low wbcs on solvadi peg n rib they want mw to decrease
libgirl07 said
Aug 4, 2014
I just left her a message questioning the use of neupogen. We shall see.
Tig said
Aug 4, 2014
I'm curious why the consideration for Neupogen or a blood transfusion hasn't been considered Libgirl? They provide a rapid increase in blood counts without the need for Interferon reduction.
Tig
libgirl07 said
Aug 4, 2014
Now she wants me to stop interferon all together until my white blood cells and neut goes up. She was pretty much saying I'm not tolerating interferon this time and I might stop and wait for the new drugs in October.
libgirl07 said
Jul 31, 2014
Thank u taz u have given me hope.
TazKat said
Jul 29, 2014
on sovaldi (just finished treatment 7/17) my riba was losered this treatment to 3 a day instead of the 6 a day i did with incivek. They even took me off for 6 days in the beginning because i was having a reaction. skin & nerves. lol but all did good. i am cleared & will know by oct 24 if i am svr..
Isiscat2011 said
Jul 29, 2014
libgirl07 wrote:
I meet with her tomorrow morning. I'm going to ask her the statistics then.
She won't have any. Certainly nothing reliable or definitive that you can take to the bank. I'd use the time to ask her the real question: What are my options?
This may sound cynical but lowering dosages is faster and easier than getting insurance approval for medical alternatives (if they are even necessary at this point). Unfortunately, the easier road is the one some health care providers travel on. If you are being treated by a nurse practitioner ask to talk to the doctor.
libgirl07 said
Jul 29, 2014
I meet with her tomorrow morning. I'm going to ask her the statistics then.
Isiscat2011 said
Jul 29, 2014
libgirl07 wrote:
I had a blister that the doctor swabbed and it tested positive doe mrsa. I think I that is the only reason I am fearful. My immune system not being able to fight that off. But I want to SVR but jeez haha. I can't find anything on SVR rates in reduction in meds for solvadi.
Hi libgirl:
Well, the reduction would not be of Sovaldi, it would be of Int/Riba. I don't think it is safe to assume that Sovaldi is so good it can overcome Int/Riba dose reductions. If it was that good it could be used as monotherapy.
There is a general rule with drug dosages that if you go below 80% of the recommended dosage it will reduce efficacy. Like everything else it depends on the individual --some may need 100% while others may get by with 60% and it depends on timing as well--so many variables. Keep in mind that Interferon is actually boosting your immune system. Gotta do what your doc says but sometimes they forget to discuss alternatives and we need to know all of our options to make informed choices.
libgirl07 said
Jul 29, 2014
I had a blister that the doctor swabbed and it tested positive doe mrsa. I think I that is the only reason I am fearful. My immune system not being able to fight that off. But I want to SVR but jeez haha. I can't find anything on SVR rates in reduction in meds for solvadi.
Scruffy said
Jul 29, 2014
Hiya Nicole
I can understand you not wanting to lower your dose. I was on epogen for 40 out of the 48 weeks and they had to add neupogen too for the last 12 weeks all not to lower my doses. Maybe with the new meds its ok?? Have a good talk with your doctor.
Good luck to you.
mallani said
Jul 28, 2014
Hi Nicole,
The ANC (Absolute Neutrophil Count) is more useful than the WCC. Mine dropped to 0.7 but there was no way I was getting a dose reduction.
The decreased ANC is due to Interferon- there's no justification for reducing Riba. With your history of relapse on the Victrelis, there's a question mark over your Interferon sensitivity and I wouldn't want to lower the dose of Peg. You're only on 12 weeks of Sovaldi triple, so ask why she's worried. Perhaps Neupogen is an option.
You must be guided by your doctor, but it's OK to ask questions. Good luck.
libgirl07 said
Jul 28, 2014
She said because my neut and wbcs are low. I go talk to her Wednesday I'm going to just continue my rib like normal I guess until I actually get to speak to her myself. I also had a blister swabbed and it was positive for mrsa so perhaps that's also why.
Isiscat2011 said
Jul 28, 2014
I appreciate your concerns. Dose reductions can make a difference in outcome, no matter what they say to make you feel better about it, and some docs are perhaps too quick to reduce doses.
My doc looked at absolute neutrophils (ANC) in addition to wbcs for a better indicator. Malcolm is the person to tackle this but it might help to provide the ANC number as well.
