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547836 tn?1302836432

Is consistency important for taking Riba with food/ fats?

many studies have shown taking fats with Riba can significantly increase Riba absorption in the system.  and i understand that there have been many threads on this topic, however i have a somewhat different question regarding the consistency we should or should not take Riba with food/ fat.

i was previously, vaguely, told by hepa to either take Riba with food, or to not take it with food at all.  i wonder if this has anything to do with consistency.  from the beginning of tx, i kept myself to take Riba with enough fats, or at lease enough food (1 pretzel stick, chips, or etc)  for my morning Riba.  But now i get so lazy in the morning to only wake up to take my Riba and go back to sleep.  is this a bad habit considering that i used to take Riba with food, but now discontinued the process?  

the idea of possibly less Riba absorption bc i stopped taking Riba with food in the morning scared me when i woke up today, so i quickly popped a Ferrero Rocher in my mouth after 15 mins of taking my Riba.

do you guys think it is better and important to be consistent when it comes to taking Riba with food or taking Riba with fats?  i think i might restart taking Riba with foods now that i took so much time to think through this.

thanks, you know your thoughts are always appreciated
34 Responses
Avatar universal
All my literature, riba bottles, and doctor says "take with food"
87972 tn?1322664839
To the best of my knowledge, there hasn’t been a published, peer reviewed study conducted to gauge the effect that dietary fat with ribavirin has on SVR rates. If people insist on the addition of fat to diet during treatment, here’s the data from Schering-Plough:

http://www.spfiles.com/pipeg-intron.pdf

“Effect of food on absorption of ribavirin:

Both AUC and C-MAX increased by seventy percent when Rebetol Capsules were administered with a high fat meal: (841 kcal, 53.8 g fat, 31.6 g protein, and 57.4 g carbohydrate) in a single-dose pharmacokinetic study.”

That’s a *lot* of fat for breakfast (or any other meal)! If it were me, I’d discuss the risk vs. benefit of this diet thoroughly with my doctor before making any decisions.

A few years ago, I spoke with an educating RN that was employed by Schering-Plough at a local HCV support group. I discussed this aspect of treatment with her, and she stated the official party line from SP didn’t include any advice on this subject.

Again, talk with your treating doctor--

Bill
427265 tn?1444080036
I asked my Dr. about the fat/Riba uptake too before tx and she said just make sure to take it with food to lessen the chances of nausea. I eat a light meal, usually cottage cheese and fruit, then take them with a little Coconut oil. I was a little concerned that the oil might just send the pills right on thru, but it's so minimal, I doubt it. So far so good. Have to wait for the 4 weeker to see if it's working.

BTW, I topped mine off this morning with a Lindt truffle, the FR's were long gone! :-)

Pam
Avatar universal
I think your question is even if you're in one camp or the other, i.e. fat or calories, is it significant to the outcome that you stay the course with your chosen route.

DON'T KNOW!  Consistency as a factor never occurred to me. I'm still in the dark about whether I need high fat, low fat, healthy fat, unhealthy fat or just calories, a few or in the hundreds.

Super-informed members have tackled the high fat/low fat /caloric intake issues and I still haven't made up my mind.

I've grown more careless as the weeks go by and sometimes it's tempting to just pop the pills without food. So far, I haven't. No matter how much I don't want to be bothered with this silly thing called riba absorption, I dutifully poke around the fridge and find something.

I admit it's been inconsistent, sometimes unhealthy fat, sometimes good fat, sometimes yummy carbs.

So far, I haven't taken it on an empty stomach. Just because the preacher told me so.

Avatar universal
Me too Port.  Diligent at first.  Had to have enough fat, had to be sure it was the same time everyday.  Now, breakfast may consist of a bowl of cereal, toast or a piece of cake.  Doesn't matter anymore, as long as I'm taking it with food.  Currently, I'm on an Elvis sandwich jag for breakfast.  Peanut butter and banana sandwich.  I've actually gained a couple of pounds which is a good thing.
Avatar universal
Mostly I have been led to believe is the fat is to keep the nausea down,  which stands to reason, (could be wrong here) fat helps absorb the riba.    

