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Thread: Dose of Rituxan? 2 vs 4, what is the total amount of meds given?

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    Default Dose of Rituxan? 2 vs 4, what is the total amount of meds given?

    My dose during the 4 week protocol of RTX was 650/week, and now that I am doing two my doctor is still doing the same dose of 650/every two weeks, so I am getting 1/2 the medicine. Is that what others are getting, or are some getting a double dose if you do the two protocol?

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    That's odd dosing for the 2 infusion protocol. Normally the dose of the 4-infusion protocol is based on weight, while the dose of the 2-infusion protocol is 1,000mg each time (ie, not weight-based). This is the dosing determined by the research.

    Have you asked your doc why s/he is doing something different?

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    Sangye, That is what I thought. My doctor would not come and talk to me about it, I was in the infusion room when they told me what I was getting, so frustrating. But yes we will be talking about it next time I see her. Do you know of any studies that support the 2 infusion protocol? Or if any of the well known doctors are supporting it? Or if there are any studies on it?

    I was really surprised at what she did and am anxious to talk with her about it.

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    The 2 infusion protocol is widely used with success, but like I said it uses 1,000mg for each one.

    If it were me, I'd be really upset at my doctor for doing something like that without discussing it with me. You can't give informed consent if you're not informed. Before you get a treatment-- any treatment-- or do a diagnostic test, she should explain her reasoning, review all your options, discuss what it's based on and leave it up to you to decide if that's what you want to try. She did none of those things. That's not just disrespectful, it's also unethical and violates standard of care practices.

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    Yeah I was so pissed I cried at the clinic. Still pissed. We normally have a really good relationship so I am just mystified at what happened. Going to be an interesting appointment when I see her in a few weeks.

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    Quote Originally Posted by aewaustin View Post
    My dose during the 4 week protocol of RTX was 650/week, and now that I am doing two my doctor is still doing the same dose of 650/every two weeks, so I am getting 1/2 the medicine. Is that what others are getting, or are some getting a double dose if you do the two protocol?
    If you are still with the same rheumy you were previously (same as my daughter,) that is what she has been switched to as well. I will be curious to hear what happens after your discussion w/ "Dr A.C." I am sorry for your experience, but it has become an increasingly busy practice.

    I do know Ulrich Specks at Mayo uses the two infusion protocol for maintenance, but I do not know at what dosage. She hasn't been up there in a while.
    Last edited by Palmyra; 09-15-2012 at 06:10 AM.

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    Palmyra, I am with the same Dr. as in the past and thought we had a great relationship which is why is am so perplexed at this situation. So frustrating. I did hear that they are adding a new doctor when I was there last week. Hopefully it helps. I was not sure in your message above, your daughter is also doing the 2 protocol? Or the 4? And at what dose? I am curious... Thanks!

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    We have had similar issues while in the infusion center. Tried to direct questions to the doc before/during an infusion, and not gotten an answer even though she is in the adjacent area seeing other patients. Alison has been doing the 2 unit protocol for the last two years(?), and it has been on about a six month basis. She says she 'recovers' more quickly from the two, than from the four infusions used in the past. I do not know the dose, but I am guessing it is similar to what you are on. I have another friend in Austin (same doc) that I can ask some question of, and get back to you.

    I do know that Specks at Mayo is doing the two infusion schedule once patients are into a medically induced remisssion--again, I do not know at what dose.

    Alison has been feeling well, and although it has been 6+ months since her last series, they are debating whether to routinely proceed with another series or wait on B-cell levels to repopulate or symptoms to occur. I believe Alison has been on RTX longer than most..she started in 2000 (and was never treated previously with other major immunosuppressives). Some others have had life threatening issues with infection after long term use, so that may be part of the reasoning for holding off on treating simply by the calendar.

    More later as I hear from Alison. She is to run her most current tests through Mayo, and get advice from Specks collaboratively.

    ~Jane

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    Please let us know what dosage regime Mayo is using or recommending.

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    Will do drz, as soon as I can prompt the daughter to contact Specks. She is supposed to do that once she receives her most recent blood work from her local rheumy.

    Jane

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