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190885 tn?1333029491

post tx diet question

i gained way too much forcing down fat and sleeping most of the time for months with low hgb....i'm just plain out of shape...hopefully the drugs got absorbed real good cause i'm fat!.... 6 weeks off drugs and just starting to eat much better......my question is ...are grapefruits ok to eat everyday now ?  a couple a day...i know during tx there not good to eat...also raw clams?? seafood? i'm not going to drink alcohol... i think i'm doing above average getting back to normal.....hard to believe with a hard time during tx..still some headaches ..not bad...some fatigue ... i'm just so out of shape.....billy
25 Responses
223152 tn?1346981971
Why aren't you supposed to eat grapefruits on treatment?  I never heard that and I love them so need to know.

I would not eat raw shellfish.  Cooked seafood is okay.  You still have liver damage whether you did achieve SVR or not.
148588 tn?1465782409
Are you insulin resistant? If you don't know, get yourself checked.
1669790 tn?1333666195
Why aren't you supposed to eat grapefruits on treatment?
------------------------
I'm not aware of any of the meds commonly prescribed for HCV having problems, but plenty of other medications do, such as some of the AD's,  Immunosuppressants, etc.  Best to talk to the Hepa to get their opinion.

"Certain chemicals that grapefruit products and citrus fruits contain can interfere with the enzymes that break down (metabolize) various medications in your digestive system. As a result, more medication stays in your body. This can increase the potency of your medication to potentially dangerous levels, causing serious side effects."

http://www.mayoclinic.com/health/food-and-nutrition/AN00413
Avatar universal
Grapefruit and  grapefruit juice was a food listed as a no - no in my trail protocol.likely for the reasons cited by flcyclist above.
Will
Avatar universal
I was on a  "trial" protocol   ..it really is my puter ;)
Avatar universal
The specialty Pharmacist where Joe gets his TX drugs said NO grapefruit with Victrelis.  He had been extra sick one week and I noticed he had been eating grapefruit from a bag he'd bought because they looked good to him.  I hadn't really thought much about it but when he started seeming sicker than normal, it occured to me to ask.  She said it can cause the Victrelis to be stronger. He did get better again soon after he stopped eating the grapefruit.  As always, cause and effect can be deceptive but considering what the Pharmacist said, it looks suspicious.
Ev
Avatar universal
Just to add, although my understanding of this fact is very limited, it seems to be anything that uses the CYP3A 4/5 pathway for its metabolism can either increase or slow down the Victrelis.  I don't know exactly how this crosses with Incivek because I never looked in to it.
There are quite a few things that use this pathway. I checked out every single supplement I  give Joe with a fine tooth comb.  If it had anything to do with CYP3A 4/5, I deleted it.  And then I let something like grapefruit pass by me without noticing!   ..."Ye blind guides, which strain at a gnat, and swallow a camel."—Matthew 23:24.  
:>) Ev
Avatar universal
You are not supposed to eat grapefruit while on incivek, it produces an enzyme that inhibits the drug. I can't find the site where I read it...but my nurse also had heard about it and said NO!
Avatar universal
Hi.
I am surprised about the weight gain. You had such a difficult time I would think you would be skin and bones. I would think that since you were not heavy before, as you get back to whatever amount of normalcy that you can, you will automatically lose the weight. You are pretty fresh off of treatment. I gained a few pounds eating the fat with incivek but it came off right away. I lost some extra during the rest of my treatment and have lost  some since finishing in spite of lingering side effects. SVR.SVR.SVR.SVR, G










163305 tn?1333672171
My son swears by the caveman diet.
Essentially you can eat all the meat, veggie, fruit and nuts and seeds.
No dairy of grains.

I know two big things that put on weight are wheat and dairy, especially cheese.
If you get hungry between meals, drink water, yup, more water!

Good luck
OH
1148619 tn?1332014584
What! No grapefruit??   Why did my doctor not tell me this, I eat it all the time. I need to do more research on this.   Its one of those things on tx that taste good to me.  Oh well.    
1148619 tn?1332014584
Hang in there WD, you,ll get it back.  My husband is also a firm believer in the Paleo Diet that someone mentioned.(caveman). Lots of fruit, veggies and meat.  I have read on this forum it can take six months, have patience The worse is over!

