Start Tx on Nov.07

[kickboxingmom]

I also posted on other forum. Can I ask a few questions?Thank you ahead of time.
Caremark delivered my meds package yesterday.Dr. Appt., Nov. 07, 3:30 p.m.Caremark called Thurs. morning and said,Caremark would not cover Ribavirin so they will give me the generic: Ribashere.Then the paperwork says, generic name : Ribavirin.2 tablets in the am, 3 in the pm.200 mg.That's 1000 mg a day.I weigh 103 lbs.Bottle reads Ribashere.

Peg-Intron Redipen Generic Name: Peginterferon Alpha-2b.Inject 0.4mL (64MCG) once weekly.
Dr. is going to show me how to inject and all the other stuff I need to know on the 7th.My husband is on Humira for the past 3 yrs.so shots, no problem?????

The box the Redipen came in reads,
PegInterferon alfa-2b
PegIntron
Redipen
80 mcg/ 0.5mL
Does this dosage and medications sound correct ?
Should I ask about pre-dosing Riba ?
Thanks Again,
Tammy

[kickboxingmom]

child24angel.Awwwwwwww ! Keep Hangin.He is and always will be your Angel !
Huggs

LindaC1207,That's so true about positive attitude.I'm not worried about first shot.I'm ready to fight.I'm trying to figure out how to make my work day plus an extra half day put into it and be at the Drs. at 3:30.Oh and to prepare all the info I got from all of these awesome people on here that took the time to explain to a naive me.Everyone of you are going to ONLY have good come to you.Thank you for your nice words

moahunter,More stress.I'll be sure and ask about that too.I will reach SVR like you.Congratulations on your SVR ! That's what all this is about.SVR ! Thank you for your welcoming words of advice.

Thank You So Much To All of You Good People ,
Tammy

[moahunter]

I had problems with the Redipen - make sure you always have at least one spare. I had more than four fail on me, which is quite frustrating - it was a manufacturing defect. I changed to the vial option (which you can ask for), and mixed it myself for the second half of treatment. Hopefully you have better luck and reach SVR like I did.

[LindaC1207]

Caremark gave me Ribasphere too, I take 3 pills (600 mgs) in the am and 2 (400 mgs) in the pm.  I also do a shot of Pegasys, 180 mgs once a week.  I didn't notice any speediness from the ribaviran at the beginning but it could have been there, I also started taking antidepressants (10 mgs of Celexa)  2 weeks before I started treatment, which I think helped a lot.  My doctor just upped my dose of Celexa to 20 mgs a day yesterday.

I'm glad that your starting treatment and I think if you go in with a positive attitude, you'll do just fine.  I felt so much better after I started, I worried about it all summer and then after my first shot, I felt like this dark cloud had been lifted from over my head, I was finally starting treatment and I was embracing it.

Good luck!
Linda

[kickboxingmom]

Thank you.Sounds like you got a little of your life back.That's awesome.Keep on living.
Hugs Back, Tammy

[Lady Lauri]

Glad your getting started! IMO, being Geno 1, the Riba is a good dose. Also IMO, slamming these critters as hard as you can to start, is good. IF the need to reduce happens, as in my case and as per your weight the possibility is there, at least you started with a bang.

I wish you an easy, tolerable tx ahead. I will be checking in and so hope to see you reach SVR.

Hugs, LL

[kickboxingmom]

Thank you so much for taking the time to answer my questions.It's nice to be able to ask.
Tammy

[zazza]

Come on, Medhelp, I thought you had fixed the problem with the greater than, smaller than symbols.

OK, Kickboxingmom, here we go again:

"I think I finally figured out your riba dosage. Ribasphere is apparently dosed like Copegus, which means 1000 mg for less than 75 kg, and 1200 mg for more than 75 kg. Usually Rebetol is given with PegIntron, and this confused me, because Rebetol is dosed 800 mg for less than 65 kg, 1000 mg for 65-85 kg, 1200 mg for 86-105 kg, and 1400 mg for more than 105 kg. Ribasphere, Copegus and Rebetol are all the same drug, just different names, different manufacturers and different weight based dosages."

[zazza]

I think I finally figured out your riba dosage. Ribasphere is apparently dosed like Copegus, which means 1000 mg for 75 kg. Usually Rebetol is given with PegIntron, and this confused me, because Rebetol is dosed 800 mg for 105 kg, Ribasphere, Copegus and Rebetol are all the same drug, just different names, different manufacturers and different weight based dosages.

[kickboxingmom]

Girl your in my prayers every morning.You and Aunt Norma.Hope you are holding on.Nick would want you to be happy.Thank You for your nice words.
God Bless,
Tammy

[kickboxingmom]

Thank you and I will do the 3 early not later.Pep me up- woo hoo.Husband is exp., not me with injecting his humira for crohn's.Thank you for the additional info.I feel I can be my own advocate at my appt.Before I decided to tx with him I ask about rescue drugs.He said, yes I'm giving you my 24/7 telephone #.
Thanks Again,
Tammy

[nygirl7]

PS I wanted to say if you do have experience already giving injections you might not want the redi-pen. That will be for you to decide but you can get it where you use a regular old needle and not that big thing.

[nygirl7]

I too would definitely set the dial at .5 - I'm a little surprised at how much riba he is giving you for your weight (they wanted to give me 800 and I was 5'7 120pounds but I begged for 1,000 which is what you will be on (I wanted more, I'm crazy!) my advice would be to take the 3 in the am and 2 at night.  The riba can make you speedy especially at first it can make a difference to help you sleep if you take the major portion earlier rather than later and it won't matter..riba builds up to a certain serum level in your body and it stays that same level.

