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Avatar universal

RIBAVIRIN DOSAGE

I am starting triple treatment soon.
I treated in 2008 and I took 1000 mg ribavirin a day and 180 ug of pegasys injection once per week – I reached UND at week 16, but stopped tx because I did not want to treat for 72 wks with low odds and I decided to wait for new PI.
Now my (new) doctor is going to treat me with PI and wants to only give me 800 mg of ribavirin a day (I will be taking pegasys and incivek).
The new doctor said I get 800 mg of riba because I weigh 115 lbs,  but that was what I weighed in 2008 when I was prescribed the 1000 mg of riba per day.  New doctor mentioned I will get Riba-Pack which I did not have the last time.
I have some ribavirin left over….not sure if it is still good to take, but I am almost tempted to take an extra pill each day , especially in the beginning or until I am cleared - because I did not clear until week 16 in 2008 with the 1000 mg dose.
I don’t know why I got 1000 mg a day of riba before, and now I am only getting 800 mg.  Just wondering what riba dosage everyone else is taking and what is your weight ?  Is there any literature out there that says  what the dose should be – if I can support taking 1000 mg. then maybe the doctor will agree.
Thanks....Gingerpal
12 Responses
Avatar universal
You had a substantial drop in HGB last time, but still it seems that it would be good to be on 1000 mg to begin so you can get to that all important 4 week rvr. He probably looked at your records and feels that you absorbed riba last time because of your hgb drop and the Incivek will add to the anemia.

Personally I would want to err on the side of too much and back off or add procrit then start at a lower dose. It seems worth discussing with your doctor, he might go for it. Do you have any other issues or any cardiac problems that may be keeping your doc on the conservative side?

What's your doctor's name? Maybe someone else has experience with the same doc.
Avatar universal
Are you seeing a hepatologist? Which PI are you taking?
-Dave
Avatar universal
Hi Gimger, i agree with you it doesn't make sense, 1000mg a day is what you should be on, just because you now on incivekis no reason to lower your riba..... If it was me i would want to know his reason. This might be your last best chance at SVR. Remember the doc works for you.... Good luck
Avatar universal
If you are going to be using Incivek and Pegasys your dose of riba should be 1,000 mg per day just as it was in all the Incivek trials, especially since you are TT phenotype and a slow responder previously.
http://www.drugs.com/dosage/copegus.html

Did you become anemic before? Have you discussed rescue drugs with the doc if needed? If you have not started tx, this would be a red flag to me unless there is a good reason for the doctor not following protocol.
-Dave
Avatar universal
thanks for getting back to me.  i have not started tx with this doctor yet...he is supposed to be a top liver md who was involved in incivik trials.   i looked at the link you sent and it surely says that for genotype 1 the riba dose should be 1000 mg - I will send this to the doctor. My hemoglobin when i treated in 2008 started at 14.5,  and at 2 wks it was 12.0,  at 4 wks it was 10.4,  at 8 wks it was 10.0,  at 12 wk it was 9.9, and at 16 wk it was 9.8 and i never took any rescue drugs.  New doctor said I can take rescue drugs.    I am very concerned about this riba dose!  I guess if this doctor does not agree to the 1000 mg dose, I will ask the reason, and then decide about going to a new doctor.  thanks for your help...ginger p.
  
Avatar universal
Hi Ginger...you mention that your HGB. stayed in acceptable levels during your last treatment....however do you happen to know what your HGB. is at present,perhaps it is low..therefore him being overly cautious...just a thought as to why he may have suggested this.
Good luck
Will..

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