Thinking of you....mo
317787 tn?1473362051
Hello, thanks for the post. Ev, I believe you are right.
I was told years ago not to eat grapefruit with my thyroid medicine.  I think it can increase the amount in your body, very similar to what happened to Joe.
This is a good thing for everyone to know.  I am sure there is a list of medications that grapefruit can change.
Billy I am sure you will be fine, it took time to gain and it will take time to lose
Funny I thought I would gain with all that fat I ate and then the Holidays came which I normally gain 10, instead I lost weight.  Not that I am going to go buying any new clothes, did that the last trial, gained it all back :)
Take Care
Dee
1972385 tn?1343830676
I lost 30 lbs. on the 2 drug program.I am now on the 3 drug program after 6 months of r+r.I have a hard time swallowing that 20 grams of fat bull***.I can't get an answer as to why 20 grams.It's true the Ivcivek is uncoated,but like other uncoated pills you eat food with it.If you are eating grapefruit to loose weight,forget it.I tried it and the health community does not recommend it.You do not loose weight eating grapefruit.But go ahead anyways if you love eating it like I do.You're safe.
1747881 tn?1546179478
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://pi.vrtx.com/files/uspi_telaprevir.pdf
1972385 tn?1343830676
I slept on this overnight and thought about it.This talks of Absorption.I need the locating website for this information you referred me to on this subject matter.Also talks of exposure.This also talks of comparison of exposure to Incivek from a 20 gram fat meal compared to fasting.I want to know the exposure rate the body needs to absorb to combat the virus.I just weighed myself and I gained 4 lbs. in the 5th week of Incivek.If I can cut out say 5 grams of the fat intake I will not gain the weight back that I lost with the 2 drug program.I read others have also gained weight from the 20 gram fat intake.The difference in Ivcivek and Victrelis is with Victrelis there is no need for the 20 grams of fat.But the success rate of Incivek is about 20% better success rate over Victrelis.
1747881 tn?1546179478
The link is listed at the bottom, vertex spent years doing research to come up with this protocol, follow it or don't totally your choice but IMO following protocol set forth by years of research is the best chance you have to reach SVR  
Avatar universal
I gained alot of weight too. I started weight watchers last week, about 10 days before the end of treatment.  I found it the easiest way to eat healthy.  I'm looking forward  to getting back to the gym and running instead of walking, exercise helps alot with weight.  I figure if I could get through the treatment, I can't diet.  I will always use this experience to remind myself that I can do anything I put my mind to.
Avatar universal
"But the success rate of Incivek is about 20% better success rate over Victrelis."

Would you please start posting links to where you come up with all this stuff you been saying?
Avatar universal
Results for Incivek that were eRVR...The results from ILLUMINATE support the strategy of RGT. Among patients who achieved an eRVR, SVR rates in those treated for a total duration of 24 weeks were comparable to those in patients treated for 48 weeks (92% vs 88%, respectively).

Results for Victrelis...Boceprevir-treated patients who achieved undetectable HCV RNA at treatment Week 8 had a high probability of achieving SVR; indeed, these SVR rates were 89% to 91% for nonblack patients and 78% to 82% for black patients.  

http://www.clinicaloptions.com/Hepatitis/Annual%20Updates/2011%20Annual%20Update/Modules/DAA%20Naive/Pages/Page%206.aspx

So where is the 20% difference? BTW Clinical care options does have quite of few expert hepatologists.

Avatar universal
But the success rate of Incivek is about 20% better success rate over Victrelis.
----------------------------------------------------------------------------------------------------------
Where did you read this info? Please post  if you would...

The study results I have seen says this:

Selecting a paradigm for treatment of HCV (boceprivir or telaprivir)

For treatment naïve patients, the rates of SVR appear very similar in patients who achieve a RVR (89–96%) and in patients with a delayed virological response who become HCV RNA negative more than 4 weeks after the initiation of the protease inhibitor (64–75%). A similar percentage of treatment naïve patients achieve a RVR (56–60%) and can be treated for a shorter duration. When divided by IL28B status, SVR rates also appear to be quite similar [23, 24]. Response rates are more difficult to compare in the retreatment population because true non-responders were not evaluated in the RESPOND-2 study. However, if one accepts that patients who are IFN insensitive during the lead-in are biologically similar to non-responders [4] than similar rates of SVR are observed during retreatment as well.



Avatar universal
The above was by DR. Mitchell Shiffman MD  Liver Institute of Virginia
Article published  DEC.29 2011
1972385 tn?1343830676
I got this information through Reuters Health Information under the heading"vertex says combo hepatitis c treatment works",The Pharma Letter writes"Opportunity in hepatitis c market for recently-approved Victrelis and Incivek;report" and on WEBMD"Hepatitis Health Center-New hepatitis c drug Incivek gets fda approval-Much better hepatitis c cure rate when Incivek added to standard combination therapy"These are the reports that I copied for my reference.I like to get the facts right.I failed on the 2 drug treatment last spring,am a chronic hep c type 1a,and started 3 drug x-mas 2011.I say like on the movie NETWORK "i'm as mad as hell and I'm not going to take it anymore".Just picture a guy yelling this out the window for the world to hear.I relate to this since hearing the 1st treatment didn't work.Now I am aggressively following the facts and getting a better understanding of what is going on.I want to hear from the other members of this community that after their follow-ups that it is finally over and not hear that the FDA are looking into reviewing newer drugs in the future,I do not want to keep trying multiple treatments trying to get rid of this.When I read a report that the function of these new drugs is to stop the virus from multiplying,this is not what I need as a chronic hep c victim.I need a drug to seek out the virus and destroy it totally.I feel used by the medical community.I am suspicious as to what is going on.Why after 33 years since I got it that all these new drugs are coming out.I do not want to be treated like a cancer patient(maybe this will work?).We as humans deserve better.
1747881 tn?1546179478
"When I read a report that the function of these new drugs is to stop the virus from multiplying,this is not what I need as a chronic hep c victim.I need a drug to seek out the virus and destroy it totally"

Because the virus replicates by the millions in one day this is a very important function in the process of the triple treatment, read up on the dynamics of how all 3 drugs work together, follow the links and learn how the meds you are taking work.

http://pi.vrtx.com/files/uspi_telaprevir.pdf

http://www.gene.com/gene/products/information/pegasys/pdf/pi.pdf

http://www.gene.com/gene/products/information/pegasys/pdf/copegus_pi.pdf
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