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riba dose reduction
I'm trying to figure out if my riba reduction will hurt my final SVR
The calculations I found were take your weight 105 LBS divide by 2.2 multiply by 12 equal 572 mg of Riba.
Which is to low but 800mg should be good shouldn't it???
I did the 1000mg for the first 12 weeks.
I don't have labs for another 3 weeks and was just wondering if I should call my doctor and ask him if I should raise it back to 1000 mg because I feel so good or if I should just enjoy.
The calculations I found were take your weight 105 LBS divide by 2.2 multiply by 12 equal 572 mg of Riba.
Which is to low but 800mg should be good shouldn't it???
I did the 1000mg for the first 12 weeks.
I don't have labs for another 3 weeks and was just wondering if I should call my doctor and ask him if I should raise it back to 1000 mg because I feel so good or if I should just enjoy.
Welcome to the forum! You've posted this question onto the end of an old thread from more than two years ago, so you may not get answers here. You will definitely get the advice you seek if you use the orange "Post a Question" button at the top of the page and ask it as a new question. Those are the ones that people really notice. Good luck!
My weight is 124lbs and my doctor started me with 1200mg which I think was too high. Then on week 4 I dropped my hgb from 135 to 110. She now wants me to drop it to 600mg. I am on triple therapy with Victrelis and am on week 5. Still waiting for first viral load results. I dont think I should reduse it to 600mg so will be taking 800mg. Any advise will be appreciated.
My weight ranges between 105 and 107. I'm going to keep the protocol I'm on. My next visit I'll have my labs to see my hgb and check my weight and do what my doctor tell me to do. It would be much easier and maybe a choice to go the extra 48 weeks now. Maybe that is the important thing to stay feeling good as to make tx as easy as possible and get back to work again to keep the the bills paid..
If you were 105 lbs. (48kg) when treatment started your doctor did well by you to start you on 1000mg,which would actually have been quite high given the guidelines for weight based dosing. However it is most important to get the maximum amount of benefit from Ribavirin early on(especially in the first 12 weeks ) and secondly until UND.
Because you were undetected at week 4 and still at week 12 given your weight and how much time has lapsed it would seem your dose is fine.
Your are currently taking 800 (16.6 mg per kg of body weight ),which is still considered at the high end of required dose
Always take a knowledgeable doctors advice tho when dosing any of these meds.
Good luck stream..glad you are feeling better..
Will
http://hepatitiscnewdrugs.blogspot.com/2011/05/optimal-dose-of-ribavirin-for-chronic.html
A relationship between RBV dose and response to therapy with both IFN alpha-2a and alpha-2b has been established in genotype 1 patients, who benefit from doses that exceed 800 mg/day (5, 14). When RBV is combined with PEG-IFN alpha-2a, relatively small reductions to 800 mg/day lead to significantly lower rates of SVR (5). Similarly, a large comparative trial of fixed-dose RBV compared with weight-based dosing in combination with PEG-IFN alpha-2b demonstrated that stratifying patients of all genotypes to receive starting doses ranging from 800-1400 mg/day depending on weight effects higher SVR rates than using a fixed dose of 800 mg/day for all patients (7). A detailed analysis of the relationship between body weight and SVR has suggested that the dose per kilogram is the determining factor of response in genotype 1 patients, based on the 40% to 50% rise in SVR for a 12-16-mg/kg increase in RBV dose (23).
Because you were undetected at week 4 and still at week 12 given your weight and how much time has lapsed it would seem your dose is fine.
Your are currently taking 800 (16.6 mg per kg of body weight ),which is still considered at the high end of required dose
Always take a knowledgeable doctors advice tho when dosing any of these meds.
Good luck stream..glad you are feeling better..
