Aa
Ribavirin/antacids/Drug Interactions
I'm taking PPI's (Nexium, Aciphex, etc.) and H2 blockers (Zantac, Pepcid AC, etc.) for LPR reflux. Sometimes also take antacids like Tums, Mylanta and Gaviscon.
My concern with the antacids is that they might intefere with ribavirin absorption. Very little in the literature conclusive one way or the other.
Wondering if any of you also take antacids and if you take them right after meals with your riba, or if you try to time the antacids a few hours before or after the riba.
My concern with the antacids is that they might intefere with ribavirin absorption. Very little in the literature conclusive one way or the other.
Wondering if any of you also take antacids and if you take them right after meals with your riba, or if you try to time the antacids a few hours before or after the riba.
Ina: Thank you so much for your interest and support. I appreciate it so much espeicailly since my docotr seems to be dismissing my issue and just telling me to pop Zantac as needed. First to clarify....I don't mean to be completely ignorant about these stomach issues but I have not been diagnosed with any of the specific problems you all have mentioned....as this is all new and has crept up on me during tx. My description of the problem is after eating..usually about 2 hours I feel nauseated, churning in my stomach, and kind of an acidic taste in my mouth with a constant pressure pushing 'UP' from my stomach which can last for hours on end. It isn't a burning pain as I suspect an ulcer would produce...more of a constant pressure and churning that makes me feel very sick. I usually try if possible to nap as it takes my mind off the discomfort...although this is difficult when I'm busy working. (self employed textile designer...LOTS OF FABRIC everywhere!) Regarding other questions: I don't use canned/jars of tomato sauce. I'm obsessed with preparing my own foods from scratch so I make my own....easy to do...tomato's, garlic, basil, onion, and simmer away...toss with pasta and voila! Salad dressings are the same...I whip it up on my own....olive oil, vinegar of some sort and usually herbs mixed in like french Herbs de Provence or something similar. I hope this info helps. Please take your time in getting back to me...I understand you are very busy right now as well! Once again your kindness is so overwhelming...Thank you.
jmjm: Thanks for your advice! Yes, I've thought it may be an ulcer but the symptoms have not seemed right to me by the reading I've done. My partner has had an ulcer and the symptoms are different from mine. I WILL however pursue this matter with a different doctor if I don't get relief soon as it is getting to be a BIG problem....my most stressful side effect at the moment: but as you ALL know....they change like the weather! I'm hoping this will phase it's way out like other challenging sides I've gotten through on tx.....Thank you again jmjm....always helpful to MANY here on the forum.
In the meantime I'm going to try Califia's recomendation: Peppermint oil and if that doesn't help I'll try Ina's and Scruffy's advice on the cabbage juice....I love veggies so this could be a treat(although dread the extrator clean up!!)
Thanks to all and I hope this tues. finds you all well with few sides and beating this virus down or keeping it at bay!
Scott
jmjm: Thanks for your advice! Yes, I've thought it may be an ulcer but the symptoms have not seemed right to me by the reading I've done. My partner has had an ulcer and the symptoms are different from mine. I WILL however pursue this matter with a different doctor if I don't get relief soon as it is getting to be a BIG problem....my most stressful side effect at the moment: but as you ALL know....they change like the weather! I'm hoping this will phase it's way out like other challenging sides I've gotten through on tx.....Thank you again jmjm....always helpful to MANY here on the forum.
In the meantime I'm going to try Califia's recomendation: Peppermint oil and if that doesn't help I'll try Ina's and Scruffy's advice on the cabbage juice....I love veggies so this could be a treat(although dread the extrator clean up!!)
Thanks to all and I hope this tues. finds you all well with few sides and beating this virus down or keeping it at bay!
Scott
Just for the record-After years of acid reflux and an ulcer-various dietary approaches and lots of antacids I moved from the city to the country and found that well water(untreated) versus treated city water made a hugh difference in how I reacted to the various foods that used to cause heartburn.If you drink treated city water take this into consideration also. Also used the cabbage juice approach which helped quite a bit when I was still using city water. frank
"I don't think you started out with stomach problems, nor did I , but I think jimjim did..am I correct? "
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I started out with ear pressure, then ear aches, then swallowing problems, lump in my throat (globus), sore throats, hoarseness, sinus pressure, headaches and generally feeling lousy from the neck up.
