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Victrelis
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Victrelis

Just started on Vic on Friday. Besides the amount of pills one mush take, I can't seem to get over the nasty after taste. Really chemical like/poison like aftertaste. oh well, poison to the virus I hope. So my question is this: it says take with food, but is it necessary to take with 20g of fat, or is that only for incivek?
Anyone else starting this stuff?
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1669790_tn?1333666195
Unlike Incivek, Victrelis doesn't appear to have a fat content requirement.  It is recommended to eat some fat with Ribavirin to increase absorption.   Be sure to take it on time and try not to miss any doses.

VICTRELIS should be administered with food. Food enhanced the exposure of boceprevir by up to 65% at the 800 mg three times daily dose, relative to the fasting state. The bioavailability of boceprevir was similar regardless of meal type (e.g., high-fat vs. low-fat) or whether taken 5 minutes prior to eating, during a meal, or immediately following completion of the meal. Therefore, VICTRELIS may be taken without regard to either meal type or timing of the meal.

http://www.natap.org/2011/HCV/results.htm
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Avatar_f_tn
prosperitypharmacy.com/wp-content/uploads/Protease-Inhibitor-Guide.pdf

It shows the food intake requirements for both drugs as well as sample times/meals.

I found that site earlier~ Also wanted to ask what made you choose Victrekis? It looks like a lot of people have chosen Telaprevir?

Just curious as I know I will be faced with a choice soon.

Thanks,

Vann
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1654058_tn?1407162666
The fat thing is killing me, I've eaten healthy for so long. It makes me nauseated. But I choke it down w/ Incivik. (My inhibbie) I always have a metal taste in my mouth and make myself eat anyway. Load up on Boost type shakes when theyr'e on sale. I also buy Whey protein and Greens at the health food store to keep muscle mass up. Take care... Karen
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Avatar_n_tn
even a moderate snack with VIC seems to be adequate, no fat required. The package insert states "[a meal or light snack]". I'm about to start w12 and make a smoothie from an apple, protein powder and blueberries for my 2:30 feeding (worse than having babies in the house again!)

Seems to work OK - but as far as taste, that's there for the duration. Good luck.
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Avatar_m_tn
yes, tastes like stricnine.
Just had my first bad weekend. Had the flu like sx. Sucked, but not a deal beaker. I actually now wonder if maybe I didn't screw up with the interferon. I just grabbed the prefilled and injected, I forgot to squeeze out to 180mcg line. a little extra for those virons to suck on.
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Avatar_m_tn
"I forgot to squeeze out to 180mcg line. a little extra for those virons to suck on. "
That won't hurt anything, it's not much. People have taken much more extra then that on purpose.

Good luck with the Victrelis. I completed tx with 40 weeks of Vic (plus 4 soc) 5.5 months ago, almost time for the big PCR. I usually ate it with whatever meal I was having or a yogurt for my 10 pm boceprevir jamboree. I had a small frig I kept next to the bed so I didn't have to go far for the meds when tired.

-Dave


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Avatar_m_tn
How did you find tx with Vic? Any regrets? Any advice would be greatly appreciated.
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Avatar_m_tn
Hi there, i'm not dave but i also treated and i'm SVR thanks to Vic. One thing i would advise is to stay on top of your HGB, once it starts to drop it can go fast. My doctor starts people on procrit once their HGB drops below 11 when taking Vic.

Its very important not to miss a dose and they need to be taken pretty much on time. Besides the added anemia i didn't have much difference then when i did SOC only....... Yeah the taste is nasty, that don't go away, hang in there and best to you.

cando
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Avatar_m_tn
I have no regrets. It'll be well worth it if I SVR which is looking pretty good since I was und at 17 weeks post. I had some pretty bad abdominal pain about 2 weeks after the Vic was introduced that lasted for about 2-3 weeks.  I was in an anemia trial and didn't get procrit until the anemia was really severe which made it pretty rough also.

