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what fat to eat with riba?

I've read that fat can help with ribavirin absorption.  But I just read in another post that cheese and peanut butter (among other things) may contribute to higher ammonia levels, which in turn may cause brain fog.  Any suggestions on what fats to take with riba, both in the morning and evening?  And how much fat is necessary each time?
14 Responses
Avatar universal
How about avocado, also olive oil should be ok (I hope.)  For me a scrambled egg with a side of salsa and avocado is good in the morning.  Olive oil is my mainstay fat source for cooking, dipping bread, dressing veggies/salads.  I sometimes take the evening pills with a Dannon Frusion peach yogurt smoothie.  I think a moderate amount of fat gets it done, not sure we need large portions.

Its so confusing!  Every time I find something I can eat it either turns out to be a bad idea or else that food starts to really turn me off.  
Avatar universal
Here's a couple of suggestions:  1 cup of ice cream,  1 Jello Pudding cup, regular kind - not the fat-free.  Unless you've had some abnormal ammonia levels in the past, don't concern yourself with that at this time-while you're treating.
Avatar universal
I'm fairly new and not on treatment.  I've read about this ribavarin w/fat.  
I'm familiar with healthy eating and getting the 'proper' amounts of fat.  Peanut butter from the stores and 'among other things' of which you speak, are saturated fats.  
Good fats are 'unsaturated fats' such as oily fish, avocados, nuts, seeds, OLIVE oil.
Do you like fish?  (Salmon, mackerel, herring, and others) - good fats, plus omega3 fatty acids.
This is a start... and sure others have ideas.
Avatar universal
Wow!  you got it covered!  I should have read yours first!  Now I've got to go eat, you've made me hungry!
87972 tn?1322664839

From Schering Plough:


“Effect of Food on Absorption of Ribavirin Both AUC and C max increased by 70% when REBETOL Capsules were administered with a high-fat meal (841 kcal, 53.8 g fat, 31.6 g protein, and 57.4 g carbohydrate) in a single-dose pharmacokinetic study.”

Last year I met with an educating nurse with SP; and although she acknowledged that dietary fat increases absorption, she denied knowledge of any studies that associated ingesting ribavirin with dietary fats and increased SVR rates.

Animal proteins can contribute to elevated serum ammonia levels in patients with decompensated cirrhosis, but I wouldn’t expect that would be a problem in lieu of that diagnosis.

I understand that years ago, cirrhotic patients were advised to limit dietary animal proteins to limit serum ammonia, and subsequent hepatic encephalopathy. In most cases, I believe medicine has recognized the importance of proteins, and now primarily controls with Lactalose.

I’m personally unaware of any documented info that discourages the intake of peanut butter.

Common sense stuff; olive oil, nuts, nut butters, and dairy products in a ratio that reflects the amounts shown above.

Best of luck to you,

Avatar universal
Just got info from my dietician at work about nutrition and liver disease. It does mention avoiding animal sources of protein. Says to eat vegetable protein. Also said to avoid gelatin (jello), cheese, salami, peanut butter and onions. These produce more ammonia. States that if the ammonia levels get too high can lead to confusion, lethargy and coma (hepatic encephalopathy).  It is very confusing. Hope this helps.
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