Will marijuna use interfere with prescription of Sovaldi?

[soldieradvocate]

Sovaldi soon to be in VA formulary. Once that step is taken, the VA will determine who is a good candidate for the treatment. Will marijuana use influence their decision to prescribe it for a patient? Patient is genotype 1, early stages, no liver damage. No alcohol consumption.

[RickVaug]

The VA here in Charleston told me that they are basing who gets to go first based upon liver condition worst go first

[dontworry_behappy1]

I find that very interesting due to the fact that the federal government  sees the use of marijuana as illegal.    Hope everything turns out ok for you.

Best of luck

[soldieradvocate]

Thank you for your research and response. Guess we just keep our fingers crossed. Generally speaking, the VA is not opposed to marijuana use, they just can't prescribe it.

[orphanedhawk]

No, not a VA doctor, but he was in San Francisco if that makes a difference and I'm post transplant.

It is true that if you have smoked pot within 6months prior to a transplant, you can be denied a transplant.

It's stupid but it's fact.

[flyinlynn]

Was that a VA doctor (Veterans Administration) orphanedhawk?

They may have a different opinion at the VA about marijuana use for their patients.

I don't know if transplant centers have change their policies since the but up here in Seattle this occurred in 2008

http://seattletimes.com/html/localnews/2004387955_webmarijuanadeath02m.html

Medical marijuana user dies for lack of liver transplant

A musician who was denied a liver transplant because he used marijuana with medical approval under Washington state law to ease the symptoms of advanced hepatitis C died Thursday.

Something to consider for us all especially if one has advanced liver disease and may need a transplant at some point. Just because you can doesn't mean it is a good idea to do so.

Lynn

[orphanedhawk]

I did the standard interferon treatment and was told it was fine to use cannabis by my doctor.
It greatly relieved the muscle pain I experienced during tx, and helped me get through that difficult time.

[JimmyMose]

or Fibroscan score >12.5 kPa

Posting error when I posted these together the info between the less than symbol and the greater than symbol got deleted

[JimmyMose]

Platelet count < 100,000 mm3

[JimmyMose]

Correction
Platelet count 12.5 kPa

[JimmyMose]

I am Vet G2a,2c   F3/4 A3 and hope to start within a month or two
Platelet count 90    
http://gihep.com/calculators/hepatology/fibrosis-4-score/
Fib-4  6.54*      
http://hepatitisc.uw.edu/page/clinical-calculators/apri
APRI  4.583

I found this
nterim Considerations for Use:
Simeprevir in combination with Peginterferon alfa and ribavirin
Sofosbuvir in combination with Peginterferon alfa and ribavirin
Sofosbuvir in combination with Ribavirin
January 2014
VHA Pharmacy Benefits Management Services, the Medical Advisory Panel, VISN Pharmacist Executives, and the Office of Public Health

excerpts
Patient Selection during interim period (prior to Drug Monograph and CFU approval/posting)

Patients with the highest risk of disease advancement should be prioritized to receive sofosbuvir. This group includes all HCV genotypes with compensated or decompensated cirrhosis and pre- liver transplant patients to prevent post-transplant HCV. Additionally, genotype 1 patients who are deemed interferon intolerant can be considered for a treatment regimen of sofosbuvir/ribavirin given for 24 weeks.

Patients who have demonstrated documented ongoing nonadherence to prior medications, medical treatment or failure to complete HCV disease evaluation appointments and procedures are not appropriate candidates for therapy until those issues have been resolved.

Cirrhosis/ALD can be defined as
Biopsy proven cirrhosis
or
Clinical diagnosis based on defined events (i.e.,prior Child class B or C qualifying events) , Fib-4 > 3.25, APRI > 2.0
or
Platelet count 12.5 kPa

            
In addition, consideration should be given to treating patients with serious extra-hepatic complications of HCV infection such as cryoglobulinemia

Interferon ineligible populations include;
Patients with severe thrombocytopenia (platelet count < 50,000 mm3)
Patients with severe depression not responsive to medical therapy (documented by mental health provider)
Patients with decompensated liver cirrhosis, i.e., Child class B or C
Patients with hepatocellular cancer awaiting liver transplant
Patients with auto-immune diseases that may be exacerbated by interferon-mediated immune modulation

This is in doc format so I used google cashe to view without downloading
http://webcache.googleusercontent.com/search?q=cache:tJaggVil0e8J:www.pbm.va.gov/PBM/clinicalguidance/clinicalrecommendations/Interim_Considerations_Simeprevir_Sofosbuvir_2.doc+&cd=1&hl=en&ct=clnk&gl=us

I guess that current use of marijuana might be factor   "early stages, no liver damage" will probably have to wait awhile my guess..

[dontworry_behappy1]

I can't answer your question because I don't work for the VA.   But I can give you my opinion.   It would make sense that vets with middle stage and advanced liver damage will be first.  I'm not sure how your marijuana will become a factor.  Especially if your not disclosing the fact.  If this treatment is important to you - then you will refrain from marijuana use if you could possibly be penalized in the VA's decision to obtain timely treatment.  You might want to network with some other vets who have been through Hepatitis C treatment for insight.

Best to you