Couple of questions on remicade
S's GI had started S out on an 8 week cycle, however, once S finished his three loading doses, prometheus test was done the morning of his first 8 week infusion. Serum levels showed no remicade left in his system so we moved to a 6 week cycle. Repeat testing at 6 week infusion showed adequate levels. But, reading back on my notes, his GI previously mentioned we might possibly be able to move to a 7 or 8 week cycle again (unfortunately, I don't remember why this was discussed??). My question is why/how would this be possible? We didn't tighten S's cycle because he was having symptoms or he was having difficulty attaining remission?? It was simply because there was no remicade left and my understanding is that this is caused by a person's metabolism. Is it possible the rate he metabolizes the drug would change?
Second question (a bit related to above)... while nothing is booked yet, S is planning on going down south (Dominican Republic, Cuba, etc.??) during February's school break. I just booked his upcoming infusions until April. The February infusion likely falls on the day before he will be travelling south. And this is now worrying me. Is your immune system the 'most' suppressed immediately following your infusion? Or does his current 6 week cycle keep his immune system at a consistently/nonfluctuating suppressed level? I realize serum levels lessen as you move away from your infusion but how reactive/sensitive is your immune system to the schedule? Do you think it would be wise to move that appointment up by one week??
Thanks :eek2:
S's GI had started S out on an 8 week cycle, however, once S finished his three loading doses, prometheus test was done the morning of his first 8 week infusion. Serum levels showed no remicade left in his system so we moved to a 6 week cycle. Repeat testing at 6 week infusion showed adequate levels. But, reading back on my notes, his GI previously mentioned we might possibly be able to move to a 7 or 8 week cycle again (unfortunately, I don't remember why this was discussed??). My question is why/how would this be possible? We didn't tighten S's cycle because he was having symptoms or he was having difficulty attaining remission?? It was simply because there was no remicade left and my understanding is that this is caused by a person's metabolism. Is it possible the rate he metabolizes the drug would change?
Second question (a bit related to above)... while nothing is booked yet, S is planning on going down south (Dominican Republic, Cuba, etc.??) during February's school break. I just booked his upcoming infusions until April. The February infusion likely falls on the day before he will be travelling south. And this is now worrying me. Is your immune system the 'most' suppressed immediately following your infusion? Or does his current 6 week cycle keep his immune system at a consistently/nonfluctuating suppressed level? I realize serum levels lessen as you move away from your infusion but how reactive/sensitive is your immune system to the schedule? Do you think it would be wise to move that appointment up by one week??
Thanks :eek2:
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