High ribavirin

[burned74]

High Ribavirin?   I am thinking about trying tx in a clinical trial with high riba. (about two times normal).
It  seems like a lot of people here who did clear  with SOC had more side effects than those who did not clear. I had few side effects but also did not clear. Maybe its the riba

I thought jmjm530 cleared using lots of Riba?

Anyone else do this or have thoughts?

[Bali05]

predosed high dose, double dosed than weight dosed now back to high dosed
my hepatologist  last comment was my HgB looks stable.
arrrrrrrrrrrrrRIBA !!!!
One problem is if you are not in a trial it is not easy to get your hands on that stuff.
The other problem is we all react differently to it and the only way to find out is to
watch your HgB as an indicator.
Bet if you are doing the trial they might measure serum concentrations. If they do
I would like to know which lab.

[burned74]

Thank you to everyone here.  Bill, I read your posts a lot and your are especially informative!!

I am thinking about giving it a try with the hope that, if it does not work, I will do Teleprevir in a year or so.

I ahve read that SOC plus PI cure rate is about 50 per cent for previous non responders, of which I am one.

[Bill1954]

Burned, this is the study that FlGuy mentioned and that Jmjm, Nygirl and I modeled in part around:

http://www.ncbi.nlm.nih.gov/pubmed/15660393?dopt=AbstractPlus
“Improved treatment regimens for patients with chronic hepatitis C, genotype 1 and high viral load are needed. Increasing the dose of ribavirin has increased the response rate, but experience with doses of more than 1,200 mg/day is limited. The aim of this study was to investigate the safety and tolerance to treatment with a high and individualized dose of ribavirin in combination with peginterferon. Ten patients with chronic hepatitis C, genotype 1 and high viral load were treated with peginterferon alfa-2a and ribavirin for 48 weeks in a prospective trial. The initial ribavirin dose was individualized and calculated from a pharmacokinetic formula based mainly on renal function. Ribavirin plasma concentrations were monitored, and the dose was adjusted to reach the target concentration. Hemoglobin was monitored, and patients were treated with erythropoietin and blood transfusions when indicated. After dose adjustments, the mean dose of ribavirin was 2,540 mg/day (range, 1,600-3,600) at week 24. The main side effect was anemia, which was controlled with erythropoietin. Two patients required blood transfusions. One patient was withdrawn at week 24 because of a lack of viral response, and one patient at week 39 because of side effects, primarily interferon associated. At follow-up (>or=24 weeks posttreatment), nine of ten patients had undetectable HCV RNA and thus were cured by standard definitions. In conclusion, a high dose of ribavirin according to an individualized schedule is feasible but associated with more frequent and serious side effects such as anemia. The viral response merits further evaluation.”

I have a hard copy of the full text study floating around somewhere if you’re interested. Good luck,
Bill

[copyman]

It is much better to take more Riba then to little. It is especially important early on in TX to have suffient Riba until built up in system. This is why pre dosing is a good idea. Becoming anemic seems to be an indicator that you are getting enough Riba. Most people that SVR have / had some type of anemia during tx.

[Bill1954]

Bwahahaha! Classic FlGuy!

Hi Burned—

I used quite a bit of riba over a three year period; I must metabolize it differently than most, because I never became significantly anemic from it. I used 1800mg/day for 36 weeks, then when I relapsed, I used 2000 mg/day for 96 weeks with no Procrit required. I dunno why, but as you can tell, I’m perfectly normal perfectly normal perfectly normal perfectly normal perfectly normal perfectly normal perfectly normal…..

Bill

[spectda]

Got a big laugh out of that figuy

Is that true bill, did the rattler venom do it?

Good luck burned74, I would guess bill will offer his experience at some point if he can tear himself away from his life to post!

Dave

[FlGuy]

I expect that the trial will simulate the Swedish advebure which reported significant results.  Jim bellied up to the engorgrf riba bar, but had to back off somewhat,  NYGirl also got a rude awakening afther thinking that New Yawk coul kick ribab butt,  The best example is Bill, the man, thy myth and the legend,  10 200mg per day for 96 weeks.  Rumor is that he chewed them and then washed it down with rattler venom.  A few , less robust, tried pre-dosing riba and maybe even a few people tried riba suppositories.  This stuff is not for the feint of hart.  But depending on the circumstances, may be worth a try,  Make sure you leave note before you suit up for riba war.