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TOPIC: What a doctor needs to know to write a script

What a doctor needs to know to write a script 2 years 5 months ago #284

  • DrJames
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Your doctor will need to know
  • Genotype
  • Fibrosis by scan or biopsy
  • Prior Treatment
  • Current Medications

Each of these impacts on the best choice of medications and duration. Daclatasvir interacts with some common medications.

Routine tests pre-treatment
  • Full Blood Count
  • Liver Function
  • Creatinine Electrolytes Urea
  • Viral Load

These tests only need to be done if there is nothing available in the last few months, but if you have them then it saves ordering them.

During treatment a 4 week Viral Load and LFTs is probably all that's absolutely required for treatment without Ribavirin. Ribavirin requires more frequent blood tests.

An end of treatment VL is nice but does not have a lot of value.

Then do SVR4/12/24 depending on how patient you are. If you have SVR12 you have a 99.7% chance of being SVR24 which represents a very high probability of cure.
YMMV
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What a doctor needs to know to write a script 2 years 4 months ago #1142

  • Phoenix
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Given that the doctors I'm asking to write a script, in the town where I live, probably won't have written a private script for these medications, I'm wondering if they might need some guidance as to exactly what to put on it. Given that I've failed boceprevir / interferon / ribavirin, and didn't tolerate it well at all, it looks like the best regime for me is probably Sof + Dac 12 weeks. Mesochem looks like my preferred supplier through the Buyers Club. So what should the doctor put on the script for Mesochem - "12 weeks", a certain number of grams for each, something else? :whistle:
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What a doctor needs to know to write a script 2 years 4 months ago #1145

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Standard is Sof 400mg x 84 and Dac 60mg x 84

I'm wondering why a doctor would be required to state the brand name on the script?
Why can't he/she simply write the generic name from the start without specifying brand?

Then, while the insurance company is taking their time denying the request, he could provide the patient with a letter stating what he has decided .... "I am prescribing ..." with the same generic names, doses, lengths of time, and pretend he has no knowledge of what the patient might do with such a letter. It should be written in present tense, "I am prescribing ..." not past or future tense ("I have prescribed ..." or "I will prescribe...")

But such a letter would likely serve perfectly well for a foreign meds provider and also as the shipping document's form of prescription.
If anyone later tries to give the doctor any flack, he just pleads ignorance of the patient's actions.
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What a doctor needs to know to write a script 2 years 4 months ago #1195

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You should ask for (this is 12 weeks treatment)

Sofosbuvir 400 mg od x 84
Dalcatasvir 60 mg od x 84

OR (Harvoni generic components)

Sofosbuvir 400 mg od x 84
Ledipasvir 90 mg od x 84

If you need 24 weeks ask for the same as above + 1 repeat

If you need Riba you need 1000 mg daily if < 75 kg and 1200 mg daily if > 75 kg

Ribavirin 1000 mg daily in 2 divided doses x 84 days
Ribavirin 1200 mg daily in 2 divided doses x 84 days
YMMV
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