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Avatar universal

diet on incivek?

my wife started the incivek etc. program today, we read that she should have a meal with 20 grams of fat before each dose... any healthy diet suggestions ??
138 Responses
Avatar universal
my wife is in her second week of taking Incivek and we are working on her diet.  Her main concern just now is about weight loss.  This was mentioned at a class  that we attended and it is a concern of hers.  No one has mentioned anything about weight loss here and She is wondering why.  All the conversation seems to be about weight gain.  Has anyone experienced any type of weight loss?
Avatar universal
@ halbev...my wife is on a 24 wk treatment of incivek and she is wondering if you went the full term for you treatment or did you stop your treatment at 12 wks.  She also wants to know it your hep C was gone after the treatment.
1815939 tn?1377995399
A couple people on the forum have mentioned nausea and vomiting and weight loss but most comments about weight have been about the weight gain while taking Incivek.

I am in my 17th week of triple med treatment with Incivek (for 12 weeks), Riba, and Inf. I will be on Riba and Inf. for a total of 48 weeks.

I gained weight (about 20 pounds) while I was taking Incivek because I was eating 20 grams  (at least) of fat 4 times a day. I was not eating a lot of food, but that 20 gams of fat 4 times a day put the weight on. Now that I have been off Incivek for 4 1/2 weeks, I am losing some of that weight. So far I think I have lost about 10 pounds of the 20 pounds I gained (which is good as I am overweight).I still eat some fat with my Riba, but my fat intake is down quite a bit from when I was taking the Incivek.

The meds can make a person nauseated (sometimes vomiting) and also the appetite is really decreased. I always had an underlying nausea. The nausea can creep up on a person gradually. I think your wife should keep tabs on how she feels and if she gets nauseated then ask the doc for an anti-nausea med. (I am on Zofran.) I think people sometimes lose weight on Riba and Inf. due to the poor appetite and nausea.

I hope your wife does well on the meds. Keep us informed of her progress.

1747881 tn?1511918860
Most gain wt on incivek due to the 20 gm's of fat needed with each dose of incivek which is very important.

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).

Avatar universal
I  just want to say i just got my incivek this am. I did 3 mths last year on the ribo and inter. I am so overwhelmed that i held off starting today, I am very glad i found this websight and everyones recommendations and experiances..I was really freaking myself out little...No, lets be honest here Alot, Thanks guys....
1815939 tn?1377995399
Welcome to the forum and congratulations on starting treatment.

I think we were all freaked out when we started not knowing what to expect so you are in good company.

Be sure you eat 20 grams of fat with each Incivek dose.

Get on top of side effects immediately if you get any. Hopefully you will be one of the lucky ones with few side effects.

Post any questions for side effect solutions/remedies. We have a lot of experience in the side effect department and I think we have figured out some good solutions/remedies.

The three months on Inc. goes by pretty fast. Once you are off Inc.,it gets a lot better, at least for most of us.

Best of luck with your treatment.
Avatar universal
Yes, I lost around 10 or more lb. first 4 weeks I stayed the same. Then I lost 5 lb within short period of time and then couple of weeks later another 5. Since then my weight didn't change. I am done with incivek as of 3pm today.
When I did Pegasus/ co Pegasus several years ago, I gained 10 lb. we'll see where my weight goes in the next 3 month.

It' s funny, that some one mentioned that the love all that fat - ice cream, dark chocolate... The funny part is that my wife still eats all my ice creem "supplies" that I purchased before starting incivek. And it wasn't a lot. My ice creem love diminished in the first week.:)
Avatar universal
Good luck to him!! I also, did not respond to the tx 5 years ago. I started this new treatment 12/7/11, and at my 4 week mark my viral load was """407""""!!!

Get his Dr. to prescribe Phenagren for the nausea. I don't take it but once a day,if at all. It helps get that food down when you would struggle because of nausea without it. When I struggle with what to eat at med time cause my taste buds are whacked out, I normally do ice cream. Oh, and drink lots of Ginger Ale! Listen to your body and get lots of rest. I have slept through a lot of my side effects.

Well, gotta run. My friend the timer just went off for my 4pm dose!!!

