Trodelvy dosage

[Ticket123]

Hello! I was wondering if anyone knew anything about Trodelvy dosages. I have had it 4 times at 100 percent dosage. 3 times have been very rough. The last time there was improvement. ( not enough though). I have heard that there is a good chance that if this med works at 100 percent dosage than it will work at a lower dose. I don’t know how much lower. I have had a nurse tell me that many/most people have to lower because the side effects are so hard. To be fair she did also say that if you can make it through a few cycles the side effects often get better. My question is if you have had your dose lowered when did this happen? Was it after the scans? Also why don’t they start it at a lower dose in the first place? That’s probably a stupid question but that nurse got me thinking. Thanks for any info /ideas! Take care. Carla

[Hazelgreen]

My understanding is that very few physicians read research studies. They simply follow the practice guidelines given to them by their professional organizations.

When new drugs are being developed drug companies often work with MTDs (maximum tolerated dosages) to detemine whether a drug is effective. Once this dosage has been shown in a clinical trial as effective, then it is prescribed at that level until another study might be done to indicate it is also effective at a lower dose. It is good to remember that drug companies are in business to make money....

[Ticket123 in reply to Hazelgreen]

Thanks for the info. It was really helpful. I want my body to be strong enough to handle whatever is thrown at it for along time. I never had heard of MTD. Will talk to onc about reducing dose.

[Iwasborntodothis]

My team has lengthened the infusion to assist with side effects and also I have quite a few *"pre-meds" that help (I have a screen shot on an older post). My first infusion was over 3 hours. They reduced it once to one hour but my side effects increased. We have settled at 1-1/2 hours for me and that seems to work. I have also been told by my team that because this works so well and so fast, that the first doses are always rough. I have completed 5 rounds now and the "bad" stuff is very manageable and I don't even have to take any Zofran.

Ask about pre-meds and lengthening the infusion.

Hope that helps.

Allison

*I get Pepcid, Tylenol, extra hydration, steroid, benedryl, anti-nausea (twice once at beginning and once before I leave)

[Ticket123 in reply to Iwasborntodothis]

hi! Thanks for responding. I have had 2 cycles. Hoping my 3rd is better. My infusion is hour and a half also. My real problem has been nausea and fatigue. The nausea meds make me feel worse. Have tried lots of them. So far a medicated patch behind my ear and Ativan has been the best. Fingers crossed it’s working and it the SE gets better!!!

[Iwasborntodothis]

I also use Dramamine brand ginger chews for nausea - chewing gum sometimes helps too. I agree with nausea meds comment - I try to avoid them. Hang in there!