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Switching from Rebif to Avonex, do I need to titrate?

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    Switching from Rebif to Avonex, do I need to titrate?

    I'm on Rebif and have been for nearly 3 months. I can't take the side effects anymore--I am out of commission 3 days a week. Because of this, I am switching to Avonex ASAP. (Per my neuro, I'm really on the far end of acclimation to the med, and he's not expecting it to get much better.)

    Rebif is 44mcg subq, and Avonex is 33mcg in the muscle. If I am switching from Rebif to Avonex, is there any real reason to titrate? I know that IM dosing and subq are very different in terms of how the meds release into the body, but if I titrate I have to do it manually, and then switch to the Avenex pen (autoinjector) after a month, and frankly, I am so sick of needles I just want to use the pen and be done with it.

    I realize this is a conversation to have with my doctor as well, but was curious what the rest of you know and have experienced about switching meds in this manner? Is tehre really a reason to titrate when I am switching to a lower dose, albeit subq to IM?

    (Sorry if their are other threads that address this; the search function brings up every thread with either drug name, and I can't select only the threads that have both.)


    #2
    Search may be outdated, but the rest of the forum is invaluable. Thank you for all that you and the other mods do!

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      #3
      It's an unanswerable question. You'll still have SX with Avonex, but only 1x weekly.

      My advice is to try different routines. I exercise after my shot and it helps. I also do it as early in the morning as possible and I never take anything with the shot - only once I get a headache.

      So we're all different - you have to experiment. So did you get the autoinjector?

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        #4
        Thanks for the input! I will be getting the auto injector, but I can't titrate with it, which is why I was asking if it is worth bothering to titrate the Avonex. I'm still on Rebif, so as accilmated as I'm likely to be before switching meds, and Rebif's dose is higher than Avonex's. To titrate I'd have to get a separate one month prescription for manual syringes, which seems like a hassle.

        I think your body likes interferon beta 1-a more than mine does. With Rebif I get fever, chills, and low grade nausea and headache from 2 hours post shot until hour eight. My entire back hurts for a full 24 hours post shot, and I'm exhausted until about hour 36. I did the shot once without premedicating--once. Never again. The meds control the chills and fever, mostly, but that's about it. The pain and fatigue are there regardless.

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          #5
          My doc didn't titrate me when I started Avonex. You should be fine.
          Just pre-medicate.

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