I didn't become und until week 10 so tx was supposed to be 48 weeks (ended at 44 from low hgb) I was lucky because I wasn't working. For the first 3 months I was still able to walk 3-5 miles a day for exercise and could have worked if it did not require much in the way of physical or mental ability, lol.
-Dave
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Avatar_m_tn
That's awesome news guys. Success stories are
so motivating. I wish you luck on svr, sounds very very promising. Did you both have a good response to lead in with peg/riba? I will know my 4 wk results soon. I hear a log drop greatly increases odds of success.
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Avatar_n_tn
yeah, success stories are great, You have to wonder about the post-tx effects though. Seems cando has been out in the woods talking to himself lately. Could it be the VIC?
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Avatar_m_tn
my starting VL was 2.65 million, at the end of week four lead-in it was 69,800. Not great, but hopefully good enough. I was und at week 10.
-Dave
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Avatar_m_tn
cbw36......... Don't recall the excat numbers but i do know it was not a 2 log drop at week 4, maybe 1 and a half..... But 2 weeks with VIC. and i was und.

Willing........:) My wife wishes i would spend more time out in the woods. You know a funny thing, every response from the women was a HUGE YES, loud and clear they say were always wrong....... Try and figure woman........ I dare ya.
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223152_tn?1346981971
cbw - I am about to start triple treatment with VIC in a week or so.  Looks like we are in the minority for sure.  I will be watching your progress closely.  Having some good friends on this forum treat successfully with the VIC was a big factor in my decision.

Hi willing, specta and can-do -- you old trail blazers, you

frijole
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Avatar_m_tn
Best of luck to you frijole and to everyone else about to start. It really hasn't been that bad (yet).
I, like everyone, just need this stuff to work. I have a great family and a beautiful baby girl that I have no intention of leaving early. I don't even care if my hair falls out, my belly becomes a pin cushion, and my blood gets poisoned by these meds...whatever it takes. I would even give my left testicle if I though it would help. It seems to be the one I always sit on anyway.
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Avatar_m_tn
Good luck with tx. Hoping all of us will be posting our SVR thread before long.
-Dave
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Avatar_m_tn
That's what it takes. Fight this thing all the way whatever it takes. Good luck to you too!
-Dave
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1722607_tn?1335751458
Is VIC the newest treatment drug that came out in may?
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Avatar_m_tn
Victrelis (boceprevir) and Incivek (Telaprevir) were approved a few months ago for treatment of HCV genotype 1 in conjunction with Interferon and ribavirin.
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223152_tn?1346981971
Dave - thanks for the encouraging words.  I hope to see your 6 month SVR post soon.  I hope you will see mine in a year and a half!
frijole
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this is a awful virus.  I will be starting soon and i read how brave and strong you all are, it helps me to be brave also.  thank you all deb
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179856_tn?1333550962
Even on plain interferon and riba I always had the most poisonous metal/medicine taste in the world. I swear I could smell it coming out of my pores - so you aren't alone most of us have had some discomfort even without adding the 3rd drug.
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Avatar_n_tn
frijole: so are you going to give details  -  how'd the appt. go? A year and a half sounds like you're planning on the full 48 regardless of response. All the best with getting it under way - the sooner it starts the sooner it's over.

cando: can't say I'm surprised by the results of that survey..but I think you're brave to get anywhere near the topic!
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Avatar_m_tn
so just a quick update...I got results of my 4 week lead in bloodwork:
viral load down to 52,000 from original 4.9 million. the doc seemed pleased with this.  CBC looks good.  Hemaglobin, neuts, and platelets all holding steady.  alt normal, ast a couple points about normal.
so doc decides to have me go check another pcr after 2 weeks on victrelis and then again on 4 weeks of victrelis.  he says reason is he wants to make sure there is no resistance issues developing.
also, offered me to take the heptimax test for greater sensitivity.
so what do you guys think?  sounds pretty kosher?
Hope all is well, best of luck to all of us.
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264121_tn?1313033056
(looks around) Ben & Jerry's... ok.  and peanut butter, always worked well for me.  Am I the ONLY one who gained weight on treatment?
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223152_tn?1346981971
willing
You know me - -just don't start too many threads.  I figured I would post my results from Friday's visit on my original biopsy thread to sort of give it an ending, but after a few hours, the post was already on page 2 with no responses.  (There are way too many (inane and redundant threads now a days).

