divide the dose.  Dug in my stacks, found this:

"Take COPEGSUS 1 time in the morning and 1 time at night (2 times a day).  Take COPEGSUS the same 2 times each day.

If you miss a dose of COPEGSUS and remember the same day (bolded letters), take the missed dose as soon as you remember.  If the whole day has passed (bolded), ask your healthcare provider what to do.  Do not take 2 doses at the same time."

copied from the Roche Medication Guide for COPEGSUS

[Isobella]

It was my understanding that they split it into 2 doses to lessen the tummy troubles.  If she isn't having any trouble with it, I don't think it's a problem to take them all at once.  We had a member here, possibly Rita that was taking them all at once, maybe send her a note/pm and ask her.

It was also my understanding that if you do split the dosing, do the larger in the morning so you aren't so speedy at night.

Towards EOT I took them all together a few times with no problems....until I took 8 by mistake....not good.  Paid for a few days.

[susan400]

THANKS, JD for your quick response.  I'm hoping that she comes on and reads.  I told her I was going to post it for her.  Susan400

[jdwithhcv]

My doc said take it 1/2 in the morning and 1/2 in the evening.  I'm pretty sure I could not hold down 5 or 6 ribas all at once, no matter what I ate beforehand.  That's a lot for the stomach to handle!