Sorry to hear Bob. That sucks. I did read this, however, and immediately wondered what Sigmund Freud would have to say about it. Google the unconscious mind.

Bob, I'm sorry to hear that. mistakes happen. I would call ASAP
and tell them what happened, and hope they will help. Do you
get it from CVS or Walgreens? Good luck Bob.

Call - someone - dr, drug co?
I'm hoping you don't have to pay for the whole replacement.
They should understand!
Joe, shipping separate sounds like a good idea.

Yes, let them know that they forgot to include the riba in the shipment. If you call NOW, you should have it by Monday.

Erik, I think I will take your advice. It's not the pharmacy's fault I have brain fog, they shouldn't have to pay.

I have enough for two more days.

Hey Erik!

Would you mind sharing with the rest of us the data you're referring to??? I'm curious about this.

Respectfully,
Henry

Sugar! Fudge!! let us know how it works out... good luck Mr OSO

Sounds like you don't really know if it was in there or not, but if it was, you didn't see it. Hopefully you have a sympathetic pharmacy who will help you. I had the experience early on that my doctors nurse wrote a script for the w rong dose (4 a day instead of 6 a day). the pharm sent it to me and I was 60 pills short. She called in a new script and the pharm filled it with no co-pay (I am sure the insurance must have rejected it since it was a week after the fill). If it were Incivek, you'd be out big bucks, but riba-- they can afford to be nice.

PS The links on dose reduction were completely helpful and timely, since I just went on a dose reduction for anemia-- these ease my mind.

Bob,

I'm so happy that your are hangin' in there! Don't sweat the small stuff. Throwing away your meds by accident is NOT a crisis.

Just call your doc's office. They will most likely have some extra Riba that they will give you in a heartbeat. When my dose was reduced due to anemia from 1000 to 400, I didn't have the right dosage of pills. I had some 400's and some 600's, and I still needed to take it twice a day.

So my HCV doc just went to a locked cabinent, and got me 2 bottles of 200's. He had a ton of them in there! He said that the Riba is the easy one. When patients quit they give him the extra, but If I needed the Interferon, that was a different story.... As long as patients don't open the bottle, he accepts them, and can give them to other patients who lose their insurance for instance, or like in my case, needed the lower dosage.
So we traded. I gave him my unopened Riba Packs, took the 200's that he gave me, and he got a new prescrition off to my pharmacy. When I was taken off 4 weeks early, I gave all my unopened Riba, and unused Proclick Interferfon shots. You would have thought I was handing him GOLD he was so happy to have that Interferon!

Also, Erik, my doc told me the same thing. Riba can be reduced without much trouble because of the long half life of it, plus he said the magic number (how much Riba we need) seems to be somewhere between 400 and 600, but the SOC is based on your weight to begin treatment and adjusted as you go along if necessary.

(((((((((BIG HUGS Bob))))))))))) I'm really proud of you! BTW brain farting lasts awhile....I still have it sometimes, and I'm almost 6 months post. It's getting better though. =)
Love,
Kelly

Kelly, thanks for the advice and support. You were one of the first to make me feel welcome in here, I will always appreciate that.

I'm actually seeing my Dr. on Tues, and I have enough to last me until then. I will call him tomorrow and see if he can comp me some, if not then I will call the pharmacy (they are closed today).

You are right, it's not a crisis. Worst case scenario is that I will take 2 pills twice a day for the next few days instead of 3 pills at a time and stretch them out.

Hey Erik!

I knew there was more to this than what met my eyes so to speak!
Caveats are almost always around yet they're not so obvious to initially recognize... So All these paragraph below are from the first two links you posted earlier:

This is from HIVandHepatitis.com

EASL: Ribavirin Dose Reduction Is Effective for Managing Anemia in Patients Using Boceprevir or Telaprevir:

Triple therapy raises the likelihood of a cure and offers the potential for shorter treatment, but it also increases side effects such as anemia (low red blood cell or hemoglobin levels). Various approaches are used to manage anemia including reducing the dose of ribavirin, adding erythropoietin (EPO; brand names Epogen and Procrit) to stimulate red blood cell production, and blood transfusion." I agree with everything before this upcoming sentence and this is the caveat: "Ribavirin dose reduction is risky for patients on interferon dual therapy since it helps lessen the likelihood of post-treatment relapse."

"In treatment-naive and previously treated patients who received telaprevir combination treatment, ribavirin dose reduction was more frequent than in the control group," the researchers concluded. "Ribavirin dose reduction, including dose reduction to < 600 mg/day, had no substantial effect on SVR rates in patients treated with telaprevir combination treatment." And then the article goes on to state this:

"Taken together, these studies indicate that the extra potency of HCV protease inhibitors helps overcome the tendency to relapse among patients who take inadequate ribavirin in dual therapy with pegylated interferon."

This last paragraph is important for one of the ladies in here who was worried about whether or not she could take a lower dose of Riba for her treatment and if being on triple tx would potentially mess up her treatment... So it all depends on whether or not you're on triple or SOC dual therapy:

"In his summary of research highlights on the final day of the conference, Jean-Michel Pawlotsky from the University of Paris said these findings "validate the use of ribavirin dose reduction" rather than adding the expense of EPO to an already costly regimen." This is from PubMed - NCBI below:

"Impact of ribavirin dose reductions in hepatitis C virus genotype 1 patients completing peginterferon alfa-2a/ribavirin treatment."

"RESULTS: Of patients who completed treatment, more had reductions (< or =97% cumulative dose) of ribavirin than of peginterferon alfa-2a (43% vs 27%). Neither early virologic response nor SVR was affected adversely by ribavirin reductions when the cumulative ribavirin exposure was greater than 60%.

"The SVR was reduced significantly (P = .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. In contrast, SVR was reduced markedly in patients who had ribavirin dose reductions and did not achieve rapid virologic response."

"CONCLUSIONS:
Minor ribavirin dose reductions to manage adverse events do not appear to affect SVR adversely, "unless cumulative exposure is less than 60%." Prospective studies, however, are required to establish the impact of ribavirin dose reduction on SVR."

In Summary Erik,
There's always a caveat! For instance, I believe this paragraph explains what this is all about by explaining the clear differences between types of therapy as well as the percentage of dose reduction and how different the results will be more than likely to happen. Very interesting indeed! Thanks again for those articles!

Respectfully,
Henry

Fortunately Riba is very inexpensive compared to interferon or incivek. My interferon and incivek would come in a cooler with ice packs (not dry ice, that would freeze the interferon solid). This was curious because incivek does not need to be refrigerated, thus creating extra shipping costs. The riba would be in a separate package (bag). The last shipment I received seemed to be missing the riba. I yelled at the poor UPS guy (riba rage) for losing my meds but when I called the pharmacy they said it had been shipped. The riba arrived the next day via FedEx. Other times the meds were always shipped by UPS only. Never did find out why my meds were shipped a day apart. My pharmacy was Accredo.

I have enough to last me through tomorrow. I will call my doctor first thing, then the pharmacy.

Funny thing is, they always send me a 30 day supply of Riba with a 28 day supply of Interferon, so I always knew I would have extra left over at the end.

MrO sorry to hear about the kerfuffle with the riba.... I don't think your dr or pharmacist will think you are abusing it... lol

Hope you are able to get it in time so you don't interrupt your treatment.

Good luck my friend

***Update***

Called my doctor this morning, the nurse told me they did not have any samples. So I called Express Scripts, they were very nice about the whole thing. They called me back after getting authorization, and are sending me a 30 day supply overnight, for a $5 copay.