The riba will cause the anemia not the interferon so if the doc is really concerned with that - at your weight you should be on the 800 not the 1,000.  Make sure you are getting frequent and regular cbc tests to monitor the hemoglobin though just in case so he could get you started on Procrit if you need.  Ask him if he is willing to do that.  Procrit has enabled MANY of us in here who would not have been able to continue onwards due to the hemo drop to finish treatment.  It can be a crucial factor in treatment, so asking him now will help.

Good luck. The redipen is bulky but it's REALLY easy to use - just remember to follow along with the directions when you start just in case someone interrupts you...that happened to me a few times and messed me up. By the end you'll be doing it in your sleep. Really.

[kickboxingmom]

Thank you !
Tammy

[IAmTheWalrus]

I think the Ribavirin is the culprit for causing anemia. Netropenia would be cause for reducing the interferon dosage. The shot part is not a big deal as it is subcutaneous, like insulin shots that diabetics have been doing for years.

Good luck!

[kickboxingmom]

That's the dose on the bottle of Riba and the Redipen.I haven't seen the man about the dosage yet.I will go in for the tutorial on the 7th.Maybe he has other plans other than what's on the labels.I hope.Atleast I have information to know the difference, now, thanks to you and others.zazza, it was nice to meet you.Now I can say I met a nice Lady from Sweden.I will get that dragon ! I'm now on a mission.
Thank You,
Tammy

[zazza]

If your doc is worried about anemia, why is he prescribing such a high dose of ribavirin? It is the ribavirin that causes the anemia.

That cake sounds so delicious! We don't even have cakes like that in Sweden! Thank you for all your nice thoughts. They encourage me to share what I have learnt with others. Now go get that dragon!

[kickboxingmom]

zazza, Yes, I will be doing the dialing .The first time will be in his office.I will ASK and Demand that they push all the way.Before anyone injects anything.My Dr. knows Bruce Bacon very well and both are well known.It surprizes me that the Redipen states 0.4.I know he's concerned about anemia because we have already talked about that and the RA.RA has been in overdrive for the past eight months.Rheumy soon to put me on Enbrel.Mikkimoe said, it worked a long time for her.
I am sending you another hug.Your words are of wisdom and knowledge.Thank You.If you were here I would bake you a cake.Cherry Chip with Fluffy Marshmellow Icing.I made one last night and when I eat a pc today, I'll think of you and what you said.Your amazing.I can see why people respect you.Thank you and God Bless,
Tammy

Trish77, I have two weeks b4 Nov.07, appt. and will call Dr. first thing in the morning and see if it's ok to start riba early." prime the pump", sounds like an expert rationalazation to me..Why wouldn't you put the filter on before you add the oil, so to speak.Thank you for your wise and knowledgable words.
God Bless,
Tammy

Meki, I hope life is still treating you with good and contentment because you deserve some piece of mind.I'm sure your daughter is well, she has you.Thank you as alway's .
God Bless,
Tammy

All,  I have an inner piece feeling today that I haven't had in a while.It's because of all of you and having the meds in the fridge ready to begin the battle of all battles.
Cancer-13 Years Clean.
With these knowlegable words and wisdom I feel like I Can Open the gate to the fierce fire breathing dragon and Take him ...I will win this battle and be able to Help Mankind with the rest of you good people.

Thank You To All,
Tammy

[Trish77]

Here's a long but informative thread on the pre-dosing of ribavirin that seems to support pre-dosing as a "prime the pump" approach to use willing's words in this thread.  The theory, in crude terms, is that it takes 1-2 weeks for ribavirin to reach maximum concentration in the body, therefore pre-dosing means ribavirin is at maximum efficacy for synergy with interferon when you do your first injection.  

The current SOC treatments and RVR / EVR / SVR measurements are based on SOC without pre-dosing. It's not the end of the world if you don't get it and alot of docs are not on board with that yet.  

However, having said that, if I was doing SOC now, I'd be asking for pre-dosing for at least one week, but that's just me.

Here's the thread ... good discussion between some knowledgable minds here.

http://www.medhelp.org/posts/show/381390?post_id=post_2252755

Hope that helps and good luck with your treatment decisions AND your treatment.  You know where to find us.  :)

Trish

[zazza]

I see you have RA, which might complicate the picture. Otherwise I would just say, you realize YOU are the one doing the dialing, right?

[meki]

I used the generics --- I was terrified that it would make a difference.. But I SVRd so it's all good.

HUGS!

Meki

[kickboxingmom]

TeeVee36, I was suppose to also get the riba pack but the ins. would not pay for the ribavirin so they gave me the turquoise blue pills but 200mg.

FiGuy, I also ask this question on the other forum and zazza confirmed with what you said about taking the FULL Redipen dose of 0.5mL.I am so going to demand that at my appt.

All, Thank you !
Tammy

[FlGuy]

Seems like riba-pak is a little more frequently used in Canada.  Just an observation over the years.  But, riba is made in several denominations 200, 400, 600 mg.

[TeeVee36]

I am not sure if I was on a generic form of ribavirin or not but I was told that it wasn't as harsh and it worked for me.  I took two pill a day, each was 600 mg and they cam in a nice box with four, seven day dosages.  They call it Riba-pak and I highly recommend it as the other ribavirin pills (two in the morning, two in the evening or whatever it was) caused sx's that were intolerable and I didn't make it past 3 wks back in 2002.  This time around I completed the entire tx on the riba-pak!  

Has anyone else heard of riba-pak (turqoise blue pils).

TV

[desrt]

"Generic forms of riba are just as bad as any other manufacturers' version."

I've often wondered about the expiration date on riba. It's like unflavored yogurt - what's it going to do, go 'good'?