ribavirin therapy dose

I was wondering any information you might have regarding svr and the ribavirin dose reduction (i did see a study regarding monotherapy with a viral load of less than 100,000 and genotype 2 here is the link http://www.ncbi.nlm.nih.gov/pubmed/19084937 any insight will be greatly appreciated.

Ribavirin has a multiple dose half-life of 12 days, and it may persist in non-plasma compartments for as long as 6 months. Therefore, Ribavirin, including Ribavirin tablets, is contraindicated in women who are pregnant and in the male partners of women who are pregnant. Extreme care must be taken to avoid pregnancy during therapy and for 6 months after completion of therapy in both female patients and in female partners of male patients who are taking Ribavirin therapy.

If severe adverse reactions or laboratory abnormalities develop during combination Ribavirin tablets/peginterferon alfa-2a therapy, the dose should be modified or discontinued, if appropriate, until the adverse reactions abate or decrease in severity. If intolerance persists after dose adjustment, Ribavirin tablets/peginterferon alfa-2a therapy should be discontinued.

Have any of you seen the new study out of Johns Hopkins regarding comparing the two Pegs? Apparently they also looked at lowering the dose of ribavirin (and interferon) when anemia occurs and found that actually improved the success rate of SVR when compared to people who toughed it out and stayed with the same dose. I was floored when I read this and wish I knew enough to know just how good this study really is. I have a lot of respect for Dr. Sulkowski.

Extreme care must be taken to avoid pregnancy during therapy and for 6 months after completion of therapy in both female patients and in female partners of male patients who are taking ribavirin therapy. At least two reliable forms of effective contraception must be utilized during treatment and during the 6 month post treatment follow-up period." "5.1 Pregnancy COPEGUS may cause birth defects and/or death of the exposed fetus.

For the management of anemia, ribavirin dose reductions should be used (refer to the prescribing information for ribavirin for its dose reduction guidelines). If ribavirin dose reductions are inadequate, discontinuation of INCIVEK should be considered. If ribavirin is permanently discontinued for the management of anemia, INCIVEK must also be permanently discontinued. Ribavirin may be restarted per the dosing modification guidelines for ribavirin.

75 kg = 1000 mg - 48 weeks ≥ 75 kg = 1200 mg - Dose Modifications If severe adverse reactions or laboratory abnormalities develop during combination Ribavirin tablet/peginterferon alfa-2a therapy, the dose should be modified or discontinued, if appropriate, until the adverse reactions abate or decrease in severity. If intolerance persists after dose adjustment, Ribavirin tablet/peginterferon alfa-2a therapy should be discontinued.

These effects occurred at doses as low as one twentieth of the recommended human dose of ribavirin. Ribavirin therapy should not be started until a report of a negative pregnancy test has been obtained immediately prior to planned initiation of therapy [see BOXED WARNING, CONTRAINDICATIONS (4), USE IN SPECIFIC POPULATIONS (8.1), and PATIENT COUNSELING INFORMATION (17.2)]. USE IN SPECIFIC POPULATIONS Pregnancy Pregnancy Category X [See CONTRAINDICATIONS (4), WARNINGS AND PRECAUTIONS (5.

Studies with Victrelis showed the patient was given weight-based ribavirin (600-1400 mg/day orally divided twice daily. At 114 lbs 800 mg of ribavirin would be in range but if you tolerate 1000 mg that it all the better and at this point I don't think you're being over prescribed. It's important to get that viral load down during the first 4 weeks and ribavirin stops the virus from replicating.

Although the study design was quite complicated, the goals included an evaluation of 28 vs 48 weeks of the triple-combination regimen and a comparison of boceprevir and peginterferon alfa-2b plus low-dose ribavirin (400-1000 mg/day) vs standard-dose ribavirin (800-1400 mg/day). Another key aspect of this trial was the assessment of a 4-week peginterferon plus ribavirin lead‑in phase before the introduction of boceprevir.

10 g/dL -- or were expected to soon reach that level were randomly assigned to reduce their ribavirin dose by 200-400 mg/day or add 40,000 units/week subcutaneous injections of EPO. If hemoglobin fell to 8.5 g/dL, secondary methods of anemia management could be added. If it dropped to 7.5 g/dL, treatment was discontinued. The primary endpoint was sustained virological response (SVR), or continued undetectable HCV viral load after completion of treatment.

