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does the 20 grams have to be solid?? incivek question for morning dose
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does the 20 grams have to be solid?? incivek question for morning dose

I know your suppost to take every dose with 20 grams of fat which I have been doing at 6am, 2pm, and 10pm.  Its been harder and harder for me to eat 20g of fat right when i wake up so for the last 2 days Ive bee taking a table spoon of extra virginolive oil which has 14gr of fat and drinking an Ensure with 6 grams of fat.  My other 2 doses I take with food.  My question is, Is it ok to be taking my morning dose without anything solid?? It still is 2 grams of fat just all liquid.
29 Comments Post a Comment
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1280753_tn?1367761532
it doesn't have to be solid fat. it can be liquid such as whole milk with cream, or what you are doing. That's fine. the morning dose was hard for me too, because of the nausea.

good luck
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1280753_tn?1367761532
i forgot to add; just make sure you get 20 grams in. just think how great you will feel when you take your last incivek pill
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3159077_tn?1356034731
I drank a cup of whole milk which has 9 grams of fat with my morning and evening meals and ate the other 11 grams in solid food. I didn't want to do all liquids for the fat but the milk sure helped me. I was not hungry at all in the mornings and in general my appetite was weak. I did not get any of the dreaded anorectal problems eating this way but maybe I was just lucky.
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Avatar_f_tn
  I remember my Docotr saying solid foods help absorb some of the meds, which may prevent burning/itching, during a bowel movement, but I think it would be okay to have the 20 grams in liquid, and then eat some bulky food, like oatmeal~ I usually chose yogurt, and a tortilla with peanut-butter, and I used flax-meal with oatbran, for bulk
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Avatar_m_tn
Avacados and coconut oil work well also. Very high in "good fat".
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Avatar_f_tn
hi my hubby struggled with morning one, he drank whole fat milk then bowl of porriage also made with full fat milk, also hep doc prescriped some protein drinks which were high in fat
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2046312_tn?1360383200
thank you all very much! As always, your answers really helped and gave me a couple good ideas for my next doses! I am so grateful for this forum and all the wonderful people on here!  xoxo
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766573_tn?1365170066
I discovered almond mild while treating.
And who can forget ice cream!!
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1815939_tn?1377995399
The instructions state to take the Incivek within 30 minutes AFTER eating  a MEAL or SNACK which contains 20 grams of fat. Always take Incivek with food.

If you are having difficulty with the morning meal then my suggestion would be to  take the 20 grams of fat however you can get it, but eat something solid with it. So drink your Ensure and your oil, but eat a couple of pieces of whole grain toast and a banana or some whole grain cereal with it. In the mornings I always ate the 20 grams of fat from/via Greek Gods yogurt, which is high in fat, but very smooth and very tasty. But I always ate toast or whole grain crackers and a banana or some other solid food with it. You do not want the pills moving through too fast. You need them to absorb and get into the blood stream.


From Drugs.com

How should I take Incivek?
"Take Incivek within 30 minutes after eating a meal or snack that contains about 20 grams of fat. Always take Incivek with food. Examples of snacks that contain about 20 grams of fat include: A bagel and cream cheese, 3 tablespoons of peanut butter, 2 ounces of American or cheddar cheese, 2 ounces of potato chips, a half-cup of nuts or trail mix, or 1 cup of ice cream."

http://www.drugs.com/incivek.html
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317787_tn?1373214989
Hi I understand not wanting to eat so early. I got lazy and just started eating peanut butter with a couple of apples, then a glass of milk.  It is hard but keep your eye on the prize and it will be worth it,
my best to you
Dee
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Avatar_m_tn
Take with a glass of "whole" milk. You will be fine.
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Avatar_m_tn
"Take with a glass of "whole" milk. You will be fine."

Yes its always wise to ignore what the experts say and just listen to a bunch of internet posters.......... Good luck
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1237562_tn?1360993180
how bout flax seed oil ?
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Avatar_m_tn
"The experts were the ones that told me milk was OK" Top Hep doc in Boston and PA both told me "whole milk is OK with meds" but add some fat once in a while, if possible. Treated 1000's of HCV patients between them.  They must have been right because I mostly drank milk with my Meds and I SVR'd. Maybe it was luck?
Comes down to making sure to take meds on schedule. If that means taking with milk then do it. Anything to keep a person on the meds and not quit.
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2046312_tn?1360383200
thank you everyone!
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4856858_tn?1365382377
Here are a bunch of things:
Food Portion Fat (g.)

