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.
0006) in patients with less than the 60% cumulative ribavirin dose and was associated with prolonged periods of dose reduction, temporary interruptions, or premature cessation of ribavirin. Ribavirin dose reductions had minimal impact on SVR in patients who achieved rapid virologic response, defined as undetectable HCV RNA levels after 4 weeks, even when they received less than the 60% cumulative ribavirin dose.
If this is the case you have had a procrit dose reduction which seems strange considering your HGB of 8.3 and your very low dose of Ribavirin.
Maybe they switched the vial strength since your original prescription. Please figure out precisely what you were taking at the begining and what you are taking now.
//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.
At least in patients with the less responsive Genotypes 1a and b it seemed to indicate a better chance of sustained viral response (that is of remaining virus free six months after treatment) after protocol completion.
In the telaprevir clinical trials, both ADVANCE and ILLUMINATE, ribavirin dose reduction was the strategy. The use of epoetin alpha was not allowed for the management of anemia. Here you can see that those patients who had a reduction in the ribavirin dose had identical sustained virologic response rates as those patients who did not have a reduction in the ribavirin dose
"The New Elements of HCV Care: Practical Skills to Optimize Protease Inhibitor–Based Therapy"
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0006) in patients with less than the 60% cumulative ribavirin dose and was associated with prolonged periods of dose reduction, temporary interruptions, or premature cessation of ribavirin. Ribavirin dose reductions had minimal impact on SVR in patients who achieved rapid virologic response, defined as undetectable HCV RNA levels after 4 weeks, even when they received less than the 60% cumulative ribavirin dose.
com/hepatitis-c/hepatitis-c-topics/hcv-treatment/3583-easl-ribavirin-dose-reduction-and-epo-both-work-for-managing-anemia-in-patients-using-boceprevir
EASL: Ribavirin Dose Reduction Is Effective for Managing Anemia in Patients Using Boceprevir or Telaprevir
"Early ribavirin dose reduction did not negatively impact SVR compared with early EPO use," the investigators concluded. "These data support ribavirin dose reduction for primary anemia management.
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