Double Dosing Peg

[ladywhy]

Anybody doin' that now...besides meself?
If you were or are...did dr. recommend injecting back to back or 2x a week? I think I remember someone sayin' they were doin' back to back...whereas I inject Tues and Fri. I am just wondering/concerned about this now....
y

[WriteItDown]

First of all please note that this thread is a year and a half old, so the original participants probably aren't around to answer anymore....

That being said, don't worry -- the double-dosing doesn't apply to you.  People (Geno 1s, mostly) who have had a hard time succeeding with standard treatment sometimes take higher doses of the meds in an attempt to really blast the virus.  

You are taking 1 injection per week, which is the normal, standard dose, and what the vast majority of patients take.

[becksta29]

i was just wondering why i am only on 1 injection per wk,im on pegasys 1.35mcg/0.5ml,i am geno type 3a and just wondering if you guys have like 1a,i would like to know why 2 is needed.

[ladywhy]

Thank you...truly, for giving me better understanding.
I hope whatever you do, you have a nice weekend.
y

[CockSparrow]

Wish the text would stop disappearing. Makes it hard to follow the thread.

[CockSparrow]

Sorry about the misunderstanding on taking Pegasys twice a week hurting. Its based on the different Pharmokinetics of the drugs.
Pegasys peak serum concentration occurs on days 3 and 4 after the injection.
At the end of the week Pegasys has around 40% of the drug still in your system. This is why Pegasys takes 6-8 weeks to hit steady state.

PegIntrons peak serum concentration occurs on days 1 and 2.
PegIntron only has about 10% and in some cases less of the drug by the next injection.
Both drugs have an initial peak at around 4 hours after the injection.
These peaks coinside with any IFN side effects you experience.

So having a midweek shot of Pegasys means you will have the initial 4 hour post injection peak sitting on top of the day 3-4 peak with Pegasys.

So what i meant in saying that this would hurt was that your side effects would be much worse doing it this way than taking both shots at the same time. If you could tolerate the sides it wouldnt be a bad way of taking it, as it would mean that your serum concentrations of the drug would quite high, but it is the cycle of high the low serum concentrations that impact the side effects.

Taking PegIntron twice a week levels out the serum concentration of the drug meaning more stays in your system to do its HCV killing. Taking both shots at the same time gives a high initial peak then drops off towards the end of the week. You would have more than 10% left but maybe not double.
Twice a week is probably a better way to go.
Cause you could always double DoubleDose if you know what I mean.

Now Pegasys is better taken with both injections at the same time, as this will minimize the Sx but there have been good results with Pegasys taken every 5 days, so once again you could combine both strategies.

I have some studies on the high dosing but I wont have time to look for them before the weekend.

Hope This Helps
CS

[ladywhy]

Yep, I've been DD since my 25 week now going into (I really don't know 4sure) 40 odd... It's quite the trip.... Thanks for your support, prayers and hope!

I love Cocksparrow saying it could hurt more than help...w/o supporting that with some data.!!!! I rarely post my medical/tx issues just because of feedback like his...it can cause serious anxiety...and too much zanax :{ It was a Friday night that I posted...what did I do? Did back to back...and have been deathly ill until today. I'm sticking to 2x a week until I hear something more concrete.

[Lady Lauri]

hepatitisresearcher is probably lost in the post also, as we are...or may never see this!

Can't help with your questions, didn't realize you were double dosing or missed the thread. D*m, feel bad for you :{ and praying/hoping it works for you! You sure do post well for all this you must be feeling.
  Just sending good thoughts.......LL

[ladywhy]

I have been trying to find info...from Roche...studies..reg. recommending back to back pegasys.
Can you people help?
My np asked to see some data

[ladywhy]

Do you have an opinion?

[cruelworld]

like all of this, many docs disagree about "what is best".  it appears that any dosing strategy can be justified for various reasons.  this is an ongoing argument in medicine
and not always easy to prove which is best for a certain situation. i would hope that generally the better docs will keep trying different things until something works.
you have been through so much, the docs may not want to push you too hard.

[ladywhy]

Does anyone have Dr. Cecil's e-mail address handy? I'd like to float this by him as well over the weekend and attempt to find out why they have me doin' it in a way that is possibly less effective...
This has me again very concerned...

homicidal ideation is not so improbable now.... (j/k kinda...)

[ladywhy]

Thanks all for your input.
Of course, now I wonder if the NP gave me he wrong info., and here I am possibly doing it wrong all along....for what 16 weeks??!!!. YIKES
Like I said on MyOwn's thread..this experience of dealing w/dr/np/tx/hepc has been like a "Twilight Zone" series.
no kidding.....
Have a nice weekend everyone...
y

[cruelworld]

i think the story goes like this

1. dose together = "blitzkrieg", or heavy pulse effect, good to push through an apparent barrier which you may have. achieves highest concentration at once for the shorter time frame. downside, its hard on your body and more dangerous.
a standard medical approach.

2. staggered dosing = more even and unchanging concentrations in your system.
no large spikes of drugs hitting all at once. no big pulse of drugs to push through a barrier. hypothetically easier and safer on your system. hypothetically less effective
for highly resistant problems.

[CockSparrow]

With Pegasys you wouldnt want to inject the 2nd shot mid week. Why? because this is when its at it maximum serum concentration. It would more than likely hurt somewhat.

With PegIntron you could take the 2nd mid week and is probably a better regime than having both injections on the same day.
CS

[NYCMark]

I did doubledose Pegasys back to back for 12 weeks.
Did it work for me? 3 month post treatment blood test coming up shortly.

Mark

[jmjm530]

I believe the common protocol, at least with Pegasys, is to do the two injections on the same day, one right after the other. That is how I was instructed by my doc when I double-dosed very early in treatment. On the other hand, I've heard (not from a doctor) that some have injected Peg Intron in a fashion similar to yourself. The idea here being that Peg Intron may start running out earlier than day 7.

-- Jim

[FlGuy]

When I did it (first 4 weeks of tx #2) it was two Pegs on the same shot day - left and right abs.  Worked for me.