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Post Info TOPIC: Sofosbuvir/Daclatasvir interaction with sertraline and risperidone


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RE: Sofosbuvir/Daclatasvir interaction with sertraline and risperidone
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Hi beer,

So, I am not used to seeing those tests "initialed" or "grouped/expressed" together exactly in that way ... "E/U/Cr".

I was already assuming the "Cr" was creatinines, and guessing the "U" was for urea, but without confirmation, one should not assume. I figured you had had some routine kidney function assessments done and that these may have been part of them, so now, with your office staff person telling you they were kidney function tests we can all just guess the "E" is standing for some of the electrolytes you had done.

How does your health care system work there? I am not very pleased that there seems to be no indication (thus far) that you will be getting any bloodwork done during your treatment. I would be wanting VL's done during treatment, and at EOT (not just at EOT+12 weeks).

I would be wanting LFT's and other routine bloods done during treatment too.

See what you can do about that.

Note the suggested blood testing schedule I was outlining in my previous post below.

Did you read the monograph for Daklinza, and did you note the suggestion to not take your meds with a high fat meal?

You can always just ask your local specialist for these things when you do go back to see him, ask for VL's and LFT's to be done during treatment (and a fibro-test, if one has not been done to indicate your Fscore). 

Keep us posted.  C.

 

 



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)



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I asked one of the staffs at the lab yesterday about the E/U/Cr and she told me its kidney function test. 

The abnormal values are: AFP 15.9ng/mL, AST 64, Sodium 133 mmol/L, Chloride 96 mmol/L

I asked the doc whether a test to determine the level of fibrosis was done but he wasn't willing to talk about it at that moment. I could deduce from the reply he gave me that no such test was done. I also called the doc who prescribed the sof/dac to discuss about getting the VL done but she told me to do the VL three months after I have completed my treatment course. 

Sure I feel a bit relieved being on treatment but I also hope to start seeing improvements in my overall health sooner. I hope that will happen.



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Hi,

Thanks for the additional info.

So, just for clarification ... when you first posted here about your labs, you also mentioned having these blood tests done  ... "E/U/Cr" ... can you just clarify what these stand for? (just so I am not misunderstanding) - I assume Cr is standing for your creatinine, but it would be good to know (for sure) what "E/U/CR" stands for exactly (according to you and your lab papers). And were they normal?

That is, if you don't mind my asking ... it is always good to know what the actual "abnormal" blood test result values were. For instance you mentioned your AFP, sodium and chloride were abnormal - can you share any of the actual results of anything that WAS anbormal?

I agree with Tig, there very well could be some tests that were drawn at some point that perhaps you do not have results for. (Fibrosis-type blood tests for example).

Your doc (or docs) may have come up with an "estimated" F score for you already (or, have just amassed a pretty good educated determination at your level of fibrosis), that you just happen not to be aware of yet. Perhaps a note of a fibrosis level for you may have already been made and exists within your docs files. These fibrosis estimations can be derived from various sources and/or by utilizing combined methods of assessments - from blood tests, to fibroscans, to liver biopsies. 

It's very good you have had LFT's done, and an AFP and an abd. U/S, (and other blood tests as well) - these provide a wealth of info and are all very good helpful assessments as to your liver health status, and your general health status. As are all the details of your hx that your docs have compiled on you, as well as their physical exams of you. All these assessments, whether they included a fibroscan or not, all compliment one another in painting a fuller health picture of you.

If you are not familiar with fibroscans, here is another link about them: About Fibroscans - or VCTE - (Vibration Controlled Transient Elastrography)

And, if you ask your doc (and IF a fibroscan machine IS available), perhaps you could get one now.

But, as well, you could just ask your doc for your Fscore, or for any fibrosis blood tests results that might be in your file, or, just search your own lab records to look for any of the commonly performed "fibrosis blood tests" they might have already done on you, such as those named in Tig's link to you. There are also quite a few other names of fibrosis-type blood tests sometimes used (not all of them are seen here):  Fibro-sure (also called Fibro-test), the Acti-test, and the Apri-test

After all your hard work and waiting to get to treatment, you must be feeling quite relieved to have succeeded in getting started eh? smile C.

