Starting Weekend After Next (28th/29th)

[hcvJames]

Will start second round of tx weekend after next if everything lines up ...

Tentatively my shot and pill schedule will be this:
1st day and weekly thereafter.
Midnight: Inf Shot, 3Riba pills, 20 grams fat:), 2 Incivek pills

Daily:
Riba:   00:00, 12:00 - midnight and noon.
Incivek 00:00, 08:00,  16:00

Anyone see a problem with dosing one on top the other like that?

Ha, kinda unrelated .. biggest fears this time is
... given problems with low platelets and WBC/ANC last time

Platelets won't stand up to the assault of the added med, telaprevir.

I know WBC won't, new med or not, but worry that about being prescribed enough Neupogen. I wasn't really last time but had arranged to take Neup no longer than 36 (usually 12) hours b4 any CBC to assure they wouldn't pull me off tx again. This time if telap increases the WBC problem and given the NP has already indicated they don't want to allow an extra dose because of expense AND should blood work only be given once a month like last time they won't catch any problem (platelets, WBC, or Anemia (next fear)) until something nasty happens and that'll be a reason to pull tx.

Anemia: My Hgb never went below 10.2, and that was at the very end. However with the numerous posts from those with the problem ... I'm worried about that also. Mainly convincing, and receiving procrit in time .. before being pulled .. Ya, I was traumatized, traumatized I tell ya at having tx interrupted 3x's @ 2 wks a pop in 09. Besides, like they say, just because you are paranoid doesn't mean they aren't out to get you.

Anyways .. about the dosing schedule, any comments welcome.
As always, Thanks

[beeblessed]

"Besides, like they say, just because you are paranoid doesn't mean they aren't out to get you."

Hahahaha!!  That is too true.  Wishing you all the best this time!  Line up those comedy DVDs for if you start feeling anxious.  Best advice on the meds......space them out a little to avoid nausea. Have ginger ale or some other bubbly water close by.  Here's my schedule on VIC:

7:00 am -- RIBA
7:30 am -- VIC
1:00 pm -- AD & Zofran
3:00 pm -- VIC
7:00 pm -- RIBA
10:00 PM - VIC

[pooh55811]

hcvJames and gene53: Hi!

Keep the end in sight.The Incivek will be finished before you know it. I found the time went by pretty rapidly. I noticed that I started feeling better the day after finishing Incivek. That first day was probably because I finally got some sleep, lol. But truthfully, while I still am not myself and don't have much energy, I definitely feel much better off the Incivek.

James, Gene is right. Be prepared in advance for the possible troubling symptoms, mainly the rash and itching and the fire in the hole. You cannot do much about the fatigue, no energy, and some aches and pains (tylenol helps some), but getting on top of the rash is a must and getting on top of and ahead of the diarrhea is a must.

Keep the stools firm. It's the soft stools and the diarrhea that will put you in major rectal pain. It took me 2 episodes to figure this out but the thrid episode I nipped in the bud with Loperimide.

So, here's a list of things to have on hand when you start:
Loperimide
Prep. H supp.
Prep. H cream
Huggies baby wipes with aloe
Benadryl
Hydrocortisone cream
These are all over the counter and you will want them at your fingertips if you get the flaming diarrhea or the itchy rash.

Best of luck to both of you!

[gene53]

Hello James,
My schedule is exactly the same as poohs, ( O Hi Pooh!!! )
I just started Jan 4th and so far so good, mostly fatigue but a little fire n da hole as they say...
So I would recommend to be sure you are prepared for the sx.
mostly just wanted to welcome you to the party but can't say to much for the party favors other then hopefully the sx will pay off for us in the end!

Best of Luck with your TX
Gene

[pooh55811]

Your schedule seems fine. I took mine as follow and it worked well:

Inf. inj. on Monday eves about 8 pm.
Riba 6am and 6 pm
Incivek 6 am, 2 pm and 10 pm.

Same as your schedule in terms of intervals except the times are different.
That worked out well except I never got any sleep due to the every 8 hour eating and doing schedule, but that could not be helped since one has to eat and take Incivek every 8 hours. I just kept in mind it would end after 12 weeks and I would get more sleep.

I cannot tell you much about the blood counts other than to say mine never dropped into dangerous territory. My Hgb. dropped from 15.4 to 11.1 eventually. My white count dropped some (not critically) initially but came back up. My Platelets are fine.

I had a complete blood count (CBC) every week while I was on Incivek. Now I am having one done every two weeks but that may eventually move to monthly if I am stable. I think while you are on Incivek they should be doing the complete blood counts weekly or at least every 2 weeks, especially considering your history. I think doing them monthly is taking a big chance. You may have to get assertive about this.

As far as the rescue drugs are concerned, in my opinion, not allowing you to have a rescue drug (or enough rescue drugs) because it costs too much is unethical. Cost should not play into the decision. The decision should be based on your blood counts and addressing any problems so your treatment regimen and SVR goal are not compromised. You might have to get assertive about that too.

On the positive side, I think most on Incivek don't have major blood count issues. Sure, the numbers drop some, but most don't drop critically. Of course, you have a history of the counts dropping on Inf. and Riba, so I know your concern is very real.

Best of wishes for your successful treatment and SVR.