http://www.medhelp.org/posts/Hepatitis-C/Liver-Biopsy/show/1561255

In a nut shell, the biopsy stands - grade 3, stage 3-4, about half fibrosis stage 3 and half fibrosis stage 4. Not eligible for response guided therapy with this dx.  The meds are ordered but I have not gotten the call from the pharma yet that they will be shipped.
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It's really good to see so many people who have been dealing with this for so long, and to see so many mainstays who were here for me, clearing, treating, and starting to treat.  Good luck to all of you and good luck to the OP.
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223152_tn?1346981971
"so doc decides to have me go check another pcr after 2 weeks on victrelis and then again on 4 weeks of victrelis.  he says reason is he wants to make sure there is no resistance issues developing.
also, offered me to take the heptimax test for greater sensitivity.
so what do you guys think?  sounds pretty kosher? "

Sounds like this doc has got your back.  I like the PCR after 2 weeks of Vic and I like the heptimax.    You had just short of a 2-log drop.  Of course, we would all like to be UND by week 4, but realistically this does not happen.  Week 12 is the do-or-die test.  

I screwed up last month and told my doctor I liked the LabCorp QuantaSure - a test sensitive  down to 2 IU/mL and that is what he ordered pre treatment.  Unfortunatley, I forgot it has a high detectable range of 2,000,000 IU/mL and I was over that.  Therefore, I don't have a good start VL.

We are currently trying to figure out what to do for the 4 week PCR (pre VIC). Apparantly some of the insurance companies are not approving the VIC without those 4-week results and the QuantaSure takes too long to get back.  I am going to tell him to order the test he usually would for week 4, but I sure want to more sensitive testing later.  He said I could do the quest heptimax, but I can't find a Quest lab in my town.

frijole
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Avatar_m_tn
i usually go to the local hospital, which has a blood draw center.  I just called today, and they say they do both labcorp and quest. And as per insurance, who don't cover quest, however, if ordering doctor is in network, than they will cover it.  Mine happens to be in network.  
so anyway check out the local hospital, it can't hurt.
sorry for the biopsy results, what were your results last time you checked? and how long ago was that?
and as for the almost 2 log drop..I too was wishing for rvr, but at least I know the interferon has some response, and I'm not just shooting duds under my skin for the last 4 weeks, as I had very little symptoms after injections.
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1711722_tn?1356491154
" I would even give my left testicle if I though it would help. It seems to be the one I always sit on anyway. "  Hahahahahahaaaa!!!  Uhm....thanks for the visual. LOL!

As for the bad taste (I too will be on Vic in a few weeks), I read in another thread that SOUR hard candies help.  I will be running out to the store to stock up.  Best to you!
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Avatar_m_tn
"I too was wishing for rvr, but at least I know the interferon has some response,"

"RVR is defined as undetectable virus (HCV RNA) in plasma at 4 weeks after the addition of boceprevir" (end of treatment week 8)

You still have 4 more weeks to determine RGT. Just to "sorta" compare apples to apples, the week 8 PCR/TMA result is comparable to the week 4 result with Incivek. If you are und at week 8 (4 weeks of vic) and week 24 the recommendation is to treat for a total of 28 weeks.

http://www.merck.com/product/usa/pi_circulars/v/victrelis/victrelis_pi.pdf
rgt page 4


http://www.drugs.com/clinical_trials/final-results-boceprevir-phase-ii-hcv-sprint-1-study-showed-significantly-higher-svr-rates-compared-7079.html

