No particular time of taking medicine

[Nothingstoxic]

Being into 15th week of inj. Pegasys and riba,since lately i have not been particular in time regarding the intake of riba tabs.Sometimes I take it at 10 in the morning and sometimes at 1 in the afternoon.My night dose is mostly at 10 or 11.Due to loss of appetite,i avoid taking medicine on empty stomach,resulting in time variation.Will it affect my recovery?Is it OK to take medicine on empty stomach?Kindly suggest.

Regards,
Monty

[spectda]

Hi Zach-

Thanks for asking. I'm just moving slowly but still und and going for my week 28 blood draw monday. I think you told me or you posted that your hgb never got above the nine range even with procrit if I am remembering correctly. I am in the same boat, and just plugging along. By the way the blue pills are now red and yellow.

I hope you had a good thanksgiving (as well as everyone else),
- Take care,
Dave

[can-do-man]

Exactly Dave, BTW how you doing?

[spectda]

I am almost sure that Ribavirin does not need to be taken at a precise time or 12 hours apart, especially once you have been taking it for a few weeks and have reached optimum blood levels. the mean half life of multiple doses is 12 days so I don't know how this could possibly matter.

I also know of many people who have been told by their hepatologists to take the second dose early if they have trouble sleeping since for some people it causes restlessness. My trial doc told me to take a morning and even dose and that it does not need to be 12 hours apart.

Consistent timing is a good idea as robert mentioned especially since you posted on another thread that you have forgotten to take your riba a few times.  

Another forum member (bill1954) who I spoke with about why they separate the dose into twice daily suggested that it may be to minimize the GI issues that some people experience when taking riba.

Pharmacokinetics

Ribavirin is absorbed from the GI tract probably by nucleoside transporters. Absorption is about 45%, and this is modestly increased (to about 75%) by a fatty meal. Once in the plasma, ribavirin is transported through the cell membrane also by nucleoside transporters.
Ribavirin is widely distributed in all tissues, including the CSF and brain. The pharmacokinetics of ribavirin is dominated by trapping of the phosphate form inside cells, particularly red blood cells (RBCs) which lack the enzyme to remove the phosphate once it has been added by kinases, and therefore attain high concentrations of the drug. Most of the kinase activity which converts the drug to active nucleotide form, is provided by adenine kinase. This enzyme is more active in virally infected cells.
The volume of distribution of ribavirin is large (2000 L/kg) and the length of time the drug is trapped varies greatly from tissue to tissue. The mean half-life for multiple doses in the body is about 12 days, but very long-term kinetics are dominated by the kinetics of RBCs (half-life 40 days). RBCs store ribavirin for the lifetime of the cells, releasing it into the body's systems when old cells are degraded in the spleen.
About a third of absorbed ribavirin is excreted into the urine unchanged, and the rest is excreted into urine as the de-ribosylated base 1,2,4-triazole 3-carboxamide, and the hydrolysis product of this, 1,2,4-triazole 3-carboxylic acid.
[edit]

[can-do-man]

I was treated by a heaptologist that was also the lead investigator for the boceprevir trial i was in, he said it doesn't matter if you take your riba even 6 hours apart as long as you take the right amount each day.......... The reason they say 12 hours is for stomach issues and yes always take it with food....... Best to you.

cando

[RobertBeWell]

Try to be consistent is the important thing. I give myself and hour window each way for my morning and evening doses, though I'm usually within 1/2 an hour. And always with a fatty meal or snack.

As others have mentioned, an hour or two each way is irrelevant after a couple weeks.

If you have trouble remembering or staying consistent, keep a medication log with the date/time and number of pills taken. Since I'm in a study, I have to do this - but I find I've never forgotten a single dose in 10 weeks with this method.

[Nothingstoxic]

Yup,u got it right.Guess i was stupid thinking that 800mg of riba/day was the concern and not the timing.Thx again dude.

Regards,
Monty

[pcds]

The riba should be taken with food to help with absorption.  Not recommended to be taken on an empty stomach.  The pills show an AM and PM for taking the medication.  If you wanted to do it perfectly balanced it would be 12 hrs between taking the meds.  So taking it at 10AM and 10PM would be timely evenly between doses. I think after a number of weeks of Riba you have a level present in your body so an hour or so one way or the other doesn't mean much.

[hcvJames]

You should take the pills a minimum of 10 hours apart. It almost sounds like you are consciously deciding to take it whenever suits you. Don't. It's one thing to forget, it's another to ad lib.