Good luck to you all!!!!!!!!!


634709 tn?1313770844
Here are a few healthy choices for achieving the fat goal...

Walnuts - 1 oz = 15 to 20 g fat

Almond butter - 1 tbsp = 10 g fat   (see note below about peanuts)*

sunflower-seed butter - 1 tbsp = 10 g fat

Macadamia Nuts - 1 oz = 20 g fat

Sesame Butter (tahini) - 1 tbsp = 10 g fat

Coconut meat - 1 oz. = 20 g fat

Avocado - 1 fruit = 30 g fat

*(NOTE: peanut butter...  there is some conflicting information regarding their benefit to the liver. This is primarily because of peanuts’ potential for being contaminated with aflatoxins)

Wish you all the best in your healing journey!  
I start treatment today!!! A bit apprehensive but hopeful and ready.
Avatar universal
I, m diabetic too. I drink 1/4 cup heavy cream with some sugar free choc syrup for my am fat, goes down easy and is a small amount at 4:30am. Lunch is 1/4 c mixed nuts or 1/2c cashews, or 1 avacado stuffed w/shrimp cheese and italian dressing.Evening is usually 1 1/2 Tbl olive oil, goes down easy.
Avatar universal
My warrior wife is now in the midst of Her fourth week of this hep C treatment and I am so glad to say that after the initial side effects(itching,burning, rashes, dizziness)She has  settled into a reasonably side effect free situation.  I inquire each morning about her condition and She is well.  I only pray that the duration of this treatment is as uneventful.  
I am truly grateful to the community for the diet suggestions because we have been able to amass a group of foods that has allowed her to not become bored with foods that she normally loves.
I would strongly recommend to anyone that is just starting any type of Hep C treatment to pay close attention to the postings here in the community.  I can almost guarantee your road to wellness  will be bumpless.(did I say 'bumpless?')  
Anyway, THANX again, you guys.
1986676 tn?1329866071
The fat is not a matter of choice, but a requirement for good absorption of your medication.  

1986676 tn?1329866071
Have you read the Incivik literture.
The fat increases the absorption of the medication.

20 grams with each meal!!!

Avatar universal
Hello to all, what a plethera of information I have gathered here. My husband will be starting the Incivik RX in the next few days. He has been on RX 5 times in the past and this is his first go round with the triple drug therapy. We were told yesterday that Zofran is not the recommended drug of choice of nausea and that they would be switching him to Phenegran. Because he has no appetite and vomits quite frequently and isn't even on the RX yet I am very concerned. I have read thru a lot of the posts and appreciate all the hints as to what foods to try and get him to eat. Good luck to all of you and I will be checking back frequently.......Gail
Avatar universal
I should be starting in  a couple of weeks, I am already over my desired weight, I just don't want to gain weight.  Thank you so much for the list of foods.
Avatar universal
I'm excited about starting & getting it over with.  I have the right gene IL28b that should cut the treatment in 1/2 for me!
2059648 tn?1439770265
How is everyone doing?  I'm getting ready to start treatment.  
Give me advice ;)
2059648 tn?1439770265
How is everyone doing?  I'm getting ready to start treatment.  
Give me advice ;)
2059648 tn?1439770265
Can anyone tell me what 1a means?
1747881 tn?1511918860
Go to the top of this page and use the orange post a question and it will start a new thread, you will get more responses that way. 1a is your genotype.
Avatar universal
I am in week 5 of incivek 3 times a day, and riba 2 times a day, and pegysus once a week.  I have a hard time with the incivek and riba but have a few tips:  

half cup of cottage cheese with 4 tsps of Safflower Oil mixed in well, then top with one of those half cups of fruit salad for kids lunches - quick, not too heavy, and works well for me.  

I found it's important to take care of your bum as soon as you get runs, or burning.  Imodium and Prep H.  The more fat, the easier the stomach seems to handle the incivek.