"Importantly, the likelihood (predictability) of attaining SVR was greater for patients who received the boceprevir P/R lead-in regimens compared to the no lead-in arms. Of patients in the boceprevir P/R lead-in arms who achieved a rapid virologic response (RVR), 94 percent in the 48-week regimen and 82 percent in the 28-week regimen achieved SVR. RVR is defined as undetectable virus (HCV RNA) in plasma at 4 weeks after the addition of boceprevir. In the lead-in arms, 64 percent of patients achieved RVR. Fewer patients in the lead-in arms discontinued treatment due to viral breakthrough."
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Avatar_m_tn
That's awesome, thanks for the info. I got to tell you though, I am like THE unluckiest person in the whole world.  I was totally surprised that I had as good a drop in VL as I did after lead in.  It will be the greatest news if I were to be UND at week 4 of vic , or even better week 2.
Honestly, it would be better than winning the lottery, as after being diagnosed with this dz, money means very little compared to having my health back.  How sweet it would be.  I'll keep popping those pills.  Eat em and smile.
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Avatar_m_tn
Maybe you could have your doc order the quantisure or heptimax and the <43, If insurance won't pay for both the <43 it's probably cheap enough to pay for on your own. Bali the PCR/TMA man told me that the heptimax result comes quickly if you order the TMA portion only or side by side with the <43. I thought I read that the TMA sometimes produces false positives is that true?
-Dave
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Avatar_m_tn
I'm not sure I understand. Wouldn't the quest heptimax be best? Why order both?
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cbw36
You are fine. You already have approval for the victrelis and the heptimax is a good choice. I suggested ordering both to Frijole because she wanted a low sensitivity test but didn't want have her insurance company to delay approval of victrelis. The sensitive tests take longer to get a result, especially the quantisure (mine took 3 weeks)


Frijole-Kind of dumb of me to suggest taking the quest test when you just mentioned that you don't have a quest lab. Oh well, you got the gist of it.
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Avatar_f_tn
I am 10 days in to Vic treatment and feel pretty good.  My biggest issue has been low ANC, am doing neupogen once per week.  Also the bad taste in my mouth.. is really bad.  The VIC causes extremely dry mouth, for me anyway.  I just bought biotene yesterday and it seems to help some.  I thought the VIC PCR indicators were at week 8.. if you are UND at week 8 then you do 28 total weeks of treatment, so you have a few more weeks to get that UND!  You will I am sure!  I have been bad about eating much when taking my Vic pills, everything just tastes bad and I don't have much of an appetite.  I just took my afternoon pills and am eating some ice cream with them.. hope that is enough.  

Good luck to you and keep us updated.  :)
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Avatar_m_tn
Oooh, ice cream. Actually, I think I'm getting used to the Vic aftertaste. Been eating like a pig last couple days, not very healthy though.
My newest thing now is itchiness over my knuckles and elbows. My left elbow looks like it is getting some kind of rash. maybe this is the dreaded RIBA rash? will be going to buy some hydrocortisone today. The goldbond helps, but the little bumps are still there.
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Avatar_m_tn
Just started the Peg/Riba lead in 9 days ago, so far so good. I've been slacking on my reading, just havn't felt like it, good info in this thread. Not sure how long I'll treat, nobody really knows I guess. I'm on the PegIntron/Rebetol, what is the difference between Alfa2a and Alfa2b? I only just noticed that there is 2 types, not sure if the difference is in the makers or what. They gave me 11 refills on both, so I guess that's just in case. Either way, I can't complain when all meds are free. I will continue to look for everyones progress and post mine as I can, Thanks all! Mike
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223152_tn?1346981971
cbw - you asked about my last biopsy?  The last one I had was in 2007 about nine months after I relapsed.  It was grade 1, stage 1-2, very similar to my first one in 2005.  This one was grade 3, stage 3-4-- quite a bit of progression in 3 years.  The issue about the PCRs is that it is getting hard for the doctors to get approval for the VIC in time to get your first dose on time.  He said he has discussed this in a forum (whatever hepatologist forum he is in, I would sure like to be a fly on the wall there) but has no answer.  He suggested the Heptimax because it is fast.

specta -- I did have a Heptimax at the hospital once during my first round.  I got all my CBC blood work in the oncology dept because I was using a hemotologist there.(I think I got the heptimax there because my GI was out of town.)  This time the hepatologist is doing all the blood monitoring.  I guess I could check with the oncology department -- they really have the best phlebotomists - but I don't want to hang out there (sometimes it takes a long time).  I will check it out though. I can't believe it took you 3 weeks to get one result in.

frijole
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