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Medical Forum / Diseases and Disorders / Hepatitis / November 2005

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Ribavirin dosing

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kjoh - 19 Nov 2005 02:01 GMT
Hi People
Here's a news bit from a large study involving 4900 patients.  They
compared weight-based Ribavirin dose to ‘flat dose' Riba. The ‘flat dose'
was 800mg Riba.  Riba is the drug that causes red blood cells to drop,
often leading to either a dose reduction or the addition of very expensive
Procrit.  The implication is that a lot of the heavier patients didn't get
enough Riba.  

The results are hopeful for me, though, because I have only been taking
800mg Riba from the beginning and have been worried that I wasn't getting
a high enough dose.  (my starting weight 145lbs, currently 118lbs) .  At
that dose, my RBC dropped to the low end of the normal range and stayed
there. I did recently find that I can tolerate 1000mg daily without going
nuts, but my RBC has now dropped slightly below normal. It seems that so
far the idea has been the more Riba the merrier, but perhaps that will
change.  
Here's a handy dandy conversion chart for us metrically impaired
Americans:

65kg = 143 lb
85kg = 187 lb
105kg = 231 lb
125kg = 275 lb

LARGEST HEPATITIS-C U.S. STUDY DEFINES OPTIMAL THERAPY
"In the WIN-R study, 4,913 patients were randomized to receive
weight-based PEG-INTRON (1.5 mcg/kg weekly) in combination with REBETOL
given either as a flat dose (800 mg daily) or a weight-based dose (800 mg,
1,000 mg, 1,200 mg, or 1,400 mg daily for body weights of less than 65 kg,
65 to 85 kg, 86 to 105 kg, or 106 to 125 kg, respectively). Patients were
treated for 48 weeks (genotype 1) or 24 weeks (genotype 2 or 3). Patients
in the treatment arms were evenly matched for gender, age, body weight,
genotype, viral load, and stage of liver fibrosis [......] Lower rates of
relapse were seen for patients receiving the weight-based combination
therapy compared to the flat-dosed ribavirin regimen, 15 percent vs. 19
percent overall, and 23 percent vs. 29 percent for patients with HCV
genotype 1."

Medical Study News
Published: Monday, 14-Nov-2005
http://www.news-medical.net/?id
kjoh - 19 Nov 2005 02:07 GMT
Oops, here's the link again

http://www.news-medical.net/?id=14495
elmoemerson@webtv.net - 19 Nov 2005 16:08 GMT
I think the amount of riba taken is a significant factor, as shown in
the study you posted.  For my second round of tx, I was in a clinical
study for PegIntron and was given 800 mg riba/day (4 caps).  My weight
was 196 lbs.  I cleared the virus by my 16th week but relapsed within a
month after coming off the meds.  In my third and final tx, I took 1400
mg riba/day along with daily Infergen, Pegasys and Amantadine.  I
cleared the virus by my 9th week and have had 'undetectable' viral
counts ever since finishing in March, 2004.
elmo
/////////
Hi People
Here's a news bit from a large study involving 4900 patients. They
compared weight-based Ribavirin dose to 'flat dose' Riba. The 'flat
dose' was 800mg Riba. Riba is the drug that causes red blood cells to
drop, often leading to either a dose reduction or the addition of very
expensive Procrit. The implication is that a lot of the heavier patients
didn't get enough Riba.
The results are hopeful for me, though, because I have only been taking
800mg Riba from the beginning and have been worried that I wasn't
getting a high enough dose. (my starting weight 145lbs, currently
118lbs) . At that dose, my RBC dropped to the low end of the normal
range and stayed there. I did recently find that I can tolerate 1000mg
daily without going nuts, but my RBC has now dropped slightly below
normal. It seems that so far the idea has been the more Riba the
merrier, but perhaps that will change.
Here's a handy dandy conversion chart for us metrically impaired
Americans:
65kg = 143 lb
85kg = 187 lb
105kg = 231 lb
125kg = 275 lb
LARGEST HEPATITIS-C U.S. STUDY DEFINES OPTIMAL THERAPY "In the WIN-R
study, 4,913 patients were randomized to receive weight-based PEG-INTRON
(1.5 mcg/kg weekly) in combination with REBETOL given either as a flat
dose (800 mg daily) or a weight-based dose (800 mg, 1,000 mg, 1,200 mg,
or 1,400 mg daily for body weights of less than 65 kg, 65 to 85 kg, 86
to 105 kg, or 106 to 125 kg, respectively). Patients were treated for 48
weeks (genotype 1) or 24 weeks (genotype 2 or 3). Patients in the
treatment arms were evenly matched for gender, age, body weight,
genotype, viral load, and stage of liver fibrosis [......] Lower rates
of relapse were seen for patients receiving the weight-based combination
therapy compared to the flat-dosed ribavirin regimen, 15 percent vs. 19
percent overall, and 23 percent vs. 29 percent for patients with HCV
genotype 1."
Medical Study News
Published: Monday, 14-Nov-2005
http://www.news-medical.net/?id

http://community.webtv.net/elmoemerson/DocElmosHepFile

http://community.webtv.net/elmoemerson/TheFamilyAlbum
john - 28 Nov 2005 03:22 GMT
Hi Elmo,
Did i read that right? Did you do pegasys and infergen at the same
time.Was the pegasys once a week in addition to infergen?   john
elmoemerson@webtv.net - 28 Nov 2005 12:52 GMT

Re: Ribavirin dosing  

Group: alt.support.hepatitis-c Date: Sun, Nov 27, 2005, 7:22pm (CST-2)
From: otk355@hotmail.com (john)
Hi Elmo,
Did i read that right? Did you do pegasys and infergen at the same
time.Was the pegasys once a week in addition to infergen?   john
///////////
That's right!  I did both daily Infergen and a weekly shot of Pegasys
for several weeks.  
elmo

http://community.webtv.net/elmoemerson/DocElmosHepFile

http://community.webtv.net/elmoemerson/TheFamilyAlbum
pajaritaflora - 20 Nov 2005 04:53 GMT
> Hi People
> Here's a news bit from a large study involving 4900 patients.  They
[quoted text clipped - 37 lines]
> Published: Monday, 14-Nov-2005
> http://www.news-medical.net/?id

Hey Kathy,
I subscribe to the more Riba the better group.Mine was started weight
based at 118 lbs and 1000mg daily. Below 110 doc wanted to lower the
dose. But I did not. We made a deal bout keeping wieght on and not
going below 110lbs......I went to those visits with plenty of change in
my pockets, layers of clothes. ..I tried heavy shoes once...haa haa ha
I almost passed out on the way up the flight of stairs to the
office...I didn't do that again. Oh, and I don't do elevators unless it
is imperitive. So my weight stabilized at 104. with 1000mg. I didn't
loose weight on purpose, but I also didn't want to lower my dose.
...just my viewpoint, not a reccomendation.

Peace,
Mary Ann
Frank - 20 Nov 2005 13:27 GMT
>> Hi People
>> Here's a news bit from a large study involving 4900 patients.  They
[quoted text clipped - 52 lines]
>Peace,
>Mary Ann

I've actually gained 3lbs since I started. I went from 175 to about 178.  For the
record, I take 1200mg a day of Copeg.  I learned to take it mid-morning with
snack as opposed to too early.  The first time I took it after an early breakfast
before work (6AM), it made me a little flat and sluggish. Taking it as soon as I
arrive at work (9AM) seems to work well.  My night dose is around 6:30-7PM.  
 
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