harvoni / omeprazole

[neptune235]

I take Omeprazole, have for years, for GERD, at a dose of 40mg twice daily.

The Harvoni packaging contains a drug interaction warning for this combination.  The packaging says to take 20mg only, simultaneously with Harvoni, on an empty stomach.

Has anyone's doc out there recommended anything different?

Thanks in advance...

[flyinlynn]

Congrats on SVR Augustine!

The deal with the acid blockers is only an issue with Harvoni aka Solvaldi/Ledipasvir because Ledipasvir reguires a normal stomach acid environment so by reducing stomach acid it will reduce blood concentration of the Ledipasvir component in Harvoni

Lynn

[AugustineMama]

I was on 40 twice a day and took it down to 20 mg 8 hours after dose of O/S by Mayo Clinic doc and their specialty pharmacy. I have reached SVR EOT12 with cirrhosis.

[His way]

I also have GERD and was taking Omeprazole before starting Harvoni. I dieted and lost more weight than may have been good, lost the fat around my middle and have been very careful what I eat, when I eat, and take tums when needed (not within 5 hours of taking the Harvoni). I think the weight in my middle squeezes the stomach.
I was very worried about life without Omeprazole, but I am in week 5 of treatment and have been able to manage without it. The RIBA makes it worse.
GERD can be miserable for sure, best of luck.
Mike

[Rbeth]

Hi ...... Well looking for a thread on flyinlynn's posts is similar to trying to find my mom's lost bracelet at the beach in Delray Beach lol & :' didn't find, BUT
:-) on pg 67 of her posts( Lynn is a faithful & tenacious poster, Yes!) there is a thread with folks bandying about PPI's. Thread is titled "day 1 of 168" posted on November 24, 2014. There are 29 comments re: another issue but scroll down & you'll find convo on acid blockers/ Harvoni . There is also another even more extensive thread, and I truly can't find that one. Gilead's contribution is on Harvoni prescribing information on page 5, table 3.
All that being said, I'm sure you'll do fine, whichever protocol you & your doc choose. These DAA's are targeted & strong :-)
So proceed to cure my friend!

Blessings,
Randy

[Rbeth]

~woes of the poster~ wait arrows & auto correct...... Sorry 'bout that ;-)

[Rbeth]

Hey there,
Just saw your post. There was an extensive thread about this back in November, I'll look for it. In the meantime, i 100% agree with Lynn's previous post to you. Yes, Gilead's literature does allow omeprazole 20mg administered simultaneously with Harvoni under FASTED conditions. I also have severe GERD & Barrett's esophagus. I took an H2 for the first week & then stopped due to the same decision to not block any action of ledipasvir. To my great surprise & relief, for duration of Tx I only had two incidences of uncomfy reflux. For some reason, unbelievable, reflux seem to abate while on Harvoni???? I'm finished Tx for 5 days now, manageable reflux but definitely back, I have returned to acid reducer to keep Barrett's ( hopefully, not proven) from worsening. In all, for me, it was gratefully fine during Tx.
You definitely should check with your doc re: your medical condition & follow his recommendation.

All best of treatment to you, and of course SVR,
Randy

ps. Anecdotally, I also read that copious amounts of H2o can be as effective in reducing stomach acid as PPI............ LOL

[Rbeth]

Hey there,
Just saw your post. There was an extensive thread about this back in November, I'll look for it. In the meantime, i 100% agree with Lynn's previous post to you. Yes, Gilead's literature does allow omeprazole 20mg administered simultaneously with Harvoni under FASTED conditions. I also have severe GERD & Barrett's esophagus. I took an H2 for the first week & then stopped due to the same decision to not block any action of ledipasvir. To my great surprise & relief, for duration of Tx I only had two incidences of uncomfy reflux. For some reason, unbelievable, reflux seem to abate while on Harvoni???? I'm finished Tx for 5 days now, manageable reflux but definitely back, I have returned to acid reducer to keep Barrett's ( hopefully, not proven) from worsening. In all, for me, it was gratefully fine during Tx.
You definitely should check with your doc re: your medical condition & follow his recommendation.

All best of treatment to you, and of course SVR,
Randy

ps. Anecdotally, I also read that copious amounts of H2o can be as effective in reducing stomach acid as PPI............ LOL

[flyinlynn]

Hi

As the original poster said the prescribing info sheet says if you are taking omepresol to take it at the same time on an empty stomach. The instructions are different if you're taking in an acid such as Tums which has to be taken no later than four hours before and no soner than four hours after you take Harvoni and if you are takng Pepsid or similar that is to be taken at the same time and 12 hours after Harvoni.

This is because the Ledipasvir component of the Harvoni needs a acid environment to be fully absorbed so by taking stomach acid reducers this causes a reduction of the concentration of Ledipasvir.

As I am a three-time nonresponder to interferon-based treatment and having a relapse last year on Sovaldi Olysio  as well as having cirrhosis I can't afford to risk a treatment failure.

Neptune for the best answer to your question you should go with what your medical professional recommends.

Good luck on treatment everyone
Lynn

[bassetgirl]

I was on the same dose of Omeprazole when I started Sovald /Olysio last May and just stopped taking it for the 12 weeks I was on treatment.

I'm not recommending that you do that because I'm not a doctor:  This was just a personal decision without my doctors approval.

I decided to not take anything while I was on treatment because the meds were so new that I was worried that down the road something I was taking would be shown to affect treatment. I didn't even take vitamin supplements.

I'm also one of those who changed toothbrushes every couple days- some people thought this was silly, but again, it was a personal decision- I did everything in my power to help the meds to work.

[keepingOnkeepingOn]

Isn't it supposed to lessen the effectiveness of the meds? I'd call the Pharmacy and reread the directions that come with the script. Solvadi and the Prilosec type inhibitors counter act each other.

[flyinlynn]

I have the same, GERD due to Hiatial hernia.

The treatment nurse advised me if possible to avoid Prilosec.

All I have been doing is taking occasional tums late at night when I can't sleep because of the acid in my throat. Which by then is well outside the 4 hour window after taking Harvoni as also recommended on the prescribing info sheet.

It has been a long 14 weeks so far without Prilosec with 10 more long weeks of heartburn to go.

I sure miss my prilosec.

Good luck on treatment,
Lynn

[Ekkiemom]

Hi Nep......you can ask RBeth she has the same Tx and knows what to take, tell her Ekkie sent you
Peace and good luck with Tx
Deb