I will begin receiving my induction dosages of Revlimid, Velcade, and dexamethasone. The Revlimid dosage is only 15 mg two times weekly, and dex is 20 mg two times weekly.
These seems like low dosages. Are they?
thx
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Kebo - Name: Kebo
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 2008
- Age at diagnosis: 51
Re: Revlimid, Velcade, and dex doses for induction
Kebo,
The dex dosage is on target for most induction regimens. Are you sure you are not confusing Revlimid with Velcade? Velcade is normally given twice per week for two weeks by IV or as a subcutaneous injection. Revlimid is oral, and is usually given everyday for 21 days, with a 7 day break, and then the cycle begins again. The dosage on Revlimid can be anything from 5 mg to 25 mg, depending upon different factors with regard to the patient, i.e. kidney problems, side effects, etc. Taking Revlimid twice a week is not the usual dosage, although there could be reason for that I am not taking into account.
Can you contact your oncologist for an explanation? Don't be shy about asking questions. It is important that you understand your treatment, and that you become educated about it. Myeloma is not a "one size fits all" disease, and learning about your condition will empower you to make decisions in conjunction with your medical team.
Best of luck, and let us know what you find out about your medications,
Ellen Harris
The dex dosage is on target for most induction regimens. Are you sure you are not confusing Revlimid with Velcade? Velcade is normally given twice per week for two weeks by IV or as a subcutaneous injection. Revlimid is oral, and is usually given everyday for 21 days, with a 7 day break, and then the cycle begins again. The dosage on Revlimid can be anything from 5 mg to 25 mg, depending upon different factors with regard to the patient, i.e. kidney problems, side effects, etc. Taking Revlimid twice a week is not the usual dosage, although there could be reason for that I am not taking into account.
Can you contact your oncologist for an explanation? Don't be shy about asking questions. It is important that you understand your treatment, and that you become educated about it. Myeloma is not a "one size fits all" disease, and learning about your condition will empower you to make decisions in conjunction with your medical team.
Best of luck, and let us know what you find out about your medications,
Ellen Harris
Re: Revlimid, Velcade, and dex doses for induction
Thanks for the reply, I'm quite sure it was 2 times weekly for RVD. He even gave me a schedule. I have a meeting in the office next week. I'll ask about his. Seems odd, but he got the schedule from a multiple myeloma specialist.
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Kebo - Name: Kebo
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 2008
- Age at diagnosis: 51
Re: Revlimid, Velcade, and dex doses for induction
Weight and height are important factors in deciding dosages. Once those are known, I suppose dosing is mostly algorithmic unless there are extenuating circumstances. The extenuating circumstances could be things like age, frailty, drug sensitivities, etc.
In my case, I am on a CyBorD protocol with me getting 525 mg cyclophosphamide once per week, 40 mg dexamethasone once a week, and 2.3 mg of Velcade once per week. Additionally, I receive 30 mg of pamidronate (Aredia) every 4 weeks.
My weight is 63.6 kg (140 lb) and I am 171.5 cm (5 ft, 7.5 in) tall.
I know milligrams of a substance seems like a small quantity, but there are zillions of molecules in a milligram of anything. This number would be far higher than the number of cells in a person’s body by a large factor.
(Using basic chemistry and the facts that Velcade has a molecular mass of 384 grams and that the human body has 1 x 10^14 cells, I can calculate the ratio of the number of Velcade molecules in a dose of 2.3 mg to the number of cells in an average human body. It is 36 million! Maybe we should be asking, “why do we need so much?”)
You can always ask your doctor how your dosage was decided? I think it a good talking point.
I hope this helps,
Joe
In my case, I am on a CyBorD protocol with me getting 525 mg cyclophosphamide once per week, 40 mg dexamethasone once a week, and 2.3 mg of Velcade once per week. Additionally, I receive 30 mg of pamidronate (Aredia) every 4 weeks.
My weight is 63.6 kg (140 lb) and I am 171.5 cm (5 ft, 7.5 in) tall.