I did have some stomach problems but it turned out most of the stomach problems were related to the the double Aciphex (PPI) that I took for a couple of months. Now that I'm temporarily off PPI's, my stomach is fine. Sometimes it growls a little but I think that is due to the Pepcid AC, which is like Aciphex Light. LOL.
What I have is called LPR (laryngopharyngeal reflux). It's when the acid or bile rises past the esophagus and into the vocal cords and throat. Sometimes even into the lungs.
It was hard in the beginning to figure out which problems were from the LPR and which from the hep c treatment. But by intentionally varying my diet, and stopping and starting various medications, I was finally able to isolate those symptons to the LPR. In addition, I've had a endoscophy and my larynx scoped that confirmed reflux activity.
My new approach (I'm on day 3) is to wean off the reflux drugs and try a sedative/muscle relaxer like Xanax to counteract the physical effects of the ribavirin which often has me tighter than a drum. Stress is a known factor for all types of reflux.
I'm not crazy about taking sedatives, but if it will help the LPR so be it. If that doesn't work, it will probably be back to the PPI's which I don't tolerate very well. They do have an operation, but it doesn't make any sense to have it during treatment.
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I started out with ear pressure, then ear aches, then swallowing problems, lump in my throat (globus), sore throats, hoarseness, sinus pressure, headaches and generally feeling lousy from the neck up.
I did have some stomach problems but it turned out most of the stomach problems were related to the the double Aciphex (PPI) that I took for a couple of months. Now that I'm temporarily off PPI's, my stomach is fine. Sometimes it growls a little but I think that is due to the Pepcid AC, which is like Aciphex Light. LOL.
What I have is called LPR (laryngopharyngeal reflux). It's when the acid or bile rises past the esophagus and into the vocal cords and throat. Sometimes even into the lungs.
It was hard in the beginning to figure out which problems were from the LPR and which from the hep c treatment. But by intentionally varying my diet, and stopping and starting various medications, I was finally able to isolate those symptons to the LPR. In addition, I've had a endoscophy and my larynx scoped that confirmed reflux activity.
My new approach (I'm on day 3) is to wean off the reflux drugs and try a sedative/muscle relaxer like Xanax to counteract the physical effects of the ribavirin which often has me tighter than a drum. Stress is a known factor for all types of reflux.
I'm not crazy about taking sedatives, but if it will help the LPR so be it. If that doesn't work, it will probably be back to the PPI's which I don't tolerate very well. They do have an operation, but it doesn't make any sense to have it during treatment.
Sounds like a good diet to me.
Maybe you've already investigated it, but stomach pain two hours after eating sounds like a classical ulcer.
If your doctor won't take it seriously, find another gastro who will. Usually for dx they do an upper GI series and/or an endoscophy. Depending on what they find, they may change your meds or even put you on antibiotics.
You really want to check out all the possiblities. I don't have to tell you how bad gastro problems are along side the hep c treatment.
Maybe you've already investigated it, but stomach pain two hours after eating sounds like a classical ulcer.
If your doctor won't take it seriously, find another gastro who will. Usually for dx they do an upper GI series and/or an endoscophy. Depending on what they find, they may change your meds or even put you on antibiotics.
You really want to check out all the possiblities. I don't have to tell you how bad gastro problems are along side the hep c treatment.
Califia: I apologize I didn't thank you for your comments. I reread the whole thread to be sure I didn't miss anyone and of course I did....sorry.....not blaming brain fog but it is a good excuse!...or maybe it was B.F.!? I will try the peppermint oil...I love the idea of natural aids to help instead of more meds...but I just can't give up Zantac yet.....I'd be even more miserable I'm afraid....I'll try the combo.