French toast

Frozen 1 slice 5.0
Homemade 1 slice 6.7

Pancakes and waffles

Waffles, frozen 2 (2.5 oz.
each) 7.0
Plain pancakes 4 (4") 7.6
Buckwheat pancakes 4 small 8.0

Granola 1 cup 33.1

Tartar sauce 1 Tbsp. 8.0
Cottage cheese, 4% fat 1/2 cup 4.7
Blue cheese 1 oz. 4.9
Ricotta, part-skim 1/4 cup 4.9
Feta 1 oz. 6.0
Monterey Jack, light 1 oz. 6.0
Mozzarella,
whole milk 1 oz. 6.1
Swiss 1 oz. 7.8
Brie 1 oz. 7.9
Ricotta, whole-milk 1/4 cup 8.0
Monterey Jack 1 oz. 8.6
American, processed 1 oz. 8.8
Colby 1 oz. 9.1
Cheddar 1 oz. 9.4
Cream cheese, regular 1 oz. 9.9
Low-fat, 2% 1 cup 4.7
Cream, heavy, whipping 1 Tbsp. 5.5
Whole, 3.3% 1 cup 8.2
Evaporated whole 1/2 cup 9.6
Strawberry shortcake 1 slice 8.9
Pound Cake (1 oz.) 1 slice 9.0
White Cake, with chocolate icing 1 slice 11.0
Milk chocolate, with almonds 1 oz. 10.1
Milk chocolate, with peanuts 1 oz. 10.8
Cookies and brownies

Gingersnap 1 0.6
Vanilla wafer 1 0.9
Fig bar 1 1.0
Chocolate chip 1 2.2
Doughnuts

Plain 1 (2 oz.) 10.8

Vanilla ice cream, premium 1/2 cup 11.9
Pastries

Apple turnover 1 oz. 4.7
Eclair, with custard and icing 1 13.6
Cheesecake 1 slice 16.3
Pies

Apple 1 slice 13.1
Custard 1 slice 14.0
Blueberry 1 slice 15.0
Chocolate cream 1 slice 15.1
Pecan 1 slice 27.0
Chocolate pudding 1/2 cup 4.0
Tapioca pudding 1/2 cup 4.0
Rice pudding, with raisins 1/2 cup 4.1
Vanilla pudding 1/2 cup 5.0
Custard, baked 1/2 cup 7.5
Corn or safflower oil, soft 1 tsp. 3.8
Mayonnaise

Low-calorie 1 tsp. 1.3
Regular 1 tsp. 3.7
Oils

Olive 1 tsp. 4.5
Vegetable 1 tsp. 4.5
Florida avocado 1 med. 15.4
California avocado 1 med. 30.0
Hamburger, extra lean 3.5 oz. 16.0
Hamburger, lean 3.5 oz. 18.4
Salami 3.5 oz. 19.9
Italian sausage links (3.5 oz.) 11/2 17.2
Bologna (3.5 oz.) 4 slices 19.7
Loin roast, lean and fat 3.5 oz. 21.5
Chop, lean and fat, broiled 3.5 oz. 27.0
Sausage patties (3.5 oz.) 4 30.9
Sausage links (3.5 oz.) 8 32.4
Chow mein noodles 1 cup 11.0
Duck

No skin, roasted 3.5 oz. 11.1
With skin, roasted 3.5 oz. 28.2
Cashews, oil-roasted 1/2 cup 31.4
Cashews, dry-roasted 1/2 cup 31.8
Pistachios, dry-roasted 1/2 cup 33.8
Almonds, dry-roasted, whole 1/2 cup 35.6
Peanuts, oil-roasted 1/2 cup 35.7
Sunflower seeds, dried 1/2 cup 35.7
Spanish peanuts, dried 1/2 cup 35.9
Filberts (hazelnuts) 1/2 cup 36.0
Pecans 1/2 cup 36.6
Persian/English walnuts 1/2 cup 37.1
Brazil nuts 1/2 cup 46.4
Macadamia nuts 1/2 cup 49.4
Salmon, cooked 3.5 oz. 7.5
Scallops, breaded, fried 3.5 oz. 11.4
Shrimp, breaded, fried 3.5 oz. 12.1
Onion ring, fried 1 3.0
French fries, frozen 10 pieces 4.4
Hash-brown potatoes, frozen 1/2 cup 9.0
Homemade Potato salad, (eggs and mayonnaise) 1/2 cup 10.3
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4856858_tn?1365382377
Here are some more but remember to be aware what effect different foods have on your digestion. I could not eat oats/cereal.
39917.9 in reply to 39917.7  

Fatty foods:
20 grams of fat in;
3 TABLESPOONS OF PEANUT BUTTER
1 LARGE AVOCADO
1/2 CUP NUTS
2 1/2 TABLESPOONS OF OLIVE OIL
3 TABLESPOONS OF BUTTER
1 CAN OF SARDINES
2 OZ OF CHEESE
4 OR 5 SLICES OF BACON
2 CUPS OF WHIPPED CREAM
1 CHEESE OMLET
1 SLICE OF QUICHE
1 BAGEL WITH CREAMED CHEESE
2 1/2 TABLESPOONS OF ALMOND BUTTER
2 1/2 ANCHOVIES IN OIL
1 SERVING OF TAKE OUT CASHEW CHICKEN
1 SERVING OF CHOP SUEY WITH PORK
1 CUP CHOW MEIN WITH PORK
7 OZ FRIED RICE WITH EGG
1 CUP KUNG PAO CHICKEN
3/4 CUP TERIYAKI CHICKEN
2 OZ BANANA CHIPS
1 CUP BAKED BEANS WITH WIENERS
3 OZ BOTTOM ROUND STEAK (BRAISED)
3 OZ POT ROAST
3 OZ BROILED OR HAMBURGER MEAT
2 BUTTER MILK BISCUITS
2 CHEESE BLINTES
1 OZ BRAZIL NUTS
2 SERVINGS FRENCH VANILLA INSTANT BREAKFAST