Your body has not been absorbing fat for 30-40 years.  Though more and more you are eharing about obese teens waiting for liver transplants.

I am with Port on this,    

Deb
Avatar universal
also EVO on a salad. tomato, pasta,  is as good CO.   I think that just depends on where you are from,  and personal tastes
179856 tn?1333550962
The ribavirin BINDS to the fat so essentially you aren't peeing it out (love my classy act don't you?).  That said, everyone who's been on tx knows that sometimes you just can't eat what you 'should' all of the time. I went to the store and bought pre-made yogurt smoothies and got VERY used to drinking one at breakfast every day and took my riba with that at least.

Seeing as the first 12 weeks are the most important - I would REALLY make an effort then to always take your riba with your meals.  Again, we all know what it's like to not be hungry but you do need to have that fat content so you can have higher absorption.

The things that will BLOCK the riba are antacids and things like that.  Otherwise you should try to take it with food.........it only makes sense for both the absorption AND for the nauseau.
179856 tn?1333550962
ps I always hated yogurt smoothies but just like everything else on treatment they became one of my favorite things somehow........and they were quick and easy and they were SOMETHING....which has to be better than nothing at all (or a chocolate candy ;)
577132 tn?1314270126
Yes, it is!!

You should definitely take your Riba with food, studies show the bio availability is increased by up to 70% compared to taking it on an empty stomach.  Also, taking it WITH food will help lessen nausea and help battle anemia.

I know it's a drag, I have the same problem too, I am just sick of "having" to eat breakfast but I force myself to do it every day, at the same time, no matter what.

Here are some studies for you to check out:

Effect of Food on Absorption of Ribavirin

Bioavailability of a single oral dose of ribavirin was increased by coadministration with a high-fat meal. The absorption was slowed (Tmax was doubled) and the AUC0-192h and Cmax increased by 42% and 66%, respectively, when ribavirin was taken with a high-fat meal compared with fasting conditions.

http://www.druglib.com/druginfo/ribavirin/pharmacology/

Effects of Food on Bioavailability

Two studies have been carried out to assess the effect of food (ie, a high-fat breakfast) on the bioavailability of single oral doses of ribavirin (Table 2). An initial study by ICN Pharmaceuticals, Inc. (Costa Mesa, Calif)[19] showed minor effects on bioavailability, but a 33% increase in Tmax. A subsequent study by Schering-Plough Corporation (Kenilworth, NJ)[6] demonstrated more substantial increases in bioavailability: food increased the AUC and Cmax by 70% relative to the fasted population, and Tmax was more than doubled.

Although both studies consistently showed that food slowed the absorption of ribavirin, the extent to which food affected ribavirin bioavailability differed widely between the studies. It is also unknown whether any food effect might be altered by the type of meal consumed (eg, high versus low fat), if a food effect would still be evident upon multiple dosing of ribavirin, and, finally, what clinical implications the food effect might have. It should be noted that in the pivotal Schering-Plough clinical efficacy studies, ribavirin was administered without regard to food. Because of the uncertainty about the effects of food, it may be prudent for patients to take ribavirin with food; if toxicity (anemia) occurs, this can be managed by ribavirin dose reduction.

http://www.medscape.com/viewarticle/416602_2
9648 tn?1290094807
Wow. We are all so different. I think I would die without breakfast. Because I have an egg every day, it's the perfect accompaniment to the riba pills.

I'm still figuring out what to do with those blue suckers.  
577132 tn?1314270126
Just following on from my previous post: logically it appears to me that dosing consistency is VERY important as one of our goals while treating is keeping the serum levels of the medication at a consistent level.  

As taking riba with food increases absorption then it logically follows that when you take it without food you are going to drop your levels so there will be a see saw effect.  

Best to keep it steady!
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