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789911 tn?1368636783

eggnog yummy

has anyone discovered that eggnog has 18 grams in a cup.  Mighty tasty too!  quick delicious way to get that fat in the mix.  
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Avatar universal
great idea!  I love eggnog... :)

I have to admit, it's been getting more and more difficult to get that 20 grams down morning noon and night... :(

I only have 5 more weeks of the INC and the day can't come too soon!  

On my grocery list for tomorrow: Eggnog!
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374652 tn?1494811435
ooh what a good idea....
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Avatar universal
Thank you! Getting me some eggnog today!  Last week of fat for me and sooo sick of everything food!
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1735424 tn?1357433558
Eggnog is delicious BUT******

It is NOT Food!!!!!

I have had discussions with Vertex re: milkfat and liquids with fat for consumption.  Unless CHEWED(eaten) with real food, (something you chew and swallow) there will be a problem.

The problem is that liquids pass thru our bodirs at a rapid pace while foods tske longer to digest.  We MUST HAVE this longer digestion time for tje meds to work and utilize MAXIMUM absorption. Otherwise we pass the meds quickly and reduce the saturation of chemicals introduced into the bloodstream and molecular and cellular level.  

CHEW YOUR FATS AND GO OVER. 20g fat if you must. Just please get to UND and eat!!!!!!  Once the trp tx ends and we finish on. SOC. We lose appetite and weight anyway!  Happy heppy eating!!!!!
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Avatar universal
so, is icecream ok ??
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Avatar universal
:-( ice-cream one of the last things I can tolerate at night now.  
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1669790 tn?1333662595
Unless CHEWED(eaten) with real food, (something you chew and swallow) there will be a problem.
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I'm not disagreeing with this statement, but I'm a bit surprised it would matter much if the fat eaten was in a solid or liquid form.  A typical, healthy adult digests food within a 24-to-72-hour time frame, beginning with a six-to-eight-hour window during which the food enters the stomach and passes through the small intestine.  This sounds like a sufficient amount of time for the absorption of the incivek to take place.  

For those that rely on yogurt, nutrition drinks, ice cream, etc., this could be important information.  Is there any references that Vertex shared in your discussion?  Some on trt have a difficult time keep foods down and will do what the can to get the 20 gms.   Would be nice to see a published reference to support this statement.

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Avatar universal
Wow, I've been pretty much getting through this on ice cream - crap. However i just found out that at 4 weeks I am undetectable though.

Hum, ice cream chase down with some potato chips or peanut butter crackers maybe? What do you all think?
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Avatar universal
When I spoke to the Vertex people, they said it did not matter how you got the 20 grams of fat.  If you were having a hard time swallowing the nurse said you could take 2 tablespoons of olive oil.
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1815939 tn?1377991799
I've been eating a lot of Greek yogurt with my meds, but I do usually eat a slice of bread with butter on it at the same time. I wonder if we ate something solid, even if it is not high fat, and also drank a cup of eggnog and then took our meds. That would take care of the solids and also the fat.
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Avatar universal
Okay, just got off the phone with the Incivek 24/7 nurse line (855) 546-2483. Ice cream is on the list of recommended fats from the manufacture. I think I'm going to continue to hang out with my friends Ben & Jerry.

I will work in some others fats too since my appetite is starting to come back. Isn't this a common misconception with milk that it is quickly absorbed and that's how "milk chugging" holding down a gallon a milk chugged in an hour was born on college campuses? You can't keep it down because the proteins in the milk don't allow for quick absorption so people begin to "lose it" vomit because it can't be digested that fast.

Yum eggnog - it's on!!!
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Avatar universal
:-)
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Avatar universal
Ice cream was definitely on the recommended list for high fat foods with Incivek, although I have had to look for sugar free ice cream because of my husband's high blood sugar.  Peanut butter, cream cheese, potato chips, cheese, nuts, and avocados are all high fat foods that he has tried.  He's pretty sick of all of them (just starting week 6 of triple tx), and thought egg nog sounded pretty appealing.  Keep us posted as to what you find out about liquid vs. chewable food for the fat intake.
Advocate 1955
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1735424 tn?1357433558
Ice cream is fine. It is frozen. It digests differently because it has to be eaten not drank.
Ice cream  IS suggested and refered to in the spiralbound book treatment reference guide included w your timer and journal log book. Page 9 clearly states Always take Incivek with food. They only show examples of foods. Liquids allow for an empty stomach not suitable for digestion of such strong meds.
Olive oil is fine, the many different oils used in cooking  are how we get most of our fats from
foods.  When using the olive oil eat something with it as substance.
Snaks are good as well. I do avoid hard nuts and do nut butters instead  tho, for the ease of occassional bowel anal issues
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1735424 tn?1357433558
Do the egg nog thats fine BUT eat something in addition to it please!!!!!!!
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1735424 tn?1357433558
Here's what they also say about absorption etc: pi.vrtx.com/files/uspi_telaprevir.pdf

This is the insert included with our Incivek.
Page 10, Pharmacokinetics. Read Absorption,  effects, distribution, metabolism and elimination. Good stuff.
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1735424 tn?1357433558
Hopefully these documents from Vertex will satisfy the request for them.  :)
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1735424 tn?1357433558
Congrats on UND!!!!!!!  Woohoo that's awesome!  
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Avatar universal
I've been eating yogurt, which I've been able to get down -- it's not exactly a chewable fat, tho, is it?  

