I know Triple is a real game changer to how treatment was on just the Peg & Riba but wow did your Hgb drop. Since it dropped this soon in treatment you might want to talk to your doctor the next time you see him and work out some kind of treatment strategy for managing your side effects. Or rather, ask him what his long-term plan would be to manage your Hgb throughout the duration of treatment.
That way you won't be freaked if you you are possibly on a reduced Riba dose throughout treatment and you will find out his position about Procrit.
OrphanedHawk has asking how the doctor manages sides and rescue meds as one the questions you should ask prior to treatment. I did not do that this time around and as I think about it I feel fortunate my doctor strives to keep me on the full dose of Riba. Yes there are studies that indicate Riba dose reduction does not impact SVR but I would not want to be on a reduced dose for a prolonged period. Especially not until week 24.
I know that is fear talking as a Prior partial responder though :)
Here is to hoping and praying UND for you by week 4!
Hi PJ....I typed a response and don't know where in the hell it went so here we go again.
First of all, are you really confident in your physician in treating you? I am just shocked by the drastic reduction in your Riba! I mean 1200 to 600 to 300 (just for today)? I am totally confused here because I don't understand his thought process whatsoever. Why didn't he call the pharmacy and have your correct dosage overnighted to you? Is he lazy and can't pick up the phone?
Also you said you HGB was 10.3. Are you having difficulty breathing? Is the low HGB too much for you? The reason I am asking is because I thought protocol on Riba was to reduce if HGB is <10. So I am guessing you feel like sh$& ? You also said your RBC was 3.45 that is low but I wouldn't think much of a concern. I just had mine checked about 3 hrs ago and it was 3.32.
Since you relapsed last time I would be raising all kinds of hell about reducing the Riba. This is JMHO....but if this was my second time around I would be in his office asking a million questions of WHY?
I hope everything works out well for you!
Seems kinda drastic to me as one wants to be UND at week 4. Alot depends on it, like doing 24 more weeks of treatment if not.
Reducing all the way from 1200 to 400 at week 2 with an HGB of 10.3, one sure hopes he's guessing right. But then again its not your doctor who is treating........... Wishing you the best
i wish i was 10hgb at day 16.......week 4 is a big one to get through
Treatment Outcome T12/PR
N = 363
n/N (%) Pbo/PR48
N = 361
Overall SVR 79% (285/363)
eRVR 58% (212/363) 8% (29/361)
SVR in eRVR subjects 92% (195/212) 93% (27/29)
No eRVR 42% (151/363) 92% (332/361)
SVR in no eRVR subjects
60% (90/151) 42% (139/332)
Outcome for Subjects without SVR
On-treatment virologic failurea 7% (26/363) 29% (105/361)
Relapseb 4% (11/298) 24% (53/220)
Otherc 11% (41/363) 10% (37/361)
As one can see response was... eRVR 58% (212/363) 8% (29/361).
So a doctor is " guessing, hoping" your und at week 2 yet only 58% was at week 4............
A Riba reduction of 1200 mg to 400 mg would scare me to death, especially at day 16. An incremental reduction from 1200 mg to 1000 mg and starting Procrit would be my option if it was me. I would even take a blood transfusion if necessary. My Hgb dropped to 10.2 and I never reduced anything.
I know this is early in your treatment (day 16) and it appears the doctor is nervous about the Hgb drop, but I still think it is a drastic reduction. He does not even know if you are UND yet. Even being UND does not mean the virus is gone. It simply means the test cannot count find it.
Is this doctor a Hepatologist or a GI or a Primary Care Physician. If it was me, I would discuss this with the doc and if he insists on only 400 mg a day, I would find a Hepatologist who tries not to reduce Riba anymore than absolutely necessary and who uses a combination of treatment (including Procrit and blood transfusions) so one can stay on an adequate dose of Riba. (Actually, that is what I did when my Hgb started to get near 10.
It is true that they concluded that Riba reduction did not impact SVR, but they were not specific about how much it can be reduced, at what point in treatment it can be reduced, and how long it can stay reduced.