 

 

 

 



-- Edited by Canuck on Wednesday 28th of February 2018 05:10:12 PM

__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)

Tig


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Hi Peter,

You can request those at any time. I would do it as early as possible. That will provide you with a baseline or starting point before treatment. An ultrasound to determine fibrosis is called a Fibroscan. Fast, fairly accurate, but may be difficult to find a lab that does them. The Fibrotest (fibrosis) and Acti test (inflammation) is determined using blood markers. That may be the easiest. It’s possible you may have had the tests drawn and your doctor has the results. There are a couple of different ways they can approximate fibrosis.

Here is a website that describes it: BIOPREDICTIVE.



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

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Apart from alpha-fetoprotein, AST, Sodium and Chloride levels, the others fell within normal range.

I didn't do a fibroscan or a blood test that came up with an Fscore. Is it too late to ask the doc whether such a scan/test can be done? 



-- Edited by beertastic on Tuesday 27th of February 2018 06:40:39 PM



-- Edited by beertastic on Tuesday 27th of February 2018 06:42:01 PM



-- Edited by beertastic on Tuesday 27th of February 2018 06:43:38 PM

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Hi beertastic,

Thanks for the info.

Did all of your other blood tests come back within normal limits? - you mentioned some other pre-assessment blood tests (other than ALT/AST).

Did you have any tests like a fibroscan, or a blood test, that came up with an Fscore (fibrosis level) for you?

So, it sounds like it was not easy to get your sof/dac.

Whichever doc you end up with (who will be responsible for following you throughout your DAA treatment) just be sure they know all the other drugs you are on. I don't know who prescribed the sertaline and risperidone for you or how long you have been on them - but like I said before your docs need to know what you take, and do not add any supplements, herbal remedies, radical diets on your own, without your doc OKing them.

Do drink lots of water. If you were fatigued prior to treatment, you may still feel fatigued during treatment. Many people can still feel fatigue or perhaps get headaches while on treatment. Water is good to help that, and an adequate amount of water is required anyway while on DAA's.

I assume you read through the Daklinza monograph link below - note that it may be best NOT to take Daklinza WITH a high fat meal. You can take your dac every day, same time every day, with just water (or if your daily dose coincides with a snack or small meal, then it best be very LOW fat one). Otherwise, throughout the day, just eat a normal, ordinary, healthy diet.

I hope you get appointments set up with the doc who will be responsible for following you through your treatment (and beyond) for LFT's and VL's at 4 weeks, (8 or) 12 weeks, and then again at EOT 24weeks - that would seem reasonable (to me) for now. That's what I would wanting while on treatment anyway.

Be patient about feeling the less fatigue, it might take a while, wait and see. I'm just glad you are on treatment now. Very good! smile C.



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)

Tig


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Good luck, Peter! Be sure to stay hydrated as you continue with treatment. That's vital and will help you avoid the typical side effects from these medications. Stay in touch and let us know how you're coming along. 



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

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Sofosbuvir/Daclatasvir interaction with sertralin and risperidone
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Thanks Canuck. Am 19 days into treatment. However, am yet to see substantial increase in my energy level. 

I have no appointment scheduled with the specialist who prescribed the drugs but I had an appointment scheduled on the 18th Jan. with the specialist I was visiting previously which I missed because I was away trying to get the drugs. I have to mention at this point that I had to travel to another state different from my state where am staying to see a specialist and get the drugs. Now that am back I plan to continue visiting the specialist I was seeing previously.

When next I go to see the doc I will do the LFT and hopefully the viral load. 

Talking about the sof/dac, it was the only available option. The 24 weeks was based on a computation the doc did from the numbers on my test results.

I was able to finish school despite my poor health. I completed my programme in 2016.



-- Edited by beertastic on Monday 26th of February 2018 09:47:01 AM

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How are you doing beertastic,

Hope everything is going well.

You must be about 17 or 18 days into your 24 weeks of sof/dac now? Still feeling OK? 

