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dose increase

GRRRR! I am a geno type 3 and was started on the standard 800 mg of riba.  Starting load was 75,000, after my 4 week lab draw my VL was 25,000.  Dr. called and told me to increase my riba to 1000 mg which i obviously should have been on to begin wtih. My eight week was 403 and neg at week 12.  My question is how big of an impact do the first 4 weeks hold on obtaining SVR?  I would like to think that since my increase I will still have a good chance to clear????  Hope this makes sense!
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Avatar universal
Your Riba should be weight based.  Your nurse will most likely have a chart to figure that out for you.  The first 4 weeks do serve as a future predictive tx outcome.  There's a log drop calculator somewhere to figure out how much you've responded.  Since you're UND at wk 12, that means your body responded to the medication which is good, keep going!!  Cory.

Avatar universal
Great news that you are und, congrats!!

My guess is that your doctor prescribed riba based on your weight. After not having a big response at week 4 and I would imagine looking at your hgb he decided to increase your dose. If that is the case I think he did a good job for you. If he started too low based on your weight by mistake it's a different story.

How much do you weigh?
do you know where your hgb was at week four and where it stands now?

At four weeks if you were und your chance of svr is definitely greater then at 12 weeks. If the dosage of medication was incorrect that would be a different story.
- Dave
Avatar universal
Unfortunately there are still doctors who go by the standard 800 dose for geno 2 and 3's, sense you wasn't und until week 12 have you talked with him about extending tx to 48 weeks..... Good luck going forward

cando
Avatar universal
thanks for the info, I didn't know they dosed geno 2 and 3 at 800 riba.
Avatar universal
Oh, by the way, since you're in tx, Keep in mind UND does not mean cured!! Keep going!!
Avatar universal
My weight was about 150 lbs.  So I think the dosage was too low, I do not have my blood work with me but i think my hgb is low right now about 9.5.  I am in week 20 of treatment and will hopefully get an extension on my meds to week 36 not the standard 24. I will also be seeing a hematologist this week to discuss my low counts.  i think prior to treament by hgb was about 14 and maybe 13.5 at week 4 then about 11 at week 8 and then remained at about 10.5 from there on. I also have lost about 30 lbs.
1117750 tn?1307390169
firstly 800mg is sufficient if you had 1000mg to start i doubt you would have responded better in all honestly , at 150lbs you are small so again 800mg would / should be ok
your hgb is ok as well so dont worry about the riba , you have responded slowly for other reasons, i would suggest extending tx.
Avatar universal
What is weight based Riba for 150 lbs ?
Avatar universal
weight based riba for 150 would be 1000 mg daily. If I understand correctly bdr3a started treatment 30 lbs heavier at 180 lbs so that would normally be 1200 mg daily.

bdr3a- It's good you are going to extend treatment, You have a good chance of becoming svr.

Good luck -

Dave
Avatar universal
thanks for the positive input!! it is greatly needed, just to clarify i started at 150 lbs, not 180,  just a female thing! lol and yes i think i should have been on the 1000 mg and i guess that is my biggest question, did that make the low drop in VL or something else????? driving me crazy
179856 tn?1333550962
Good luck you have every chance if you extend treatment. I too had to (geno 1A and 1B) for 72 weeks......it wasn't fun but it worked.  It's too bad your doctor didn't know that weight based is the way to go these days as all the studies have shown but now you can let him know and perhaps help others to come after you in the future.

It's a shame that we have to learn more than they know about the disease........but it's just a fact of life with this disease. They should keep current about it but, they all don't.
Avatar universal
Those weighing less than 143 lbs (less than 65 kg) received 800 mg
Those weighing between 143 lbs and 187 lbs (65-85 kg) received 1000 mg
Those weighing between 189 lbs and 229 lbs (86-104 kg) received 1,200 mg
Those weighing between 231 lbs and 273 lbs (105-124 kg) received 1,400 mg
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