So, I'm confused:  ice cream, yes; yogurt, yes; eggnog only, no?

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1669790 tn?1333662595
Following is the Incivek insert information referenced.  Although it mentions food, it doesn't specify whether the food needs to be in solid, semi-solid or liquid form.   I think this is the issue and would like to hear if anyone can clarify.  As soon as ice cream goes down the throat, it melts very quickly, so no longer frozen.

It may be healthier for our diet to eat more solid foods, but when it comes to Incivek absorption, I don't understand why it would make much difference as long as you got your 20 gm of fat.  If there's something that I missed in this insert which would help to clarify, please point it out.  It is interesting reading and thanks for posting.

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).
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1815939 tn?1377991799
I do agree with Lifenet62 about the pills absorbing more slowly if there are some solids. That is why I was eating a large slice of bread with a lot of butter on it along with a huge portion of Greek yogurt (for my morning snack).

I think if we think about it, any pills we put into our mouths (tylenol,, benadryl, loperimide, any pill) does absorb faster if taken on an empty stomach. I can tell it does because a tylenol will work faster if I take it by itself and not with food or after a meal. Even alcohol should always be taken with food to slow down the absorption rate. I don't think milk or eggnog would slow the absorption of alcohol very much but a meal, even a light meal, would. So to me, it just makes sense that the Incivek would also absorb slower if taken with solid food, at least some of it solid, along with the high fat part. It takes food a lot longer to go through the system than it takes liquids to go through the system.

I don't want to take the chance so I will eat some solids along with anything else I eat/drink.
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1765684 tn?1333819168
I'm not taking this drug so I have no clue...  But just reading the above leads me to believe that the addition of fat relates to bioavailability of the drug in your body.  Nothing to do with how fast or slow it takes to move through your stomach and intestines.  :)
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1735424 tn?1357433558
Ribavirin is absorbed from the GI tract probably by nucleoside transporters. Absorption is about 45%, and this is modestly increased (to about 75%) by a fatty meal. Once in the plasma, ribavirin is transported through the cell membrane also by nucleoside transporters.

Ribavirin is widely distributed in all tissues, including the CSF and brain. The pharmacokinetics of ribavirin is dominated by trapping of the phosphate form inside cells, particularly red blood cells (RBCs) which lack the enzyme to remove the phosphate once it has been added by kinases, and therefore attain high concentrations of the drug. Most of the kinase activity which converts the drug to active nucleotide form, is provided by adenine kinase. This enzyme is more active in virally infected cells.

The volume of distribution of ribavirin is large (2000 L/kg) and the length of time the drug is trapped varies greatly from tissue to tissue. The mean half-life for multiple doses in the body is about 12 days, but very long-term kinetics are dominated by the kinetics of RBCs (half-life 40 days). RBCs store ribavirin for the lifetime of the cells, releasing it into the body's systems when old cells are degraded in the spleen.

About a third of absorbed ribavirin is excreted into the urine unchanged, and the rest is excreted into urine as the de-ribosylated base 1,2,4-triazole 3-carboxamide, and the hydrolysis product of this, 1,2,4-triazole 3-carboxylic acid.

With Incivek, similar info has been documented in their insert and it is strongly suggested to adhere to a strict regimen exactly as indicated  
For me, I am going along with what the companies have instructed.  

I had a conversation with a RN at Genentech(pegysys) last nite and she mentioned to me that the water consumption info has been changed. It is now straight acrossthe board 8-10 8 oz glasses of water per 24 hr period.  They had found people in SOC and triple tx were drinking not enough or too much water depending on weight (50% body weight vs oz water). In drinking too much water, although hydrating, our electrolytes are being flushed out unknowingly.  
I am confirming this w my physician tomorrow. Thought y'all might be interested in that ditty.
P

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1669790 tn?1333662595
Eggnog is delicious BUT**   It is NOT Food!!!!!
CHEW YOUR FATS AND GO OVER. 20g fat if you must.
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As suezeeque pointed out above the real issue is bioavailability of the drug in the body.  As long as Incivek is taken with a meal and part of the meal contains 20 grams of fat, whether ice cream, yogurt, egg nog, etc., does it make any difference?  Does it really matter if the fat is solid or liquid?

The statement I'm having trouble digesting (pun intended) is understanding why the fats need to be solid and chewed.  As long is there is some solid food in the stomach to slow digestion, drinking an eggnog sounds perfectly acceptable.  I'm also not sure what you mean by the "strict regime exactly as indicated".   Does this also relate to "chewing the fat"? (another pun intended)  :o)  I'm not challenging your statements, just want further clarification/references for those on INC since consumption of fat is so important.  Thx.
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