How many doctor appointments and blood draws do you have scheduled throughout your 24 weeks of treatment?

Do you go for LFT's and a VL draw at 4 weeks?

Also, was wondering how you and your doc ended up deciding on 24 weeks of sof/dac for your drug treatment choice - were you and he considering any other drug choices or lengths for you initially? What were the deciding factors?

I recall when you first were posting here you had mentioned school/education, are you still in study?

May I suggest a signature line for you ... maybe something like this? ... Male, (age), GT1a, VL 172,000/log 4.9, ALT 34, AST 64, AFP, U/S done. SOF/DAC 24 weeks, SOT (Feb 9?, 2018) EOT ( Jul ?  , 2018). Do you know what your Fscore is?

Drink lots of water, eat well, get sufficient rest. Avoid taking any supplements or remedies your doc does not know about.

I am so glad you were finally able to get on treatment! Good for you in your pursuit of it. smile C.

 



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)



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Thanks for the link Tig. I checked for interactions between sof/dac and the other drugs mentioned but there was none.

It's been a while canuck. I did a couple of lab tests before I got to the point of starting treatment. The tests I did include HCV genotype, HCV viral load, lft, full blood count, -feto protein, E/U/Cr, abdominal USS and a couple others. Hcv genotype is 1a. Viral load is 172,000 copies/ml (log 4.9.). AST 64, ALT 34.



-- Edited by beertastic on Thursday 22nd of February 2018 04:38:54 AM

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Hi beertastic,

Haven't heard from you for a while.

Great you got your sof/dac.

You will have to bring us up to date on your GT and lab assessments that got you to the point of being abe to get started on your sof/dac.

Here's a mongraph for Daklinza - I did not read "risperidone (Risperdal) nor sertraline (Zoloft)" on the monograph list-of-drugs with interactions to Daklinza. 

DAKLINZA Product Monograph - Bristol-Myers Squibb

 
There may be "some" drug interaction between "risperidone and sertraline" themselves though, this may be known to your doc, and some docs
do prescribe these two drugs together anyway. You can ask your doc(s), if you are seeing more than one doc, all of them (who know all the drugs
you are on) for a review of the drugs you are on, and confirmation for any possible interactions.
C.
PS  - oh good, I see now Tig has looked for you already!  : )



-- Edited by Canuck on Sunday 11th of February 2018 09:09:20 PM



__________________

HCV/HBV 1973. HBV resolved. HCV undiagnosed to 2015. 63 y.o. F. Canada.

GT3a, Fibroscan F3/12 kPa - F4/12.6 kPa, VL log 7.01 (10,182,417), steatosis, high iron load.

SOF/VEL with/without GS-9857 trial - NCT02639338.

SOT March 10 - EOT May 5, 2016 - SOF/VEL/VOX 8 week trial.

 

(SEE UPDATES IN BIO)

Tig


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Congratulations on starting treatment. The time will go by quick, just do your part and don’t miss any doses. Do that, take care of yourself, drink a gallon of water everyday and all will be grand!

I looked for interactions using the Drugs.com checker. There doesn’t appear to be any issues between Sof/Dac. Check the Sert/Res though. Here’s the LINK to the info. Hopefully it’ll open for you. You can get a good idea from that website. Your doctor and pharmacist are good ones to check with as well. If you can tie them down long enough that is... wink



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Tig

62 yo GT1A - 5 Mil - A2/F3 - (1996) Intron A - Non Responder, (2013) Peg/Riba/Vic SOT:05/23/13 EOT:12/04/13 SVR 1-4 years!

Hep C FAQ   Lab Ref. Ranges

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Sofosbuvir/Daclatasvir interaction with sertraline and risperidone
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I've been placed on sofosbuvir/daclatasvir for 24 weeks. I was able to get the drugs at subsidized rate which is 1/5 the actual cost of the drugs here. The entire 24 week course of treatment cost 614.94 usd. I began taking the pills four days ago. So far there has been no side effect. I've also been taking risperidone and sertraline. Is there any chance of interaction between these drugs and sofosbuvir/daclatasvir?  



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