Will
http://hepatitiscnewdrugs.blogspot.com/2011/05/optimal-dose-of-ribavirin-for-chronic.html
A relationship between RBV dose and response to therapy with both IFN alpha-2a and alpha-2b has been established in genotype 1 patients, who benefit from doses that exceed 800 mg/day (5, 14). When RBV is combined with PEG-IFN alpha-2a, relatively small reductions to 800 mg/day lead to significantly lower rates of SVR (5). Similarly, a large comparative trial of fixed-dose RBV compared with weight-based dosing in combination with PEG-IFN alpha-2b demonstrated that stratifying patients of all genotypes to receive starting doses ranging from 800-1400 mg/day depending on weight effects higher SVR rates than using a fixed dose of 800 mg/day for all patients (7). A detailed analysis of the relationship between body weight and SVR has suggested that the dose per kilogram is the determining factor of response in genotype 1 patients, based on the 40% to 50% rise in SVR for a 12-16-mg/kg increase in RBV dose (23).
here are a couple of passages from the Telaprevir briefing document. it seems that ribavirin does reduction will not effect SVR, especially considering you are undetectable before you reduced.
Apart from permanent discontinuation, RBV dose reductions due to AE did not appear to affect the SVR24 rates in the telaprevir groups
Ribavirin dose reductions and interruptions are sometimes required with standard Peg-IFN/RBV treatment and were also reported for telaprevir-based regimens containing Peg-IFN/RBV. In Study 108, 57% of subjects had at least one RBV dose reduction with or without at least 1 dose interruption (Table 9). However, the rates of SVR24 among these subjects were not adversely affected by ribavirin dose reductions.
Apart from permanent discontinuation, RBV dose reductions due to AE did not appear to affect the SVR24 rates in the telaprevir groups
Ribavirin dose reductions and interruptions are sometimes required with standard Peg-IFN/RBV treatment and were also reported for telaprevir-based regimens containing Peg-IFN/RBV. In Study 108, 57% of subjects had at least one RBV dose reduction with or without at least 1 dose interruption (Table 9). However, the rates of SVR24 among these subjects were not adversely affected by ribavirin dose reductions.
Hello, Have you lost weight? 105 lbs would be aligned with 800 Riba weight based but you started at 1000.
I weigh between 120 and 130 mostly and was prescribed 800 Riba and have to admit, this strength (800) has been much easier than my first treatment in 2007 when at the same weight I was prescribed 1000 Riba which had to be reduced many times and I eventually relapsed. The worst part was the feeling of bone rubbing bone from loosing 25 lbs or so, down to 102 lbs. I was not allowed rescue drugs.
I am convinced that the Riba reduction cost me a possible SVR. This time around it is my determination to do everything but reduce dosage. But then again, I am not a doctor and will ultimately do whatever my Doc requests.
In the past I would disobey my Doc and as soon as I felt a little better, I would increase my Riba with out permission and then paid for it by really tanking so don't try any brilliant uneducated ideas like overriding Doc's orders.
Congratulations on your UND. Grrreat job. Good fighting Warrior!!!!
Darling, this is one rough ride but hey in our own ways, we are paving the way for so many just like others have for us.
I weigh between 120 and 130 mostly and was prescribed 800 Riba and have to admit, this strength (800) has been much easier than my first treatment in 2007 when at the same weight I was prescribed 1000 Riba which had to be reduced many times and I eventually relapsed. The worst part was the feeling of bone rubbing bone from loosing 25 lbs or so, down to 102 lbs. I was not allowed rescue drugs.
I am convinced that the Riba reduction cost me a possible SVR. This time around it is my determination to do everything but reduce dosage. But then again, I am not a doctor and will ultimately do whatever my Doc requests.
In the past I would disobey my Doc and as soon as I felt a little better, I would increase my Riba with out permission and then paid for it by really tanking so don't try any brilliant uneducated ideas like overriding Doc's orders.
Congratulations on your UND. Grrreat job. Good fighting Warrior!!!!
Darling, this is one rough ride but hey in our own ways, we are paving the way for so many just like others have for us.
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