3 days past a due dose is 0.43 half-lives at the seven-day half-life this class runs on, which leaves about 74.3 per cent of that dose still circulating. One line of arithmetic: remaining fraction is one half raised to days over half-life, so 0.5^(3÷7) = 0.743. At 74.3 per cent you have not been off it in any meaningful sense. The interval stretched from 7 days to 10 and the trough went lower than usual; that is the whole of what happened. What the product label says and what the pharmacokinetics say are two different answers here, and the first is the one that governs. Restarting, holding or stepping down after a gap is decided under supervision, and nothing here is medical advice.
The honest answer is that a single missed weekly dose is not an event, and that two in a row starts to matter.
Never take two doses close together to compensate. The peak exposure is roughly doubled, and gastrointestinal tolerability tracks peak exposure closely.
The underlying point is that to change your regular dosing day, move the next dose later rather than earlier, keeping at least three days between doses for a weekly agent. Moving earlier compresses the interval and raises exposure.
Peak exposure rather than average exposure drives gastrointestinal tolerability, which is the reason doubling up is advised against.
Repeated missed doses are a different problem from an occasional one and should be treated as such.
Set a recurring reminder attached to something you already do weekly.
7The arithmetic on steady state is worth doing once and remembering. – Dr_Idris_Coulibaly 1 months ago 6Two of us compared schedules and the difference was entirely in patience. – Dr_Ilse_Vandenberg 10 months ago add a comment