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!

[frijole]

"I was told that the incivek was mostly for non responders. :( That's me..lol "

I think this is totally false.  I think you could succeed with either one

[frijole]

Lynda
"Ribavirin dose optimization is not ultimately achieved through a high fat diet.  It may be helpful but primarily it has to do with how well the body metabolizes the ribavirin and how well plasma ribavirin concentrations are maintained.  Dosage can play a significant role in this. "

Exactly - you are able to put this in concise words oh so well!  We know if that riba is working, when we get anemic.  In reverse, there have been members -- bill1954 and fishdoc -- who have been riba resistent (whose hgb never dropped significantly).  The way they solved the problem was NOT eating more fat, but upping the riba dose

frjiole

[frijole]

'What surprises me the small amount of people on this sight who are doing Inc instead of Vic'

Okay, I admit to being a little anal but I have started a spreadsheet of people starting therapy since May.  I have missed a lot but it looks like INC - 30, VIC - 8.

My Ribashere labeling says this under Clincal Pharmcology - Pharmacokinetics:
"Effect of Food on Absorption of Ribavirn - Bioavailability of a single oral dose of ribavirin was increased by co-administration with a high-fat meal.  The absorption was slowed (T max was doubled) and the AUC 0-192h and C max increased by 42% and 66% respectively, when the ribavirin was taken with a high-fat meal rather than fasting."

So the absorption is better with a high-fat meal but the absorption is slowed down (over fasting).  It is far more important  for trough ribavirin plasma concentrations to be reached. And it takes about 12 WEEKS for that to happen.   In the long run take food or not -- I think taking all of your doses and taking them close to 12 hours apart is more important.

One of the biggest differences between ribavirin and incevik is the half-life.  The half-life of a single dose of ribavirn is 120-170 hours.  The half life of Incevik 9-11 hours according to the FDA advisory committee briefing document (page 4)  The only way to keep INC in the system is to take it every 8 hours or so.  The fat helps with that maximum short-term bioavailability.  With the ribavirin, overall, we just need to keep it going in our system and let it build up -- with or without fat.

I have never seen anything about the amount of fat and nothing on 20 grams for riba.

frijole

[shanro]

i'm having some brain fog/wallowing issues right now and the mention of having to indulge in fattening food sounded comforting so I went with that.... with the brain fog I thought I was arguing my point well but with bs... so i will openly admit now that i don't what the hell i'm talking about right now... LOL... i think i'll quietly step away from this discussion now...

[willbb]

I try to have some additional fat with each meal taken with Riba.  I don't obsess about how much or if I forget, but figure it won't hurt.  

Perfect :)

[flcyclist]

Hey brianmo,  I bet you didn't expect your post to turn into a Riba and fat vs no fat debate. lol

Based on the studies I've read I try to have some additional fat with each meal taken with Riba.  I don't obsess about how much or if I forget, but figure it won't hurt.