Hope4 said
Jul 28, 2014
Afraid I have no information for you about the proposed decreases. Did they say if it would just be a temporary adjustment, for a week or so? I'm starting the same treatment on Thursday this week so I just wanted to check in with you, say hello and I'll be following your updates. Wishing you the best.
libgirl07 said
Jul 28, 2014
My 4 week labs aren't bad but my wbcs dropped to 1.54. My doc wants me to lower interferon to 140mcg and go from 3 rib in am n 2 at night to 2 in am 2 at night. I'm scared to lower my dosages. I relapsed last time on beceprevir lowering my rib. Anyone have any input please
I just left her a message questioning the use of neupogen. We shall see.
I'm curious why the consideration for Neupogen or a blood transfusion hasn't been considered Libgirl? They provide a rapid increase in blood counts without the need for Interferon reduction.
Tig
Thank u taz u have given me hope.
on sovaldi (just finished treatment 7/17) my riba was losered this treatment to 3 a day instead of the 6 a day i did with incivek. They even took me off for 6 days in the beginning because i was having a reaction. skin & nerves. lol but all did good. i am cleared & will know by oct 24 if i am svr..
She won't have any. Certainly nothing reliable or definitive that you can take to the bank. I'd use the time to ask her the real question: What are my options?
This may sound cynical but lowering dosages is faster and easier than getting insurance approval for medical alternatives (if they are even necessary at this point). Unfortunately, the easier road is the one some health care providers travel on. If you are being treated by a nurse practitioner ask to talk to the doctor.
I meet with her tomorrow morning. I'm going to ask her the statistics then.
Hi libgirl:
Well, the reduction would not be of Sovaldi, it would be of Int/Riba. I don't think it is safe to assume that Sovaldi is so good it can overcome Int/Riba dose reductions. If it was that good it could be used as monotherapy.
There is a general rule with drug dosages that if you go below 80% of the recommended dosage it will reduce efficacy. Like everything else it depends on the individual --some may need 100% while others may get by with 60% and it depends on timing as well--so many variables. Keep in mind that Interferon is actually boosting your immune system. Gotta do what your doc says but sometimes they forget to discuss alternatives and we need to know all of our options to make informed choices.
I had a blister that the doctor swabbed and it tested positive doe mrsa. I think I that is the only reason I am fearful. My immune system not being able to fight that off. But I want to SVR but jeez haha. I can't find anything on SVR rates in reduction in meds for solvadi.
Hiya Nicole
I can understand you not wanting to lower your dose. I was on epogen for 40 out of the 48 weeks and they had to add neupogen too for the last 12 weeks all not to lower my doses. Maybe with the new meds its ok?? Have a good talk with your doctor.
Good luck to you.
Hi Nicole,
The ANC (Absolute Neutrophil Count) is more useful than the WCC. Mine dropped to 0.7 but there was no way I was getting a dose reduction.
The decreased ANC is due to Interferon- there's no justification for reducing Riba. With your history of relapse on the Victrelis, there's a question mark over your Interferon sensitivity and I wouldn't want to lower the dose of Peg. You're only on 12 weeks of Sovaldi triple, so ask why she's worried. Perhaps Neupogen is an option.
You must be guided by your doctor, but it's OK to ask questions. Good luck.
She said because my neut and wbcs are low. I go talk to her Wednesday I'm going to just continue my rib like normal I guess until I actually get to speak to her myself. I also had a blister swabbed and it was positive for mrsa so perhaps that's also why.
I appreciate your concerns. Dose reductions can make a difference in outcome, no matter what they say to make you feel better about it, and some docs are perhaps too quick to reduce doses.
My doc looked at absolute neutrophils (ANC) in addition to wbcs for a better indicator. Malcolm is the person to tackle this but it might help to provide the ANC number as well.
Afraid I have no information for you about the proposed decreases. Did they say if it would just be a temporary adjustment, for a week or so? I'm starting the same treatment on Thursday this week so I just wanted to check in with you, say hello and I'll be following your updates. Wishing you the best.
My 4 week labs aren't bad but my wbcs dropped to 1.54. My doc wants me to lower interferon to 140mcg and go from 3 rib in am n 2 at night to 2 in am 2 at night. I'm scared to lower my dosages. I relapsed last time on beceprevir lowering my rib. Anyone have any input please