vx950 pi's and h2

[crsrph]

  i am wondering if any one in the prove 1 trial with the xv950 was on either a proton pump inhibitor ( prevacid,prilosec, protonix, nexium , aciphex) or a h2 blocker (zantac pepcid tagamet axid ) thanks chuck

[jmjm530]

Two PPI's per day (1 every 12 hours) definitenly if your diaganosis is LPR (Laryngopharyngeal Reflux).

You will in all probability not get this diagnosis from either your family doctor or even a GI. You need to go to an ENT because they can look at your layrnx with a painless light probe they usually stick up your nostril. As to brand name, Aciphex didn't work for me, Nexium worked better. Heard this from others. Lots of brand names to experiment with.

Also, if you're not on the treatment drugs you can experiment with Zergerid for either LPR or even difficult ordinary GERD.Zegerid is a fast acting PPI that lasts 18 versus 12 hours. Zegerid can be taken on an intermittent basis because it doesn't need that 1-3 day lag time like other PPI's to get going. Zegerid has the same active ingredient as Nexium but is buffered with an antacid so it dissolves in the stomach rather than in the intestine. Because of the antacid, Zegerid should not be used while you are on ribavirin, or at least within 3 hours of taking riba.

-- Jim

[crsrph]

i may be guilty of not checking on current research . i baised my lpr tx protocol 2 month on single ppi (i skiped this step)if not cured then ppi 2 time daily at normal dose for 2 months . my beleif is that basically all ppi are created equal as far as clinical outcome though would go with prevacid in hilobacter eradaction also should have probaly should have done a hilobacter treatment before starting treatment for hcv am doing better now with gerd if it occurs again will check with md thanks for the info

[jmjm530]

Pepcid, Zantac 100 and similar OTC H-2 inhibitors are often prescribed as a first line of defense against reflux although many docs will skip that step since the PPI's like Nexium have done better in trial with a very good sfx profile. Some will combine the two, usually a PPI in the morning and an H-2 inhibitor at night,  where some think the H-2 inhibitors (while sleeping) may outperform the PPI's. Alternatively, some like myself who had reflux up higher in the layrnx region, took 2 PPI's (morning and evening). The one thing you don't want to take during treatment are antacids within 2-3 hours of your ribavirin. Pepcid AC therefore is OK, but Pepcid Complete is not OK because it contains an antacid along with the H-2 inhibitor. Post treatment it doesn't matter and I occasionally chew on  a Pepcid Complete myself.  

All the best,

-- Jim

[jmjm530]

I haven't done any research on how PPI's effect the bioavailability of VX-950, so you should pursue that both with your doctor and any other source you can find. As far as with ribavirin, PPI's do not affect the biovailability at all. Antacids on the other hand do and should be spaced at least 2-3 hours away from the riba. If you're refluxing up into the larynx -- like I did -- then you are underdosing the PPI. Standard dosage for LPR (Laryngopharyngeal Reflux) is two 40 mg Nexium a day, taken approx 12 hours apart and 30-60 minutes before meals. The reason is because the tissues in the larynx area are more sensitive than lower in the esophagus, so you need more acid suppression for healing to take place.

-- Jim

[crsrph]

i had some stomach problems before treatment but the riba and vx950 realy bothered my stomach was taking 1-2 prilosec 20 mg daily was getting reflux into the larynx after about 10 days on the triple therapy .looking over my failed treatment results started at 10 million was down to 18,000 at day 8 was over 114,000 by day 15 coincidence or does vx950 need an acidic enviroment for adsorption .also of note 1 of the protease inhibitors for hiv shows a 50-70% decrease in bioavabilty when ppi's are used during therapy and of course the higher the dose the greater the effect. im sure the initial research couldnt miss this possable drug interction but the doc even asked me once if i was taking all my meds and i never missed a dose. thanks for the reply

[willows]

Was not ever on VX either, but since tx, I have had to take a OTC like pepcid or tagamet twice a day.  IFN really did a number on parts of me, starting at my tummy and working outward.  Either that, or the liver not functioning at as well as it should is affecting my gastro parts.  So I live with PTC pepcid, double the dosage and it is as potent as a prescription.  Seems to work.

Willow

[jmjm530]

Didn't do VX-950, but was on PPI's during most of SOC with Peg and riba. In fact, on 2 Nexium/day for around six months.

-- Jim