//www.hivandhepatitis.com/hepatitis-c/hepatitis-c-topics/hcv-treatment/3583-easl-ribavirin-dose-reduction-and-epo-both-work-for-managing-anemia-in-patients-using-boceprevir "Reducing the dose of ribavirin and adding erythropoietin are both good options for managing anemia in hepatitis C patients treated with boceprevir (Victrelis) triple therapy, according to study findings presented at the 47th International Liver Congress (EASL 2012) this week in Barcelona.

In patients treated with telaprevir-based therapy, anemia as well as ribavirin dose reduction had no apparent effect on SVR rates as compared with patients treated with peginterferon/ribavirin alone. These data suggest that management of treatment-related anemia with ribavirin dose reduction appeared not to impact SVR with telaprevir-based therapy." http://www1.easl.eu/easl2011/program/Posters/Abstract284.

a randomized study of treatment duration and ribavirin dose. Ann Intern Med. 2004;140:346-355. 2. Zeuzem S, Buti M, Ferenci P, et al. Efficacy of 24 weeks treatment with peginterferon alfa-2b plus ribavirin in patients with chronic hepatitis C infected with genotype 1 and low pretreatment viremia. J Hepatol. 2006;44:97-103. 3. Jensen DM, Morgan TR, Marcellin P, et al. Early identification of HCV genotype 1 patients responding to 24 weeks peginterferon alpha-2a (40 kd)/ribavirin therapy.

I start Triple Therapy tomorrow and I am absoluteky TERRIFIED!!! Im only 26 but have an infant and 4 year old and while medicaid is gonna pay for my meds I figure I better jump on it! Im taking the following medicines: Ribavirin 200mg tablet, INCIVEK 375mg tablet, & Pegintron Redipen 120mcg My nurse said first few shots would be rough but I read this not to be true, that they get worse and worse the further u go along!!

In patients treated with telaprevir-based therapy, anemia as well as ribavirin dose reduction had no apparent effect on SVR rates as compared with patients treated with peginterferon/ribavirin alone. These data suggest that management of treatment-related anemia with ribavirin dose reduction appeared not to impact SVR with telaprevir-based therapy.

Feld, MD, MPH, Hemant Shah, MD, FRCPC Adverse Effects and Management Strategies The use of either peginterferon/ribavirin dual therapy or in combination with direct-acting antiviral agents can lead to significant adverse effects that necessitate dose reduction or discontinuation of treatment. Early recognition and intervention can help clinicians ensure patients are able to complete therapy where possible and achieve the goal of viral eradication.

Jim - I think a lot of ribavirin dosing is done with extreme caution. There are still doctors out there who will cut riba dosing instead of adding Procrit - which has come under more safety scrutiny lately, as I'm sure you know, and is off-label for ribavirin anemia. Some insurances won't pay for it. Some high-dose riba patients have needed transfusions to get them through therapy.

Researchers also found that in the third of study participants whose ribavirin dosage was reduced as a result of anemia, cure rates actually improved to as high as 52 percent, whereas in those whose ribavirin dose stayed the same, cure rates were lower, at 37 percent.

Although the pegylated interferons are the primary drugs used to treat CHC, a combination with ribavirin is more effective than pegylated interferon alone. Ribavirin-associated AE may be lessened by ribavirin dose reductions and by maintenance of the hematocrit..." See: http://www.medscape.com/viewarticle/578705 Ribavirin improves early responses to peginterferon through improved interferon signaling. Gastroenterology.

A positive linear relationship exists between ribavirin dose and SVR; ribavirin doses greater than 10.6 mg/kg/d have higher SVR rates" http://depts.washington.edu/hepstudy/hepC/mgmt/anemia/discussion.

s of riba since I started triple therapy. In 16th wk now and stopped the Inc. Jan 22...is this a normal dose? Sounds like everyone else is taking a lower dose? Just wonderin... Thanks :) you guys are the best...

Ribavirin therapy dose

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