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Avatar universal

How important is the 20 grams

Do you have to have exactly 20 grams of fat. I find myself just taking a rough guess sometimes over sometimes under. Also how long does the fat stay in blood helping the drug do it's job. Say you had 25 grams @ lunch 1;00 PM and took meds @ 2;30 PM do you need another 20 grams.
10 Responses
Avatar universal
The 20 grams of fat  is " very important" as are the "time" frames
Will

http://www.vrtx.com/current-projects/approved-medicines/incivek.html

Take INCIVEK exactly as your healthcare provider tells you. Take two INCIVEK pills 3 times a day, 7 to 9 hours apart, with food. Eat a meal or snack containing about 20 grams of fat within 30 minutes before you take each dose. Talk to your healthcare provider about examples of food you can eat.

http://www.vrtx.com/current-projects/approved-medicines/incivek.html



Avatar universal
Exactly? More then likely not but i would get as close as possible. As for eating at 1:00 and waiting till 2:30, No. It clearly states within 30 minutes of eating... My thoughts are why take chances if your going to go thru this torment. A lot of time and money went in to the research and this is what they found to work best.......... Just do it!!!
Avatar universal
It is recomended by the drug company. I found that if I took incivek without the recomended fat it would upset my stomach and set my butt on fire. I only did it a couple of times and learned my lesson. I always took cheese or yogart with me when I had to be out during the day.
2062453 tn?1350336542
Hi Fish. I concur with WIll. In addition, my technique was to shoot for between 20 and 25 grams of fat because I experienced less anal irritation with a little more fat. I think that by eating more fat, less of the Incivek was passing through my system -- just a guess. V/r, GB
1815939 tn?1377995399
The fat is extremely important. In fact it is critical. The Incivek must be taken within 30 minutes of eating the fat. The fat enhances the absorption and increases plasma concentration of the drug.

It is NOT okay to eat 10 grams at 6am, 20 grams at 2pm, and 15 grams at10pm.You need 20 grams each time you take the pill and the pill needs to be taken within 30 min. after taking the fatty food.

Also, do not guess. Read the labels. If you don't know the fat content of something, then eat something else along with it, something that you know has the fat. Any time I was not 100% sure if I had enough, I drank heavy whipping cream (read label) or had berries with heavy whipping cream or extra Greek Gods yogurt.

It cannot be stressed enough that the success of your treatment (whether you attain SVR) depends on you taking the medications exactly as instructed. If you do not eat enough fat or if you do not take the pills within 30 min. of eating the fat,  or if you miss pills, you risk treatment failure (mutant resistant strains of the virus can emerge).


Pharmacokinetics

"The pharmacokinetic properties of telaprevir have been evaluated in healthy adult subjects and in subjects with chronic hepatitis C. Following multiple doses of telaprevir (750 mg q8h) in combination with peginterferon alfa and ribavirin in treatment-naïve subjects with genotype 1 chronic hepatitis C, mean (SD) Cmax was 3510 (1280) ng/mL, Cmin was 2030 (930) ng/mL, and AUC8h was 22,300 (8650) ng•hr/mL.


Absorption and Bioavailabilty

Telaprevir is orally available, most likely absorbed in the small intestine, with no evidence for absorption in the colon. Maximum plasma concentrations after a single dose of telaprevir are generally achieved after 4 to 5 hours. In vitro studies performed with human Caco-2 cells indicated that telaprevir is a substrate of P-glycoprotein (P-gp). Exposure to telaprevir is higher during co-administration of peginterferon alfa and ribavirin than after administration of telaprevir alone.

Effects of Food on Oral Absorption

The systemic exposure (AUC) to telaprevir was increased by 237% when telaprevir was administered with a standard fat meal (containing 533 kcal and 21 g fat) compared to when telaprevir was administered under fasting conditions. In addition, the type of meal significantly affects exposure to telaprevir. Relative to fasting, when telaprevir was administered with a low-fat meal (249 kcal, 3.6 g fat) and a high-fat meal (928 kcal, 56 g fat), the systemic exposure (AUC) to telaprevir was increased by approximately 117% and 330%, respectively. Doses of Incivek were administered within 30 minutes of completing a meal or snack containing approximately 20 grams of fat in the Phase 3 trials. Therefore, Incivek should always be taken with food (not low fat)."

http://www.drugs.com/pro/incivek.html



From: the Incivek website:
http://www.incivek.com/how-to-take-incivek

How to Take INCIVEK
Take INCIVEK exactly how your healthcare provider tells you. Your healthcare provider will tell you how much INCIVEK to take and when to take it.
•Take 2 INCIVEK pills (a dose) 3 times a day
•Eat a meal or snack that contains about 20 grams of fat, within 30 minutes before you take each dose of INCIVEK
•Each dose should be taken 7 to 9 hours apart. Pick the same time each day to make it easier to remember
•INCIVEK must be taken with peginterferon alfa and ribavirin

Always take INCIVEK with food

If you take INCIVEK on an empty stomach, you may not get enough medicine in your blood to clear the virus. That's why it's important to eat a meal or snack that contains fat, within 30 minutes of taking each dose of INCIVEK.

Examples of foods that contain about 20 grams of fat that could be eaten with INCIVEK include*:
•Bagel with cream cheese
•1/2 cup nuts
•3 tablespoons peanut butter
•1 cup ice cream
•2 ounces American or Cheddar cheese
•2 ounces potato chips
•1/2 cup trail mix
766573 tn?1365170066
The fat is crucial.

One time I read a post about a member who drank two tablespoons of olive oil with orange juice to meet the 20 grams of fat. That amount of olive oil is correct to meet the fat requirement however when I tried that I was OK for about 40 minutes so I walked my dogs. 30 minutes later I was about a mile from my house and without even feeling it coming I had an explosive bowel movement. TMI, I know but I honestly thought the way I consumed the fat in the olive oil would absorb the pills since Hey, it was 20 grams of fat!

Well, what a mess and what a hassle that was. I never did that again and nothing like that ever happened to me again. Lesson learned.
Avatar universal
Agreed, I've been doing very good with the correct fat intake if I'm unsure I eat a bit more. I just wanted to know how important it is and if there was any lead way. So far not a problem, my Dr. said sun flower oil is a easy source of fat mixed with Ensure. Thanks for your response's you're all correct.
Avatar universal
You will learn to rotate food items around.  I found that whip cream worked pretty well as a fat booster.  It was 6 grams for 1 tablespoon.  I could have a normal breakfast with 2 tablespoons of whip cream with milk and chug it.  Tried coconut oil but was a little slimy for me.  There are tons of recommendation on this site for what to do; but fat is what we do with the purple pills.  Just finished 12 weeks and getting off the dosing schedule was a relief.

Good luck with tx.
Avatar universal
From what I've read and from what my husband's NP told us, the 20 grams of fat is critical for the optimum absorption of Incivek into the body.
Advocate1955
Avatar universal
It doesn't have to be exact. I did successful incivik triple therapy and I only drank a glass of "whole" milk with the pills.
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