Is 1200mg of Ribavirin a day to much?

[NorthIdaho54]

I received my meds from Pegasys and am going in tomorrow for my 1st peginterferon alfa-2a injection. I'm questioning the dose for the ribavirin - the bottle says 3 tabs 2x daily which = 1200mg a day. Is that a normal dose? Should I bring up my concern to the nurse tomorrow?

Also in the med guide it stated that ribavirin (copegus) can cause a drop in red blood cell count, should I be concerned that my platelets are below normal now? Is it likely to cause my platelets to drop anymore?

Hate being such a drama mama but I'm really nervous about starting tx.

[James10500]

It depends on the genotype. 2's on alpha 2a do 800 mg's, not weight based.

http://www.drugs.com/dosage/ribavirin.html

[paen53]

Interferon and Ribavirin work in tandem, but I believe having an adequate Riba dose (or higher as tolerated) is critical to an SVR especially for those of us with advanced liver disease. And the earlier you reach the point of being undetectable the better - 4 weeks (or earlier) being the optimum.

Couple things to discuss with your Dr. if you haven't already-

1. Will they use Procrit rather than a dose  reduction of the Riba for low hemoglobin and at   what level would they order it?

2. How often will they be running PCR's in the first 12 weeks?

3. What is their cut-off for low platelets? Mine was 24,000 but this may differ with others.

4. If your platelets do tank, what are they options to keep you in the game - INF reduction?

5, How often will labs be run to monitor your blood counts (CBC)?

Good luck on your tx start today!!   Pam

[uncledudeness]

i asked the exact same question prior to tx. my platelets were @ 87k and my RBC was at a 5.25, a good level. well after 2 weeks my platelets are @ 107k, but my RBC dropped to 3.61. i just took my 4th shot. i'm starting Procrit in a couple of weeks to manage the RBC.
the riba is the cause for the RBC drop. i take 1200mg/day.

the side effects are different for each person, but i have to say that mine are manageable so far. jump in with both feet and keep a positive attitude. most importantly, don't dwell on the negative sides of treatment; you might handle it with little problems.

i will say that the first shot is the hardest; not because of the sides. i felt like i was at a dart board and couldn't let go of the dart. i finally let it go and it was no big deal.

good luck.

[Bill1954]

If I recall, the Copegus (ribavirin) taken with Pegasys for genotype 1 patients is weight based; 1000 mg/day for less than 75 kg (165 lbs), 1200 for greater than 75 kg (165 lbs). That said, viral relapse is thought to be tied closely to ribavirin, and I believe response is dose dependent. If you tolerate 1200 mg/day, I’d definitely try to maintain it. A good therapeutic dose is 12-15 mg/kg/day.

Thrombocytopenia (low platelets) is a result of interferon, and not ribavirin. If your platelets fall below 35-50,000, doctors will probably discuss dose reduction of IFN; they don’t usually get too excited before that.

It’s understandable to be a bit cautious at first; these are rather strong meds. Most of us find the anxiety of waiting and beginning to be anticlimactic after the fact; it’s not usually as bad as it’s made out to be.

Try to remember to take a couple of Tylenol with the first injection, keep hydrated, and don’t expect too much of yourself the day after the initial injection. From personal experience, both times I did my first shot, I woke the next morning with a pretty decent whiskey-style hangover. It washed off with a hot shower and coffee, and I was able to go about my day. Much later in treatment I get very tired and fatigued, but never really became overly ill.

Good luck; check with the group here after the shot, and perhaps the nest morning to check in; someone will be around to hang on to :).

Good luck and take care-

Bill