I know milligrams of a substance seems like a small quantity, but there are zillions of molecules in a milligram of anything. This number would be far higher than the number of cells in a person’s body by a large factor.
(Using basic chemistry and the facts that Velcade has a molecular mass of 384 grams and that the human body has 1 x 10^14 cells, I can calculate the ratio of the number of Velcade molecules in a dose of 2.3 mg to the number of cells in an average human body. It is 36 million! Maybe we should be asking, “why do we need so much?”)
You can always ask your doctor how your dosage was decided? I think it a good talking point.
I hope this helps,
Joe
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Wobbles - Name: Joe
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: June 2016
- Age at diagnosis: 67
Re: Revlimid, Velcade, and dex doses for induction
Oops.
I meant to write that there would be 36 thousand more Velcade molecules than cells in a human body for a 2.3 mg dose of Velcade.
A case of chemo brain,
Joe
I meant to write that there would be 36 thousand more Velcade molecules than cells in a human body for a 2.3 mg dose of Velcade.
A case of chemo brain,
Joe
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Wobbles - Name: Joe
- Who do you know with myeloma?: myself
- When were you/they diagnosed?: June 2016
- Age at diagnosis: 67
Re: Revlimid, Velcade, and dex doses for induction
Kebo:
I have never heard of the Revlimid dosage as you described. It is more likely 14 days on and seven days off, or 21 days on and 7 days off.
Good luck to you. Regards,
I have never heard of the Revlimid dosage as you described. It is more likely 14 days on and seven days off, or 21 days on and 7 days off.
Good luck to you. Regards,
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JPC - Name: JPC
Re: Revlimid, Velcade, and dex doses for induction
My induction dose of Revlimid was 25 mg daily for 14 days on and 7 days off.
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Janet1520
Re: Revlimid, Velcade, and dex doses for induction
I suspect the Revlimid will be dosed daily for either two or three weeks, followed by a week break before the cycle starts again. It's probably the Velcade that will be given twice a week.
You will be able to take the Revlimid on your own, at home. You won't have to go to the oncologist or cancer center. That's why your doctor may only be focusing on how often the Velcade is dosed.
But who knows? Maybe your Revlimid dosing will be unusual and it will be just twice a week instead of every day.
A lot of myeloma drugs have dose levels that are not at all dependent on a patient's weight or height. This is true for Revlimid, thalidomide, and dexamethasone, as far as I can recall.
Infused drugs like Velcade, melphalan, and Kyprolis have their dose levels set by the "body surface area" of the patient. The "high dose" of melphalan that's recommended for use during the stem cell transplant process is NOT 200 mg. It is 200 mg per square meter of body surface area (mg/m2).
Usually. a patient's body surface area is estimated using an equation that takes the patients weight and height as inputs.
You will be able to take the Revlimid on your own, at home. You won't have to go to the oncologist or cancer center. That's why your doctor may only be focusing on how often the Velcade is dosed.
But who knows? Maybe your Revlimid dosing will be unusual and it will be just twice a week instead of every day.
A lot of myeloma drugs have dose levels that are not at all dependent on a patient's weight or height. This is true for Revlimid, thalidomide, and dexamethasone, as far as I can recall.
Infused drugs like Velcade, melphalan, and Kyprolis have their dose levels set by the "body surface area" of the patient. The "high dose" of melphalan that's recommended for use during the stem cell transplant process is NOT 200 mg. It is 200 mg per square meter of body surface area (mg/m2).
Usually. a patient's body surface area is estimated using an equation that takes the patients weight and height as inputs.
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Jonah
Re: Revlimid, Velcade, and dex doses for induction
Thanks for the replies. Yes, Revlimid (15 mg) will be daily for 2 weeks, then one week rest. I did confirm this will my oncologist. The Velcade will be twice a week.
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Kebo - Name: Kebo
- Who do you know with myeloma?: self
- When were you/they diagnosed?: 2008
- Age at diagnosis: 51
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