80% dosage rule and is there a safer time to lower peg or riba?

[GingerB]

What are your feelings about the 80% dosage rule  ? --> that taking 80% of your medicine is sufficient.
If my doctor were to lower my riba or peg - is there a safer time to do so....for example after a certain amount of time of doing tx,  or after a certain amount of time upon reaching UND?  Does it matter how much the meds were reduced?  And for how long it was reduced ?  Would a short period of time (whatever that may be) be ok?                      
Or do you feel that it is more important to maintain full dose of riba and peg throughout entire tx?  
By the way, my 8th wk VL was 270 IU , down from pre-tx 2.84 mil, so I am hoping that I may be UND at wk 12.  I am GT 1a, female, 5' 5' and  116 lbs, first time tx,  and have been taking 180 mcg peg weekly and 1000 mg riba daily.
My doctor does not share much info with me and when I have asked him about rescue drugs, he says 'we'll see'.
My 8 wk HGB  (on 3/4/08) was 10 and my doctor had no comment on it -   I fell that I am doing ok, just moving around slower.  
Does pretty much everyone at some time or another during tx need to take rescue drugs or reduce their tx meds?
My doctor has mentioned the 80% rule...that a patient can get by with 80% of their medication dose.  So now I wonder if this doctor may be the type to rather lower my dosage of peg or riba instead of offering rescue drugs.  If so, I would want to be prepared how to handle this.  Appreciate any comments.   Thanks.  GingerB
P.S. This doctor just told me that since I was not UND at wk 4 to extend tx from 48 wks to 72 wks.

[GingerB]

Thanks all for your comments.     I will  try to get more info out of  my doctor.   GingerB.

[zazza]

I totally agree with GoofyDad.

[GoofyDad]

If I recall from reading the original paper a long while back - it seemed to be offered to demonstrate the importance of getting at least 80%. It compared the 80% plus population against the 79% minus. It's being used backwards IMHO.    

[zazza]

I'm not fond of the 80% rule. I think it is better to calculate the dose in relation to one's weight. With your weight I would not want to go below 800 mg ribavirin. Being a geno 1 I would not want to go below weight based dosing if I could avoid it. Our chances of SVR are bad enough as they are.

My hgb has been at 10 almost all through tx, and my doc has not had a comment on that either. I even had 2 occasions of 9.5, but he was willing to wait until next blood count 4 weeks later to check if I was back at 10, which I was.

It is a good idea to talk to your dr about Procrit, so you will be prepared if your hgb gets still lower.

[Bobby1952]

   I was going to say the same thing. You are on a high Riba dosage for your weight. Your hgb is at 10. That is when they usually start using Procrit. How do you feel. If  you are not totally exausted you are doing good. I would monitor the hgb very closely. Get blood work more often.
   I would talk to your Dr about Procrit now instead of lowering your Riba dose. Try the procrit first. If you had to lower it I would try lowering to 800. Below that can take away the thereputic effect according to something i read on clinical options dot com.

Bobby

[CockSparrow]

You are on a very high Riba dose for you weight. 116lbs=52kgs.
If you were taking PegIntron instead of Pegasys you would be on 800mg Riba.

Unfortunately the Roche protocol is to drop to 600mg Riba. Which in your case is probably about right for your weight anyway.
So in your case I would not expect a riba dose reduction to have much impact on your svr chances. So long as you dont have to do this until after you are UND. Which you almost are.

If you are not und at week 12 then 72 weeks makes sense.
Not sure that it makes the much sense if you are clear then.

All the Best
CS