Confused

[aj7538]

So, I had my first shot sept1, along with my first dose of riba. Thursday will be 1 month and my first blood test. I know we have discussed this before. But still confused. My dr office insists I start the victrelis oct6, the pharmacy says I should start friday. My ins co says I should start tommorrow? Why is everyone not.on the same page? Dont want to do anything to jeopardize outcome. Drs office.is counting 5 weeks from start date. Pharmacy says first day starting 5th week.  Any suggestions?

[beeblessed]

Lynda & Will -- And of course.....I don't have that information with me at the moment.  My training nurse told me that the rule was, we could move the shot ONCE during treatment. I believe it was 1 day forward once, or 1 day back once.  So I took my 1st injection on a Thursday night because my nurse does not work on Fridays (and because I wanted to have the weekends to rest).  She has been a Hep C nurse for about 30 years.

I do understand what you are both saying about the 8 days.  But I know I read early on in the forum that others started on a Thursday and switched to Friday the following week.  I'll see what my pharmacy thinks (even though it's moot for me) so I am not giving incorrect info.

[aj7538]

Dr had told.me.it was ok. This.is.when you are at their mercy. I was told as.long as.it was 24 hrs either direction it was ok. B dr told her the same. At any rate it is a done deal . I am learning more on this forumn than anywhere else. Cannot tell u how much I appreciate all your input.

[willbb]

bee& aj

Like lynda ..I have never heard of a change/ forward rule either...The concept of having the weekend to recuperate makes sense .however I don"t believe 8 days between peg shots is  ever advised.

[lynda607]

I've never heard of the one day change/forward rule.  You can take the interferon shot one day earlier but it is not advised to extend it out one day.
You don't want 8 days to pass between injections.  Pegylated interferon is designed so that the efficacy can be maintained within 7 days.  Actually, peak efficacy is reached around 72 hrs after injection of Pegasys and the trough slowly diminishes thereafter.

EX:

Shot Thursday -  can take shot Wed.

[aj7538]

Thanks . Sorry forgot to mention that. Will

[beeblessed]

Hi.  We did the 1st shot on a Thursday, the 2nd shot (and all those thereafter) on a Friday.  It was that 'one day change/forward rule' on the Interferon.  This gives the weekends to recuperate.

[willbb]

Well now I am confused ...I thought you said you took your first shot on the 1st which was the Thur  so if you start Vic on the Fri.as directed that is the 30th ..the day after your 5th shot on Thur evening...correct .or did I miss something

[aj7538]

Good luck. They also repeated for blood tests results to be accurate. Majority rules. Can do man was right. I guess it is.impt to listen to who is treating us. Best of luck

[evangelin]

I at least won't let him take the shot very late.  Maybe the earlier the better.  
Ev

[evangelin]

Well, that agrees with what I was told so that is what we will do.  Thanks for sharing your information.  This is too important to risk a misunderstanding. The morning before the 5th shot it is.
Ev

[desrt]

" I only have enough understanding to be dangerous."

I don't think anyone - doctor, pharmacist, or manufacturer could tell you whether you have a better chance of clearing if you start Fri. or wait till the 6th.
The one thing you can be sure of is getting plenty of different opinions if you ask.

[aj7538]

Thanks guys. Miracle of all miracles drs office called and,said to take the.pills friday. The morning of the 5th shot. Also. The rep from the drug co was there and said it was best to take it friday morning of the fifth shot. They felt very strong about it. They even offered to supply the drug for free so I could start then . So I am starting friday. They are shipping me my meds thursday. This is exhausting. Will thank u so much , you are a great source of.info. B, hope this.helps. And yes, I tend to agree the.pharmacist was very sure and knowledgable. He felt very strongly that I should start frid.morn before the shot. By the time this.over I wont be able to count to ten.lol. Never thought something so easy would turn out so screwy. Thanks all. Hopes this helps anyone making this decision.  Evg, looks like your dr. was right

[evangelin]

I hope we can get more expert opinions before we commit anything.  I only have enough understanding to be dangerous.
Ev

[beeblessed]

Hi there.  AJ and I started the same day, so your response helps me too.  You make an EXCELLENT point......"I am going to have to think about this because why would you want an almost worn out peg shot to be all you have in your system when you start the PI"

Thanks :)

[evangelin]

My husbands Dr. and specialty pharmacy says to start Victrelis the morning before your 5th shot.  I would have to assume that they have a very good understanding of the Victrelis because Dr. Bacon did a big presentation on the Vic. at a big liver conference.  On the otherhand. Dr. Shiffman is also a well known Dr. and seems to think it best to have it start after the shot.  My uneducated opinion likes Dr. Shiffman's plan because it seems like it would be best to not introduce the Protease inhibitor until you are well covered with the peg-interferon.  If my husband is doing OK at the time, we might move his shot one day forward and start the Vic the next morning .  They tell you it is OK to take the shot 24 hrs. before or after (Not that I would chance 24 hrs. after) but I wouldn't hesitate to have him take it 24 hrs before if he was OK.  I am going to have to think about this because why would you want an almost worn out peg shot to be all you have in your system when you start the PI.  

Just the ponderings of someone that doesn't really know so don't try and cash this check...I could be all wrong. Maybe it won't make a difference but maybe it will.  Just thinking of resistance possibilities and I just want to be as careful as possible.
I really don't get the Oct 6th date. ??? Hope we get some clarity soon.
Best wishes on your Victrelis experience,
Ev

[beeblessed]

Perhaps one of these will help and can be something you can share with your doc:

(on this link, scroll down to Dosing)
http://www.drugs.com/newdrugs/fda-approves-merck-s-victrelis-boceprevir-first-class-oral-hepatitis-c-virus-hcv-protease-inhibitor-2651.html

http://nursing.advanceweb.com/Magazine/RX-and-OTC-Updates/Victrelis-Boceprevir-First-In-Its-Class.aspx

http://hepatitis-c.emedtv.com/victrelis/victrelis-dosage.html


http://www.hepctrust.org.uk/Treatment/Potential+New+Drugs/Boceprevir+%28Victrelis%29

[can-do-man]

I would start either thursday or friday, 1st. thats when your suppose to and 2nd, when you have your 8 week pcr you want to have 4 full weeks of Vic, could be very important tx wise, not only with your ins. but your 8 week results.

[R Glass]

Everyone having there own count may explain why  many of us had so much left over Riba.

[wtbleep]

Just my 2 cents worth - being a pharmacy technician in a hospital I would tend to trust the pharmacy as any pharmacist worth his/her salt would be the most accurate source of drug information after the drug company itself.

Pauline

[willbb]

Sorry my first post could be confusing ...I meant to say he said to start the VIc on the morning after the 5th shot   not the 5th week...   so after 4 full weeks of SOC
Will

[willbb]

If you haven"t already ..you must register  for this site ..however it is a free registration and the info.they give is excellent I believe the info you are looking for is on the 4th slide.
Will

http://www.clinicaloptions.com/Hepatitis/Treatment%20Updates/Battling%20HCV/Interactive%20Virtual%20Presentations/Adverse%20Events.aspx

[willbb]

Yes ..it seems like everyone has there own protocol on this. DR shiffman that did the physicians presentation on COO said  to start VIC on the morning after the INF shot of the 5th week...however some docs are saying to take it the day of the 5th shot...so it sounds like in your case it would be on  the 29th or the 30th

Taking it on Oct. 6th doesn;t seem to makesense as that would be after a full 5 weeks and the protocol is after 4 weeks

Good luck ..hope thy get it all straightened out for you

Iwill post that COO presentation for you and possibly chat with your doc about it

Will