My doctor has agreed to prescribe Besemri for me. I am currently on 500 mg of hydroxyurea three times a week. The initial dosage of Besemri is 500 mg/ml every two weeks. This seems high. May I ask what dosage others have been prescribed? I am waiting for a call back to discuss this; I am assuming I will continue on the hydroxyurea initially and taper off as I increase the Besemri. Any advice is welcome.
#Besemri
#hydroxyurea
Hi. 500 is the max dose of Besremi, and I don't think your doctor would want to start you at that level (or that you'd want that). I've been on Besremi for almost two years (for PV). The doctor started me at 100, and we increased it by 50 every two weeks until I maxed out at 500. Getting to 500 is often not needed or even attempted, but my doctor wanted to go as high as I would tolerate and then back it off to find that right maintenance dose. I'm at 250 now.
There's also a study out there that showed that getting to a higher dose rather quickly may have some benefits. That's a relatively recent study, and I'm not sure about the details.
Even at the high dose, I tolerated it well. I had some fatigue, especially on the evening after the dose. I've had some minor rashes now and then. As we were increasing to 500, I did go through a few months where I felt some melancholy and moodiness (mental health challenges are a potential side effect that can be of concern); but that eventually went away.
For me (and everyone's different), Besremi has been very tolerable; and it's making a positive difference. Only time will tell, but early indicators are that it's modifying disease progression, which was a huge motivator for me to get on Besremi and not be afraid to be aggressive with it.
Best of luck to you!
Thank you so much! I just contacted the nurse and the dose is actually 50 µg every two weeks. I must have misunderstood the pharmacist that called me regarding my prescription (but, I did write down 500 mg/mL… Maybe that’s the same thing)
Hi,
Start slow and go easy! MY MPN specialist started me at 50mcg of Besremi and then increased to 100mcg. I experienced some adverse events so the dose was lowered to 75mcg and I am tolerating that dose well. 500mcg seems excessive, so ask for the slow approach.
Thank you
The initial dose of Besremi is 100mcg unless transitioning from hydroxyurea. Then it is 50mcg. The label recommendation is to increase by 50mcg every two weeks until a complete hematologic response is achieved or the Besremi is not tolerates. Many MPN Specialists and patients prefer a low and slow approach, more gradually increasing the doses and giving a 200-250mcg dose time to work before pushing the dose higher. I have responded very well to Besremi but 175mcg is the highest dose I can tolerate due to leukopenia. Note thst we all respond differently and some do tolerate a higher dose than I do.
Hunter, what is considered to be a complete CHR? Does that vary between patients?
Based on the numbers the definition is as follows.
Hematocrit level less than 45% without phlebotomy for patients with PV. Some use 42% for females. Leukocyte count less than 10 × 109/L. Platelet count less than 400 × 109/L.
Suggest it is very important to include absence of bothersome symptoms in the definition of "remission"as well; thrombotic-hemorrhagic-microvascular events, splenomegaly, pruritis, fatigue, etc.
Thank you
I have been on Besremi over a year and we slowly increased. Been on 225 mcg for 6 mos. Would definitely check with your doctor.
Thank you
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Hydroxy Rare Side Effects
The Effects of long-term hydroxyurea
