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1148619 tn?1332014584

changed mind....again!

I have decided to not go with Inc. and do Vic instead (4 week lead in). I start tx on the 22nd so this is a last min. decision. The anxiety I was having  was unbearable. I could not rap my brain around the 60 grams of fat. I don't eat cheese or bread so that didn't help so after a week of anxiety I talked with doctor and we decided to do the other triple therapy. Now I feel better and not spending so much time with list of fat and searching the stores for what I could possibly eat. I know i have to eat with the Reba dose but she said a snack will do. Does not have to be high fat. Its not that I was afraid of putting on weight, it was more of not being able to do it!  What surprises me the small amount of people on this sight who are doing Inc instead of Vic. Either way, I just want to get this started!
42 Responses
250701 tn?1320978365
I was told that the incivek was mostly for non responders. :( That's me..lol
Avatar universal
I think Vic. is prescribed more.  That may have something to do with less sever side effects or the price tag.  Vic. is about 1/4 the price of Incivek.  The clinical trials indicated that Inc is more effective in non responders/relapses but the difference in naives was small.
1669790 tn?1333666195
As the following article mentions, neither drug has been proven superior.  It comes down to patient preference and risk factors.  I haven't read anything about either having an advantage for non-responders, but that might be the case.  If so, it would be good to list a reference for a published trial.  

If I had to do things all over and needed to choose a PI, I'd be leaning toward Vic since I'm a rashy guy and my Hgb hasn't been an issue.  

The following article was posted last month by Diane12855 and is a good read.

http://www.idse.net//ViewArticle.aspx?ses=ogst&d=Hepatitis&d_id=213&i=ISSUE%3a+August+2011&i_id=753&a_id=18862

Best of luck as you begin.  Try not to overthink this stuff.  I know I don't.  hahaha.
Avatar universal
Hate to tell you this but for Riba to be effective it should be taken with just as much fat if not more then incivek. This has been proven with data to back it up. My thought was is if I had to take fat with riba anyway I might as well take the incivek at the same time with the same fatty food.

Also one of the main reasons people are doing incivek more is the possibility of only having to treat for 24 weeks. That by itself is a huge factor. The less time these drugs are in your body the better. And of course you will take a lot less fat in 24 weeks vs 48 weeks :)
1711722 tn?1356491154
Really?  From the posts I have read since June, there seem to be many more people on INVICEK than on VICTRELIS.  But then, I am only checking this community, so maybe there are more in the Social Community or somewhere else.  The draw of INV is shorter treatment time (typically), while the draw for VIC is less intense sides.  My doc initially had me scheduled for INV but after talking to her colleagues, she discovered that many were having trouble with the sides, particularly -- anal pain and/or bleeding and firey bowels, to the point where they had to stop treatment.  So I am currently on the Pegasys (Interferon) and Ribavirin, then at the beginning of the 5th week, I will add VIC.  Either way, there is a ton of helpful information on what to do about sides for both drugs, and everybody responds differently to tx.

As for the RIBA......To make the morning dose more comfortable.....my training session suggested a "robust" breakfast, to avoid tummy issues since you have been fasting while sleeping (and therefore; your stomach acid is higher and wants to suck up the first thing you give it; and since the RIBA is hard on GI issues.....you want to start off with a bit more food in the mornings).  I found that I was overeating, trying to do this but I have decided/learned that a regular breakfast is good.  So more than a snack.  Hope this helps.  Best to you in tx!
Avatar universal
>for Riba to be effective it should be taken with just as much fat if not more then incivek.

not true.The food requirements  in  the medication guide for copegus (one of the brand names under which rbv is sold) makes no mention of fat:
"Take COPEGUS with food."
http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=12149#Guide

whereas the language in the inci package insert is explicit about the requirement for 20g of fat/dose.

"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.accessdata.fda.gov/drugsatfda_docs/label/2011/201917lbl.pdf

Many pts do opt to take rbv with additional fat, to improve absorption, but this it is not a  requirement (and the need/advisability is controversial).

>one of the main reasons people are doing incivek more is the possibility of only having to treat for 24 weeks
for naives who clear after 4w of PI  both inci and vic specify 24 w of tx. Vic add a 4w lead in, making the total 28 w. The risk of not doing a leadin is potentially pointless exposure to the PI.

What is true however, is that the amount of PI exposure time with inci is never more than 12w and thus always shorter than vic.  
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