[thefroy]

New forummer - looking for a bit of dosage guidance

by thefroy on Sat Dec 24, 2011 4:33 pm

A fairly general question but looking for some short term advice. I can probably provide more information but I'm not sure that the specifics are entirely required at the moment. I am a complete novice over the science and mechanics of the dosages, so apologies if these are stupid questions.

- My Dad has been undergoing treatment for Myeloma. He has been taking CYCLOPHOSPHIMADE 650mg - 13 tablets every Wednesday for a few weeks. He has 12 of these tablets left.
- His case has recently been reviewed and he has had a new stronger dosage prescribed (not sure of the exact prognosis) - CYCLOPHOSPHIMADE 900mg, 15 every Wednesday.
- The new dosage is making him feel dreadful for about 3/4 days. The old dosage was relatively bearable.
- He has Domperidone 10mg, 3x a day. Not sure if this is very effective.
- It is my brother's wedding next Saturday. My Dad is desperate to be able to attend.
- We cannot contact the doctor at present (we have a voicemail waiting for him and understand that this is the route that we will end up taking, but I want to help my Mum over Christmas with any advice I can)

Can my Dad take the old pills for one week next Wednesday?
Can my Dad take the new pills on Tuesday next week so he has longer to recover?
Can he take fewer of the new pills on Wednesday?
Can he take a stronger/different equivalent to Domperidone?
Is a change to his regime so that he feels OK next Saturday going to ruin his treatment?

Many thanks for your help.

[Dr. Ken Shain]

Re: New forummer - looking for a bit of dosage guidance

by Dr. Ken Shain on Mon Dec 26, 2011 1:51 am

I feel that as an armchair quarterback, or physician in this case, it is not appropriate for me to make a comment about how you are receiving your medications. If your father 's dose was increased, it was for a reason. And I cannot know what that reason may be. Tolerance is important for sure. To me, you need to contact your MDs office (understanding that you have tried) and try to figure out some better supportive care assistance for your dad. There are number of agents that can be used in combination for nausea (Reglan, Compazine, Zofran, Aloxi, even ativan and steroids are excellent anti-nausea medications). Make sure that he stays well hydrated- 6-8 cups of water or like fluids daily.

Further, generally we will do our best to allow you to participate in acitivities such as your brother's wedding around therapy. BUT AGAIN, I am not your dad's MD and it is most appropriate for you to find out from your physician what the plan may be for your dad.

I am sorry that I was not more helpfull. I hope that all works out and congratulions to your brother.