changed mind....again!

[brianmo]

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!

[Magnum]

I'm on Victrelis and feel 90% normal. No Anemia, no anger, just a medicine taste in my mouth. Tic Tac. Partial responder. As for the fat with Riba, doc said 10 grams is enough. Get it from organic peanut butter. 48 weeks in the course of a lifetime is nothing. At least no horrendous rash from Incivek. Spoke to lab tech at Merck who said if partials don’t clear after 12 weeks, they could clear after 6 months, so don’t give up too easily...

Magnum

[willbb]

Spoke to lab tech at Merck who said if partials don’t clear after 12 weeks, they could clear after 6 months, so don’t give up too easily...
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That may be ...keeping in mind the labeling says  if>100 at 12 weeks   or still DET at 6 months  to discontinue per futility protocol .

Possibly this tech may not agree with the company's labeling?

[copyman]

Wow, I thought everyone knew this to be very true. Guess not. Just so any newbies get the RIGHT information here it is again.

Let me state this again. Ribavirin is better absorbed with a high fat meal. Like I said there are studies and proven data to back it up. Google " taking ribavirin with fat". Here is one example from PubMed, a well respected website:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1804105/

The component of the final population pharmacokinetic model that describes the absorption phase is complex. Although a standard meal did not affect ribavirin bioavailability (F1), administration of ribavirin with a high-fat meal increased bioavailability by 46% relative to the fasting state. A high-fat meal prolonged the duration of the zero-order input part of the absorption model, with D1 increasing from 0.498 h (fasting and standard meal) to 0.740 h. The type of meal also influenced the first-order input part of the absorption model (Table 1).

[hrsepwrguy]

Ok now I'm confused, I am in a study of concentration controlled ribavirin dosing.

http://clinicaltrials.gov/ct2/show/NCT01097395?term=hepatitis+c+AND+colorado&rank=1

When I went in for my first day, for them to run the AUC 0-12 (11 blood draws) I was made to show up in a fasking state and was not allowed anything to eat until 5 hrs after my first dose of ribavirin, not once has the hep c research team at UC Denver told me I needed to take riba with fat, they have stongly suggested that I take the tela with 20 grams of fat but only needed to take riba with food to avoid nausea. So my thought is this, who do I believe people on the internet, who I know have done tons of research on the matter or the hep c research team at UC Denver who knows exactly how my body is absorbing the riba based on AUC 0-12 after my first dose.

[willing]

"not once has the hep c research team at UC Denver told me I needed to take riba with fat"

no such recommendation was made because no package insert for the drug requires it. As noted above many pts opt to take rbv with fat to increase absorption but this is a 'home brew' remedy aimed at increasing rnv concentration. Other, equivalent home brew remedies are a low purine diet (purines and rbv compete for the same molecules for transport from the gut to the blood stream) and simply taking a higher rbv dose.

Unlike the fat requirement for inci, none of these home-brew remedies are  required/recommended . Searching the mh  archives will show much discussion/controversy on the topic.

A key factor is the dramatic difference in the additional absorption effect induced by a high fat meal, For rbv bioavailability increases "46% relative to the fasting state" whereas for inci it increases 330% relative to fasting (from the quotes above).

The claim that rbv, to be effective, requires as much if not more fat than inci is nonsense,

[lynda607]

"The claim that rbv, to be effective, requires as much if not more fat than inci is nonsense,"

Totally agree.