another riba reduction

[screaming48]

Well last week my hgb went to 9.7 I have been doing three shots of procrit a week and I feel like a pincushion, my riba had been reduced the 3rd week to nothing still undetected at 4 weeks and started with a viral load of 13.9 million, this past Friday more bloodwork and even with the procrit my hgb has dropped again and is now 8.3 my riba is now 4oo mgs a day better than none but still low. What bothers me is why is the procrit not working and will I stay undetected at 12 weeks. Hope this made sense would appreciate any input especially as to why the procrit is not working.. thanks guys

[screaming48]

My riba was stopped at three weeks for two weeks and still at 4 weeks blood I was undetected. I started out on 1200 mg of riba and after being taken off for two weeks we went with 800 mgs now because my hgb still is falling even with procrit I am down to 400 mgs a day 200 morn and 200 evening. Only reason why I think that 400 is low is because of the posts that I have read, but of course alot of these were on reg soc without the third drug so looks like docs and everyone else is still learning, thanks Hector for the info it helps to look over stuff like that :) This friday will start the last 4 weeks of incevik yippee only 4 more weeks hope I can hang in there...

[working dog]

i had to stop riba for 10 days aug 8th through aug 17th...kept up the 180 interferon...as well as the incivek...at the same time started procrit on the 8th of aug...by the 17th my hemo was up to 11!!!!! went back on the riba....who knows...my doctor said it wouldn't make a difference...it didn't seem to but who knows...wish i had started the procrit when i first went into the 9s....i don't feel at all like the parties over for me....i'm on 1000 riba now..180 still interferon....good luck....billy

[HectorSF]

"my hgb has dropped again and is now 8.3 my riba is now 4oo mgs a day"  

According to the Ribavirin prescribing label...

* hemoglobin <10 g/dL - Ribavirin should be reduced to 600 mg/per day. ( One 200 mg tablet in the morning and two 200 mg tablets in the evening).

*hemoglobin <8.5 g/dL - Ribavirin should be stopped.

Once Ribavirin tablets  have been withheld due to either a laboratory abnormality or clinical manifestation, an attempt may be made to restart Ribavirin tablets at 600 mg daily and further increase the dose to 800 mg daily. However, it is not recommended that Ribavirin tablets be increased to the original assigned dose (1000 mg to 1200 mg).

"4oo mg a day better than none but still low"

Maybe? There is no data for how this will affect your chances of SRV, as all studies have been done using the standard treatment protocols  above. Using the standard dosages will not affect rates of SVR vs. no anemia and no dosage reductions.

If you are on only your third week of treatment you should discuss your future treatment strategy for dealing with anemia with your doctor. You could always have transfusions. But that is a lot of transfusions if you just started. If you have little liver damage you could always wait for newer meds that might not cause anemia.

Good luck!
Hector

[working dog]

i take 60000 procrit a week...only keeps me about 9....i had to reduce my riba and get a transfusion to get it going last time....you may need a combo...anemia is something i go through everyday...from 7 to 9...but now mostly high 8s to low 9s....i could reduce my riba to 800 but for now i'll take the anemia as long as i can.....billy

[spectda]

Procrit comes in many different strengths. Whats important is how many units you are taking. Did you start taking a full 20,000 unit vial twice a week (40,000 units per week) and now you are taking 1/2 a 20,000 unit vial 3 times a week (30,000 units per week). If this is the case you have had a procrit dose reduction which seems strange considering your HGB of 8.3 and your very low dose of Ribavirin.

Maybe they switched the vial strength since your original prescription. Please figure out precisely what you were taking at the begining and what you are taking now.  

-Dave

[screaming48]

I have  been on the procrit now I think about 4 weeks and it did work at first now my hgb is going down again, I take .05 cc of procrit I think the bottle say 20.000units I was on 1 cc twice a week when I first tanked. Yes iron and the rest have been checked have been doing a cbc every week. He seems to be more concerned with the hgb and my kidney function now which had been going bad but has improved some. I think the drugs are just kicking my butt to the moon and back.

[spectda]

When did you start the procrit, it can take a few weeks to work? Has your iron level been checked? How many units of procrit are you taking, I've never heard of someone on hcv tx taking three injections per week although I believe chemo therapy people sometimes take lower dose injections more often.

Procrit doesn't work for everyone, or maybe it works but the drugs are destroying redblood cells at such a rapid rate that the procrit can't keep up. I took 40,000 units every 4-5 days and still my HGB went to 7 and I had to stop tx at week 43 because of my trial parameters (no transfusions allowed) I wasn't taking 400 mgs though.