It's one pill, I don't know how you could add one pill gradually? Just take the added pill along with the ones you already take. 3 in am, 12 hours later, 3 in pm.
Why gradual? Just go for it. 3 in the am, 2 in the pm to avoid any possible sleep issues.
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You know, you don't sound bad at all for a 9. Really. You aren't whining and crying at ALL! You are one tough cookie! :)
But then...we all knew that already.
The reason I don't just add it is because they still can't get the anemia under control with the 4 I'm taking and I am on Aranesp for the anemia.
That is why I am hesitant I thought maybe if I tried every other day I could build up to it.
I don't know I'm just afraid to go back to the 5 because of the sx before
As with others, I'm a bit confused by your question since it appears your doctor told you to up your riba from 4 to 5 pills a day. Yes, you could do it "gradually" but I don't think that is what he wants you to do. Best to follow his advice and start taking 5 a day.
That said, increasing riba gradually isn't simply adding another pill every day or every other day. I know this from personal experience when I upped my riba "gradually" from 1200 mg/day to 2000 mg/day early-on in treatment. My thinking was not to do it all at once, so I "gradually" did it over a weeeks period. I also ended up in the emergency room :)
Any change in ribavirin takes 2-4 weeks to get translated into a change in hgb (hemoglobin) levels. So in that sense, "gradual" dose increasing for riba would probably be to increase every 2-4 weeks. Same thing for Procrit. Takes 2-4 weeks to kick in.
This 2-4 week time lag is why so many of us get into trouble with anemia early-on in treatment. Many doctors simply wait too late as hgb declines before intervening with rescue drugs. We see it time after time here. The doctors should know better but many really don't. Maybe if they had riba-induced (hemolytic) anemia once in their life they would move faster.