I take incivek and riba night dose with an anti-nausea pill - works well.
Avatar universal
olives w/ garlic = 1 gram of fat

1/4 cup of walnuts = 20 grams  
Avatar universal
Hello to all: So glad to find this site! I completed the Peg-Riba treatment 4yrs ago.Did reach 0 svr but after 6 months it was back.I hv followed the Incevik trials.And made sure my doctor did as well.Should be starting my Triple Treatment next week.This is a Great Forum ,keep it updated I think it will help alot of people who don t know where to turn for help and encouragement to work through HEP-C treatment.THANK YOU ONE AND ALL FOR BEING THERE...
Avatar universal
Avatar universal
Thanks for the info. On fattys food. I'm starting the incivek,  RIBA & pega. Next week
Avatar universal
haha, I eat a klondike bar almost every night.  It's so easy to get down.
Avatar universal
Starting treatment on May 7. I am pretty worried about weight gain, depression and ability to continue working as my job involves physical work. Would appreicate anything that will help me get through this. Thanks so much.

2061362 tn?1353283118
Tried the healthy route, got old real quick. I still try to be somewhat healthy but its just easier to grab whatever. Plus my tastes have changed. Also, I find something I can get down, and soon I just can't tolerate it anymore. Can't even stomache the thougth of peanut butter anymore. I figure it is only 12 weeks, I'm going to get down whatever I can to get that 20 grams in. I have become very creative. Still get avacodo in, Cooked Spinach with some butter or olive oil, garlic bread with real butter and Italian cheese blend. mini cream puffs; small light and airy, and only 6 of them to get 22 grams. alot of things that only equal partial fat, I will follow up with Udo's chocolate truffles (so good for you and 1 little square has 7.7 grams of fat). mini BLT with lots of mayo. Just a few ideas.
1815939 tn?1377995399
Welcome to the forum.

This is an older thread although people do post in it at times. You may get a better response if you start your own thread by going towards the top of the page, and clicking on the orange bar, and posting a question.

We were all very scared and anxious before and when we started. We all expected the worst, I think.

Everyone is different and the body responds differently in different people. Some have few side effects, others have more. Some have mild side effects, others have more serious side effects. You will not know how you willl respond until you are on the meds. The other thing is the side effects, most of them, come and go and change around. You may have one side effect for a week or two and then it disappears. On the other hand, a few tend to hang around.

You did not state which drugs you will be on, Incivek or Victrelis. Some side effects are peculiar to one or the other.

That said, most people do experience some flu like symptoms from the interferon, some fatigue, some malaise, and a few other things. You may want to start your treatment regimen on a Friday eve so you have the weekend to recuperate (that is, if you have weekends off).
I find taking a couple of tylenol near the time I take the injection does help the achiness feeling.

If you are going to be on Incivek you probably will gain weight (due to the fat intake). I did. But I lost it all after going off Incivek. In fact, now I am losing weight (still on Inf. and Riba.).

If you have a history of depression then you should talk with your doc about that. The doc may want to start you on antidepressants prophylactically. They take about 3 weeks to kick in and about 6 weeks to reach full effect. Many of us are on ADs. Otherwise, if you have no history of depression, and if you start feeling depressed during treatment, let the doc know right away so you can get started on meds.

Work is another story. You do not say what type of work you do other than it is physical. The type of work does matter or may matter. Also the number of hours may matter. Many people do continue working while on treatment. Others work part time, work shorter hours, do a desk job, take sick days as needed, etc.

If you are doing presision work or dangerous work (electrical) or climbing ladders or balancing on roofs or beams, or lifting heavy objects, work may be a problem. While not everyone gets these side effects, the following side effects, if you get them, may interfere with work: brain fog or inability to think clearly (and doing things incorrectly that you normally can do correctly, like putting a postage stamp on the wrong side of the envelop or driving past your exit several time and having to turn around and go back several times or wondering why your TV remote won't open the garage door), problems concentrating, memory problems, balance problems, weakness, dizziness, extreme fatigue, anemia (thus extreme fatigue and shortness of breath), nausea and vomiting, diarrhea, etc. You can see why if you are on a pole repairing electricity, you may have a problem. Besides the weakness and dizziness, you may connect the wire to the wrong place and electrocute yourself. Or you could fall off of high places.

