Copegus 800 mg enough?

[wonderingwhen]

Hello everyone, I am not new to his forum just mostly read all the posts, this time I have a question.  Some good info!
Just started tx on the 16th of Sept. So far sides are not as bad as I thought they might be. But in doing a little reading I found that I should be taking 1000 mg of riba, not the 800 mg I was prescribed. Being that I am type 1, stage 2-3 56 yrs young, 160lbs and treatment is scheduled for 48 weeks and not for 24. I have a call in to my Dr to ask if this is correct. Any input out there will be greatly appreciated.

Thanks
Chuck

[jmjm530]

So check the box. LOL. Just kidding (sort of). Most docs do not order the week 4 PCR but many do.

Regarding your platelets and low WBC. My knowledge on these values is limited mostly to after treatment starts and not pre-treatment.

That said, many doctors tend to overreact on both these values while they ironically underreact with hemoglobin. Go figure.

In any event, once you start treatment, the important number is ANC (absolute Neutrephils). My doctor doesn't get concdened until they drop below 500. Currently my ANC is bouncing between 600-900 and my WBC is 1.4.

I'd really press him on the riba dose and/or get a second opinion. And definitely get that week 4 PCR if you can to see how things are working out. You're looking for at least a one-log drop in four weeks but ideally you'll have two-logs or better.

-- Jim

[wonderingwhen]

I am looking at my lab forms as I write. My 2 week lab ask for ALT(SGPT) and CBC(HEMOGRAM/PLT/DIFF 4 week asks for the same plus liver profile it does NOT have the HCV RNA QT, PCR-NICHOLS checked.

[GoofyDad]

Jim's right on the weight cutoff. It's 75 kg or 165 lbs. I'm 163 undressed and I'm on 1,200. I started 10 days ago & Doc told me to cut myself back if I dropped below 75kg. Well, I started below 75kg, so I plan to stay at 1,200 unless I lose more than 10 lbs or so. My plateletes & WBC are also a bit out of range to the low side.

PCR = Polymer Chain Replication or some-such nonsense. Essentially its the quantitative measure of the HVC. There are other tests too, but PCR has a finer graduation.

Jim, at week four, even with a 0 pcr we know we harbor the virus. So is it material whether that's <200 copies, or <50  copies per unit of measure? I mean, I see it as almost the same: You still have HVC either way. You know it's just a tiny bit either way. So is it material whether that tiny bit is a tiny-tiny bit, or a little bit bigger tiny bit?

You can prolly see where I'm going with this. I'm scheduled for wks 4, 8, and 12 quantatative tests, but they are branched chain vs. PC whatever chain.

[Fisheress]

I am female 140 pounds (have not lost or gained any wait as of yet) 46 years young and started treatment on the 12th of this month.  I also take Copegus, 1000mg per day.  400mg in the morning w/my cheerios & milk and 600mg in the evening after dinner.  So far so good with few sides.  Had hip pain during the night a few days ago, got up took 1 tylenol pm and was fine the next morning.  Although I am having occasional muscle pain in my thigh and calf in my right leg since I did injection in that leg on Sat. night, my study cordinator told me to take ibprophen during the day for that.  It has helped.  Think I like the tummy fat for injections better.  Also hope I don't lose any weight or I won't have that lil roll to depend on for injections! (:

I hope you speak w/your doctor about the low dosage you are receiving as it sounds like others here feel you are getting too low a dose also.

Good luck to ya!

Fisheress
P.S. They told me I would have a PCR test on my 4th week. They are so COOL at my clinic, make me feel as if I am their only patient!

[cougareyes]

Your counts look good, my test list out the neutrophils the same way. You get the ANC by multiplying the two. I forget what denomination the numbers are listed as, but if my calculation is correct your ANC would be 1269,which is good. But if you are still concerned check w/ your doc; I'm not an expert.  Good Luck

[jmjm530]

Your WBC is more than adequate. Look for something that says "neutrophyils, absolute" or something similar. Same as ANC.

Susan,

Good for you on the high dose riba. Here's hoping it gives you the edge this time. For those not familiar, at a certain point moving the riba up too high has certain risks and your doctor should always be in the loop.