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427265 tn?1444080036

Ribavirin dosage question

I'm to start tx January 2nd agressively with 180 mg. Peg 2x per week and 1600 of Riba. I know as a stage 4 this will give me my best chance to RVR, but 1600 mg!!!!!  I've seen anywheres from 800 to 1400, usually about 1200 for someone my size (140-145 lbs, leaning to the low side with the stress levels amping up). I will bring up my concerns at my next visit, but want to hear from anyone that has done this. Is it do-able?? I really want to do this, but I want to be able to stay in the game too.

Any thoughts?

Pam
15 Responses
577132 tn?1314270126
Look for a guy called DoubleDose.
Avatar universal
Hey Pam; this is a small study (and on co-infected too) but it looks interesting.

http://www.hivandhepatitis.com/2007icr/ias/docs/080307_h.html

here is the "meat" from the results;
--------------------------------------------------------------------------------
Results

8 of 11 subjects (72%) in the double-dose arm achieved more than a 1 log reduction in HCV RNA by day 7, compared with 1 of 11 subjects (9%) in the single dose arm (P=0.02).


Percentages of subjects achieving HCV RNA < 615 IU/mL were greater in the double-dose compared with the single-dose arm:
Week 1: 27% vs 0%;
Week 4: 54% vs 27%;
Week 8: 63% vs 36%;
Week 12: 72% vs 45%.

Among those who completed treatment, subjects in the double-dose arm had a higher end-of-treatment response rate (45% vs 20%) and SVR rate (40% vs 18%) compared with subjects receiving standard therapy.
----------------------------------------------------------------------------------------------------

The idea is appealing.  Get an RVR before the RBV starts to kick your hiney.

Get a good heating pad.  ; )

willy
Avatar universal
Bill1954 would be a good one to talk about this, he was also on a high dose of riba. Wow 1600mg for someone your size and being stage 4 i hope your doctor is going to do weekly blood tests....... Wishing you the best
Avatar universal
Also flguy i think was on something close to this and he was also stage 4 and is now svr
427265 tn?1444080036
Thanks for the responses.

Willy, those stats on double dosing are encouraging and follow on others I've read. It's the reason I'm pumped to give it my all, but I still don't see alot of the higher Riba dosages which gives me pause. My Dr. said the worst sx they've dealt with from the amped Riba is the rash...and the ONLY time they have dropped a dose for a week...otherwise it's pretty much NO reductions.

Can-do-man: yes, I will have weekly bloodwork for monitoring. I do worry about tanking early on before I even have a chance to RVR, but am willing to give it my best shot as long as it doesn't take me out with it. But I really need to believe in it to do this, hence my quandry about the high dosage.

I think this double dosing club is growing fromthe sounds of it.
Avatar universal
In the boceprevir trial they predose with the SOC.  The idea is that it takes a while to get up trough levels, particularly with RBV.

You might also consider predosing the RBV.  IF you do too large of a dose it can cause your blood scores to tank.  A little lead with RBV could still provide about the same dosing (in particularly the first 4 weeks) but with less danger of low WBC or RBC.

There are a few good threads here in which predosing (of RBV) is discussed at length.  I don't know that the idea is accepted or proven yet, however.

willy
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