If Plan A is to work, then I would have a Plan B and a Plan C waiting in the wings in case you need them. Plan B and Plan C could be sick time, vacation time, holiday time, comp. time,  short term disability leave, longer term disability leave, family medical leave, flex time, part time, shorter hours, temporary desk job, etc. You should talk with your boss and see what is available if you need it. I think eveyone is entitled to family medical leave if they need it.

You may be fine and have only mild side efects, but you cannot count on that. You need to be prepared for any scenario.

If you are on Incivek, you must take at least 20 grams of fat every 8 hours and you must take the Incivek within 30 minutes after eating that fat (every 8 hours). The fat and the med timing are crucial to treatment success.

To do this I would recommend getting a watch with an alarm that is capable of being programmed to go off when your meds are due. At home, use the watch, use alarm clocks, use portable times that you can carry with you. Anything to make sure you remember to take your meds. Most of us would never remember to take our meds without those alarm reminders.

Also, get a pill organizer if you need one (depends on how your pills come). Mine came in blister packs and I just wrote the days and the times on the blisterm packs. Do not rely on your memory to remember if you took a dose or not. You have to have a system because more than likely, you will not remember if you took it 10 minutes ago let alone a few hours ago. So you really have to figure out a system that works for you so you take all of the pills on time and so you do not miss doses or take too many doses.

If you are on Incivek, here is a thread that gives you many food with high fat content:

Scroll down to 80mecheng's very long post with many, many foods to choose from.


A few thing you may want to have on hand when you start:
Benadryl caps.
Loperimide tabs
Hydrocortizone cream
Huggies baby wipes (if on Incivek)(to keep the butt very clean)
Preparation H supp. and cream (if on Incivek)
Ice pack
(I know there are more but I am blanking on them.)

If I think of anything else I will post it.

You may be fine but you have to be prepared that you may get problematic side effects.

Also, the three things that really need to be controlled as soon as possible are nausea and/or vomiting, rash/itching, and diarrhea. You can get prescriptions for the first two if you need them. For the stools, just keep them firm, quite firm. I found if they get loose or even soft, the anal problems really kicked in.

Also, be sure your blood counts are monitored at least every two weeks, preferably every week. The hemoglobin can drop fast.

Get hard copies of  all labs that you have done and keep your own file.

Hope you have few side effects but post any that you get and we will offer suggestions and remedies.

Best of luck.

Avatar universal
I started the hep - c treatment yesterday . And so far just feeling a little tired but not unbearable . I did sweat throught the night though . I took a nice shower after my a.m. pills and 20 grams of fat ( bagel and cream cheese) . I am drinking plenty of water . I believe so far that I will be on this treat ment for 6months and the incivek for 3 months. I was diagnosed in 1994 . I am a true baby boomer at age 60 . I believe I always had it in my blood since the late 60's . But as stress brought it to the surface when I did not feel good at all in '94 . My genotype is 1a so the Dr. who did a liver biopsy in 2003 said that I had 0-1 inflammation and that they would just watch me every 6 months . So they did and I myself went back to a new Dr. to question the new treatment for my genotype and we put the wheels in motion and here I am . I pray it works for me .
Avatar universal
I started the hep - c treatment yesterday . And so far just feeling a little tired but not unbearable . I did sweat throught the night though . I took a nice shower after my a.m. pills and 20 grams of fat ( bagel and cream cheese) . I am drinking plenty of water . I believe so far that I will be on this treat ment for 6months and the incivek for 3 months. I was diagnosed in 1994 . I am a true baby boomer at age 60 . I believe I always had it in my blood since the late 60's . But as stress brought it to the surface when I did not feel good at all in '94 . My genotype is 1a so the Dr. who did a liver biopsy in 2003 said that I had 0-1 inflammation and that they would just watch me every 6 months . So they did and I myself went back to a new to question the new treatment for my genotype and we put the wheels in motion and here I am . I pray it works for me .
Avatar universal
I am a realtor and could barely function first 3 months anemia had a blood transfusion. I am on it for 12 months 4 more to go I am still working I am a walker and had lots of energy have my days but overall not too bad
Avatar universal
I started treatment almost 3 weeks ago.  Your information was most helpful in preparing for the treatment....purchasing the items you recommended.  Thank you.  
Avatar universal
i'm getting ready to start the incivek on 7/13/12,( yeah i know friday the 13th).  i'm scared to death!  anyone with any helpfull hints would be appreciated.
thanks, pam
Avatar universal
Hello,great to see so many posts on this treatment im starting on the 11th sept so not long now.Going back to barts hospital london on that date to have base line blood samples and some scans mri etc.Starting the triple then as far as i know ive also been told to have 20gms of fat in my meals 12wks and then 36wks more.Im hoping that im going to be able get through the full treatment only because on my first lot treatment which was just rib/interferon they halted tx because of low platelets/white cell count.Just good to read all the info on this illness so im off now wish all the best to all of you.Col.
3127648 tn?1342374603
I started triple treatment last nite, so far no side effects what so ever so far, nothing, nada. That may not be a good thing, any comments.
Avatar universal
My gastro told me the reason for all the fat was to control the anal burn mostly.It has helped.
1815939 tn?1377995399
The 20 grams of fat is necessary for the absorption of the Incivek. If one does not take the fat, the blood level of the Incivek is lower and thus one does not get the optimum dose of Incivek. This could impact treatment in a negative way, so that 20 grams of fat is very crucial.