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Avatar_f_tn
Eat solid if you can, only my opinion. But post Tx I had scope, upper and lower.  Drugs eroded stomach lining, ulcerative spots, multiple polyps, it just looked really harmed.
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Avatar_f_tn
  Eat Ludvig, you must eat :)  (a line from a movie about Mozart, I believe?)
    I ate food with my meds, and also small meals thru out the day, to keep my appetite up.
   If I let my stomach get empty, then the nausea would immediately crop up, plus a 'weird" feeling...dizzy and unhealthy feeling.
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2046312_tn?1360383200
wow thank you very much that was a great list!
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4950316_tn?1394188185
Only been on Teleprovir etc for 2 days, and the incidious thing has already got me bleeding, diarrhoea etc.That is one powerful toxic drug!
As a person who had a low fat diet, and I too have difficulty eating at the moment and especially first up, I feel that the increase in fats, especially dairy, may be part to blame. Even though one doesn't have to be lactose intolerant, the increase can cause diarrhoea. I have taken a codeine tablet today, just to slow it down. Does anyone know if that's OK?
I am determined to try and eat more solids.
Also, I just want to say, I have been reading all these posts for past 2 days, and you guys are brilliant. What a wealth of knowledge and comfort to me!
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1815939_tn?1377995399
The codeine is not going to hurt your treatment, but if I were you, I would take Immodium (Loperimide) instead. That is what I used. I never took it every day. I used it when I could feel a looser stool coming on. I immediately took the Loperimide tab and that pretty much controlled the problem.

It is the Incivek that is most likely causing your diarrhea and bleeding. Incivek can wreak havoc on the rectal/anal area. It is a burning type diarrhea and it irritates the rectal and anal area. It is important to keep that diarrhea under control or your rectal problems may get worse. I had extreme internal pain (like crapping shards of glass) (probably from rectal fissures caused by the Incivek). I accidentally discovered that the way to control that pain (actually to prevent it) was to keep the stools very firm with Loperimide. They need to be firm, not at all soft. Not like rocks, but very firm, like cookie dough that you are molding into cookies with your hands. Keeping the stools firm with Loperimide as needed got rid of the burning diarrhea and the shards of glass and kept me from getting amy more problems. Get it under control because if it gets bad, it is a potential game changer.

Loperimide is over the counter. If that does not work, then Lomotil is a prescription antidiarrheal med.
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4856858_tn?1365382377
Probiotics may help.
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4950316_tn?1394188185
That's what I was thinking. Got a store up just before I went on.
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1815939_tn?1377995399
Probiotics may help some. They sure won't hurt. However, it is the Incivek causing the burning diarrhea and the anal/rectal problems.  

I practically lived on Greek God's yogurt (a yogurt filled with Probiotics), eating it at least twice a day (along with some other more solid foods), but I still had the anal/rectal problems. I certainly would still recommend Greek Gods yogurt because it is so high in fat, goes down easily, and tastes delicious.

The Greek Gods Greek Yogurts are traditional Greek Yogurts containing .....healthy probiotics. Greek Gods All Natural Greek yogurts ..... contain 5 Live and Active Cultures (including Probiotics), rbst/rbgh free milk, natural juices, and a thick and creamy consistency.....
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4856858_tn?1365382377
The Probiotic I took during Incivek and throughout the Tx has 50 billion CFUs. Also, when it starting hurting bad, I got the doc to give me a script for Hydrocortisone AC (suppository). Don't know that I had hemmoroids (hemorrhoids) but I took this only 3 or 4 times and it got rid of the worst of it. Then I used vasoline until I did not need that anymore.
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Avatar_f_tn
My body found the drastic change in diet pretty traumatic that first 4 days but it is ok now. (Touch Wood!) I am pretty pendantic about the food as I want to get every last ounce of effect from the telaprevir. I found various nutrition charts and they seem to give different measurements so now I read the label of the actual product to try to get the most accurate measurement. It seems for me having a mix of soft and hard food works. I have not had any rectal problems so far. I thought I would love being able to eat ice cream etc but I can't even stand the thought of it. Can't stand yoghurt either. If I am having the fat from eg flaxseed oil, I will slop it up with a banana and whole grain bread. Salmon is a good choice - you don't need to eat much to get the 20 gms of fat. Also, some high fat dressing over a healthy salad or cold veges. It might take some Trial and error. All the best
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Avatar_f_tn
Also, I think its very important to maintain your nutrition during tx. There is a long gap between breakfast and the lunchtime pills so I use that time to eat as much nourishing food as possible.
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2046312_tn?1360383200
I have no appetite at all but I try to eat fruits and veggies inbetween doses.  The first week was awful for me, im almost finished with my 2nd week but I am starting to feel better, the fatigue is starting to go away but still having trouble eating the 20g at 6am! but everyone who posted was very helpful and gave me some great ideas. thanks alot! xoxo
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