Ina: You are so kind! My diet has been fairly healthy for many years...could be better however I'm sure. 80's I was macrobiotic....90's vegitarian....2000....eat only organic foods and now eat organic meat. My typical diet is a.m.: whole grain cereal with bananna and yogurt, keifer, or occassional cottage cheese with blueberries....or a fruit salad I pull together. Of course with my Riba. I seem to never have a problem in the early a.m. with the stomach. Lunch: miso soup often, tuna salad sandwich on whole wheat bread, fruit, toasted arugula/ asagio cheese sandwich, sometimes organic turkey breast on a bed of lettuce or in a sandwich, bean soups and lots of fruit. my reflux/ stomach pains are the worst about 2 hours after lunch EVERY day. I usually feel very nauseated by 4:00p.m. every day. I take Zantac BEFORE it starts but it always flairs up terribly just as my fatigue starts to hit me in addition from the days energy spent. I usually end up taking 3 Zantac every afternoon...sometimes helps, sometimes doesn't. Dinner is my most dificult meal...I have lost alot of my dinner appetite (and weight now..20lbs!) as I don't think I'm eating enough 'little' meals through the day. Dinner is typically pasta with fresh veggies, or grilled chicken breast with brown basmati rice with a side veggie, or a large mixed green salad with avacodo,lots of grilled fish too. On rare occassions I make myself eat some red meat like a lean steak or sometimes a small pork chop but this is really unappealing to me right now and I feel nauseous often afterwards. I do cook with butter alot as weight isn't a problem and things are so much tastier. I have a terrible craving for sweets which I didn't have before tx, but refrain as I don't want THAT kind of weight gain! I don't drink ANYTHING but water and LOTS of it all day long. Doctor told me I should start drinking Ensure to help keep my weight up. I seem to not notice any difference how my stomach/reflux feels based on what I'm eating (except for those rare times I suffer after attempting a Mexican meal "treat"....very very bad idea!...certainly NOT a treat afterwards.) So that is a generalized list ....so what do you think? I appreciate your input and suggestions. Maybe I need more yogurt, keifer, buttermilk, cottage cheese etc?...I do eat these but only about 2-3 days a week. Thanks again..you are very kind as always! This is the worst side I'm facing right now and until you go through it one wouldn't know how bad it is!
Scott
Ina: You are so kind! My diet has been fairly healthy for many years...could be better however I'm sure. 80's I was macrobiotic....90's vegitarian....2000....eat only organic foods and now eat organic meat. My typical diet is a.m.: whole grain cereal with bananna and yogurt, keifer, or occassional cottage cheese with blueberries....or a fruit salad I pull together. Of course with my Riba. I seem to never have a problem in the early a.m. with the stomach. Lunch: miso soup often, tuna salad sandwich on whole wheat bread, fruit, toasted arugula/ asagio cheese sandwich, sometimes organic turkey breast on a bed of lettuce or in a sandwich, bean soups and lots of fruit. my reflux/ stomach pains are the worst about 2 hours after lunch EVERY day. I usually feel very nauseated by 4:00p.m. every day. I take Zantac BEFORE it starts but it always flairs up terribly just as my fatigue starts to hit me in addition from the days energy spent. I usually end up taking 3 Zantac every afternoon...sometimes helps, sometimes doesn't. Dinner is my most dificult meal...I have lost alot of my dinner appetite (and weight now..20lbs!) as I don't think I'm eating enough 'little' meals through the day. Dinner is typically pasta with fresh veggies, or grilled chicken breast with brown basmati rice with a side veggie, or a large mixed green salad with avacodo,lots of grilled fish too. On rare occassions I make myself eat some red meat like a lean steak or sometimes a small pork chop but this is really unappealing to me right now and I feel nauseous often afterwards. I do cook with butter alot as weight isn't a problem and things are so much tastier. I have a terrible craving for sweets which I didn't have before tx, but refrain as I don't want THAT kind of weight gain! I don't drink ANYTHING but water and LOTS of it all day long. Doctor told me I should start drinking Ensure to help keep my weight up. I seem to not notice any difference how my stomach/reflux feels based on what I'm eating (except for those rare times I suffer after attempting a Mexican meal "treat"....very very bad idea!...certainly NOT a treat afterwards.) So that is a generalized list ....so what do you think? I appreciate your input and suggestions. Maybe I need more yogurt, keifer, buttermilk, cottage cheese etc?...I do eat these but only about 2-3 days a week. Thanks again..you are very kind as always! This is the worst side I'm facing right now and until you go through it one wouldn't know how bad it is!
Scott
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