Avatar universal
I was told not to have any calcium within 2hrs either way while on incivek
Avatar universal
i can relate starting triple therapy am tomorrow all so excited to take this journey know from past failure attitude is everything got awful sick  on peg and ribba but we're strong and will get thru hope to hear good things from all.
3203287 tn?1346460234
I start on the 29th.  I'm a relapser so the chances are higher now with the 3 med treatment.  This is a great forum and I got so much information from it reading it tonight.  I've made a list of fat foods that I collected from everyone's comments.  Thanks for all the information and I look forward to hearing how everyone is doing and whether or not we have many cures from these treatments.  Good luck to everyone.
3203287 tn?1346460234
I've not seen anything from anyone about sleep issues (insomnia).  I had terrible insomnia last time I did the program with just the peginterferon and the Ribavarin.  Does anyone have any issues with this?
Also I wondered about exercise.  My doctor says that I should continue but not to the point of exhaustion.  Is anyone able to exercise if they were exercising before starting?
Avatar universal
I started my triple therapy this July 15. We should compare notes. I have genotype 1a, 56 yr old, portal to portal bridging in my liver. First diagnosed in 2004. Went on riba/interferon tx in 2005. Was an early responder and SVR for next 6 months but then developed severe anemia. Was hospitalized 5 days and doctors reduced ribavirin dosage to 2 am and 2 pm(instead of 3 in the pm). Two or three weeks after I got out of hospital the virus returned. I was taken off all tx immediately. That was Aug 2005.   This time I reached Undetectable viral load at three weeks. Having awful rash that started 5 days ago. Already went to hospital 2 weeks ago for transfusion. Docs started me on procrit injections. Tonight I give myself the interferon injection. Having 100 degree fever starting in evenings.  The bathroom experience is like having a baby each time with the hemorrhoids the incivek has caused.  Tell me about your experience.
Avatar universal
I started incivek 7 weeks ago and like most people i am finding it very difficult to find foods with 20 grams of fat to take with it that i can tolerate...
I am going to try the carnation instant breakfast that someone had suggested
And i don't know if anyone else is having this problem but it seems that these very large pills seem to be irritating my throat and making it very difficult to swallow ....I have found that it is much easier taking them with a very cold glass of milk and if my throat is bothering me a whole lot i dip the pills in ice cream before taking them.....
But i continue to loose weight  because i cant find food to eat with 20 grams of fat ....if anyone has any suggestions it will be greatly appreciated
1280753 tn?1367761532
do a search on the forum (20 grams of fat) and you will find hundreds of posts on the subject.

