you have to space your riba about, morning and evening. i take three am and four pm.
i'm no expert but it seems right in there, in terms of dosing.
drink a LOT of water. i drink about five or six one liter bottles every day and then some.
lol did I actually type a "log" of water? My mind is already gone and I haven't even started the tx yet...
Sounds like you're on weight based ribavirin, which is good. 1000mg should be sufficient for someone of your weight. And yes technically you should take the riba twice a day, and yes usually the pills are 200mg (mine were at least), so you'll need five a day. However, don't get too hung up on when you take the riba, it has a very long half-life so it's not like it'll drop to unefficacious levels in the afternoon if you happen to forget to take it one morning. Bottomline is that in reality, you could get away with taking it all at once a day, but it's less than ideal so just split the daily dose between morning and evening. Also make sure you take the pills with a fat rich meal or snack everytime. Ribavirin's bioavailability increases dramatically with fat, and you really want to get this nasty drug into your system as well as you can. Also, you have a very low starting VL which is good, that makes it more likely you'll go UND sooner rather than later. Based on your stats, you probably have a better chance of clearing the virus than most others with type 1 (although the pre-existing anemia problem you mention may pose a challenge for you, keep your procrit handy). Pam (pln) here had type 1a and 1b and had a starting VL similar to yours and also had borderline anemia when she started. She's SVR now and with only 24 weeks of reatment, although she was in the VX950 trial.
Best of luck...
As far as the Pegasus, it’s a one size fits all. Your Riba dose sounds like you are on the high end for your weight but many on this board think that’s a good thing. It may make your HGB tank, so watch your CBC’s closely.
It’s best to take 3 Riba in the am and the 2 early Riba in the pm as it makes some folks a bit speedy and you DO want to sleep at night. Take the Riba with a bit of fatty food for better absorption. Yogurt or milk or the like.
BTW, I live 50 miles south of B’ham. May I ask what area you live in Alabama. Are you treating at UAB? They have a liver center there.
Best to you.
why not go to the pegasys website and watch the video on how to give yourself the injection and start tomorrow anyway. sounds like the right amount of RX. best of luck and may the tx make you SVR
Sometimes you have to trade popularity for advocacy in your doctor's office to get things done right. Good that you pushed your nurse to do her job.
Yes, usual protocol is to split the riba. It could be 3 in the morning and 2 in the evening or vice versa. If breakfast is bigger than dinner, I'd say take the 3 riba with breakfast and the 2 with dinner. If dinner is your big meal, then reverse it. Reason being that taking riba with food is both kinder on your stomach and it also helps it to absorb better. Meals with riba should have at least a moderate amount of fat in them.
That said, some people take the larger riba dose in the morning, regardless, because they feel they sleep better with the smaller dose in the evening. Lots of ways to do it. Also, don't get hung up on taking the riba 12 hours apart. Riba has a very long half life, so the timing isn't as crucial as getting the full dose down the hatch every day. My usual breakfast on treatment was at 10-11AM and my dinner 4-5PM. So that's when I took my two riba doses.
As to treatment suggestions. Make sure you get a senstive 4-week viral load test (50 IU/ml or less) which should be taken the day before your fifth injection. Discuss this upfront so there will be no misunderstandings.
Also, if you havent' had a viral load test in a few months, try and get one right before starting treatment. That and at least a complete blood count. Also, make sure they do a thyroid panel periodically during treatment.
You mention only your nurse. Do you have a way to communicate with your doctor if need be? Don't be afraid to ask to speak to him directly. If he has email, ask him if you can use it.
I agree, no reason you have to wait for shot instructions if you're already injecting Procrit. Maybe talk to the doctor direct on this ask for another nurse if there's a choice.