Good fats
3oz salmon: 10gm fat
Peanut Butter 2Tbsp: 16gm fat
Dip bread in 1 Tbsp of olive oil with Italian herbs: 14gm fat
4 Tbsp Italian salad dressing: 14gm fat
1/2C guacamole: 14gm fat
1oz of Almonds/Peanuts/Mixed Nuts:  15gm
1 Cup Sunflower seeds: 23gm fat

Every now and then
1Cup tuna in oil= 14gm fat
Ice Cream: 7gm fat per ½ cup
2Tbsp Cream Cheese on a bagel :  10 gm fat
1C Whole Milk: 8gm fat
1 egg= 5gm fat
1/4Cup or 1oz Sharp Cheddar Cheese: 10gm fat
1Cup Tuna Salad: 19gm
Slice of Pizza: 10gm fat
Avatar universal
My husband is only on week 4 and is having his work day yet, big time nausea and thinking the treatment is not worth it.  I keep telling him it is only a temporary set back , any suggestions of support since you have been through this.
I would love suggestions of fat ideas. I hope you are doing well, that would also inspire him to continue with hope.  Sincerely, LW

1815939 tn?1377995399
Welcome to the forum.

Sorry your husband is having problems with treatment, but nausea is a very common problem with Incivek as well as the other meds.

Have him ask his doctor for a prescription for Zofran. I took Zofran 8 mg every 8 hours (for much of treatment) and it worked wonders. Kept me from vomiting and helped considerably with the nausea.

I ate a lot of regular (NOT low fat) Greek Gods Yogurt. It is high in fat (read the label for the amount to eat) and it tastes really good, creamy, like pudding. Get the honey type as it is the highest in fat. Read the label. It has to be Greek Gods Yogurt as the other kinds of yogurt are not high in fat.

Other things high in fat:
Peanut Butter
Cheddar or Havarti Cheese (2 ounces = 20 grams fat)
Brie Cheese
Liver Pate
Cream Cheese

There are many more, just read labels. The thing about the Greek Gods Yogurt is that you can eat anything and then eat the yogurt and you will have plenty of fat. I also used to add heavy whipping cream to stuff. Be sure he eats food, not just liquids. The drugs absorb better and the efficacy is better if he eats food 20 minutes before taking his pill. He need to take his Incivek 20 minutes AFTER eating the 20 grams of fat.

I really recommend that he get the prescription for Zofran ASAP. Treatment is worth it, but the side effects do need to be addressed so people can continue on the meds.

If he gets any other side effects, start a new thread and post the side effects and ask people for remedies. Many of us were on Incivek and we know the remedies.

If he starts to get a rash, get on top of it immediately. The rash can and will spiral out of control rapidly. The rash needs immediate and aggressive intervention, any type of rash. Otherwise, it will snowball out of control.

Also, just a tip, keep the stools firm. If they get soft or loose, he may get very bad rectal pain. So keep the stools firm. I used Loperimide at the first hint of a soft or loose stool.

Also, get copies of all lab results to keep at home. Keep an eye on his Hemoglobin. If his blood count numbers start to get low, post and we can offer help.

Tell him the treatment is definitely worth it. Most of us who treated are now cured (sustained viralogical response). Treatment is no picnic, but it is doable and well worth it. The consequences of not treating can be dire.

Go to this thread. I announced my SVR (cure) on that thread and listed my stats as well as my side effects. It will give you and your husband some idea of what we all went through to get cured. Plus you can see the support that we have for each other.


Best of luck to you and your husband.

Avatar universal
Coconut oil is an amazing source of healthy omega-3 fatty acids! It has so many health benefits & uses & I would definitely recommend this type of fat source before any unhealthy ones. One of the ways I use Coconut oil is in my breakfast smoothies each morning. I blend berries, spinach, banana, ginger, plain yogurt, protein powder & 2 large spoonfuls of coconut oil. This type of fat is amazing for you & is the type of fat that is quickly turned to energy inside the body. Avocados, fish like salmon, & olive oil are also all great sources of healthy fats. Hope this can be of some help! =)
Avatar universal
That is exactly what I recommended! I use it already for everything! It's especially great in my morning berry/veggie smoothies & so incredibly healthy. I have not started Tx quite yet, but when I do, you can bet coconut oil will be #1 on my list for getting my fat, Oh & ice cream of course! ;)
Avatar universal
my mum is 56, she is going to start therapy on Monday. I am really scared of this therapy... please advice how yours treatment gone true.  
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