Hep C Discussion Forum

Oh food, glorious food! Once you are finshed with yer cure 5, you and me is gunna havta convince Obs to do some experimental custom cuisine on us , "mail-meals on wheels", or something like that.  C. 

hm 5  - I thought we already covered a lot of this, about taking PPI's, antacids, sups and other drugs, food, baking soda water, stomache ph, etc., etc., etc., .... but good lamassu and you and everybody keeps reviewing it - because review is always good, and repeating and clarifying things always helps the next person coming along too when they read it or re-read it.

All the monographs for almost every drug anyone could possibly be prescribed for HCV is here and available on this site (the "on-line" monographs, originally created by the drug manufacturers). The "on-line" monographs versus the "paper" version of your drug package insert, in some cases, may actually offer even further, more in-depth info about your drug, than what is shown on the paper insert. So, search for the actual on-line version of the monograph as well as the paper insert. Read both the insert that comes with your drug package AND the manufacturers "on-line monograph", explore the extra/further "link" and reference info you may find in the "on-line" version and read it all.

My reading differs in some key areas, but not that much from lamassu's. If one makes the effort to do a lot a reading, you will find out why "some drugs" should best be taken with a "moderate fat content meal", and why it might be recommended that this be done. Many times (depending on the regime) it will simply say "take with food",  or, it will simply say "can be taken with or without food", but further info about that and why, may be available via that companies more in-depth monograph info.

I have said this before, overriding all of this, one basic premise to consider, is that any drug, depending on the drug, and if not contraindicated to do so, I (personally) would choose to take it with food (versus without food), and of course, with lots of water all day long. Not only may one find it potentially "easier on the stomache and gut" to take many various drugs with food, but sometimes drugs are better absorbed this way, if taken along with food - but (not in all cases) - one has to read the specific drug monograph. 

But back to some of the regimes which "require/dictate" you should take it "with food"? - you will find (mostly) it is any regime (whether that be a double, or triple, or more, regime) which contains a NS3/4A as a component, a "P.I.", as in "protease inhibitor" (such as voxilaprevir - Vosevi, glecaprevir - Mavyret) - these are the more current P.I.'s, as well as grazoprevir - Zepatier. Zepatier is a funny one ... [Effect of Food Relative to fasting conditions, the administration of a single dose of ZEPATIER with a high-fat (900 kcal, 500 kcal from fat) meal to healthy subjects resulted in decreases in elbasvir AUC0-inf and Cmax of approximately 11% and 15%, respectively, and increases in grazoprevir AUC0-inf and Cmax of approximately 1.5-fold and 2.8-fold, respectively. These differences in elbasvir and grazoprevir exposure are not clinically relevant; therefore, ZEPATIER may be taken without regard to food] . There have been quite a few older NS3/4A's (P.I.'s) used in the past, some out-of-use or less/rarely in-use now ... ritonavir, paritaprevir, simiprevir, boceprevir, telaprevir, asunaprevir.

If the taking of food is "required/recommended" in the monograph (as is with almost all the NS3/4A containing regimes), then the food-taking with the drugs is (mostly), in our cases, for setting up the correct ph environment for drug absorbtion, a ph situ which may require a fat component to the meal to orchestrate this. We often (at best) just see it say "take with food" but one may also find and read monograph info specifically about it being a "low, moderate or high fat content meal", to generalize .... when it says "take with food" and the regime you are taking contains a NS3/4A, I would always opt to take my dose with a moderate fat content meal.

If you delve further into any of the available links (inside the manufacturers on-line monographs), you may find the researched/specified differences between the drug absorptions with and without food.

For regimes (mostly the NS5A/NS5B double combo's) - such a Epclusa, Harvoni, Daklinza - they will say you can take them "with or without" food, the pharmaceutical company has studied the effects of food or no food (and PPI's, and many other drugs and potential interactions and contraindications), and have found if there is a lack of food intake with the drug, it held NO significant effect. There may be a difference in absorbtion, but it would NOT be significant enough to affect any change from what is intended for adequate absorbtion. It may still hold true that you may well absorb an amount more of ... say ... ledi or vel, the NS5A's in Harvoni or Epclusa respectively (when taken with a moderate fat content meal), but regardless, when they SAY you CAN take these NS5A/B doubles without food, you should still be able to very adequately absorb enough of the NS5A/5B to effect the cure even without taking the dose with a moderate fat content meal - the drug and the course length have been designed to do just that, allow you to absorb enough drug without food!

If your monograph says "can be taken with or without" food you may do either safely and be perfectly cured (personally I would just always opt to take it with food and food being a moderate content fat meal). And, even if you have not quite adhered to a "take with food" requirement (if there is one), I doubt anyone would fail due to minor transgressions, pharmaceutical companies have designed a bit of "just right overkill" (sufficiency/efficacy) into these drugs by dosage and by duration, I think that it would be rare indeed for failures to be occuring with minor slip-ups. 

Following medical advice while on treatment is paramount, and keeping yourself aware of what is good or not is everyones job.  C. 

I really hope you see some improvements with your sensitivities, once the SVR has firmly been established. There are so many extrahepatic manifestations related to this disease. It boggles the mind...

Hey 5,

do you make or eat kimchi? You seem to really enjoy vinegar and its a refreshing healthy snack.

Tig, I love all things sour...I put lemon on almost all fruit when I cook it. Also right now Im making Moroccan preserved lemon peels to use in stirfrys and chicken dishes Yummmm cant wait for it to be ready.

Now I think a rhubarb scone would be the best of both worlds! A little sweet and that tartness from the rhubarb. Yum! Send me one, I'm hungry and needing a little snack! I think we could overnight one, maybe?

I think regardless of our choice, to eat or not to eat, we have some good ideas. I must admit, oatmeal and vinegar might be a tough decision, lol! I'm game for some of those cinnamon buns, though!

lololol C ,

lololol tig,

that's like my old recipee for oatmeal....... oatmeal,splash of vinegar and freeze dried asparagus

now the vinegar moved to daytime

i can actually eat cinnamon, just not all the time...... tomato products and cheese are the main ones that get me quickly.

but i can still eat cake and cookies.

sweetpotato chips don't agree with me right now, but that's ok

but no cinnamon buns before bed for me on a normal day.hahahaha, days off from work are for that.

i got my kashi dark mocha almond bars tho, any time day or nite

Oh, MAAAN obs, ya just had to do it eh!, you culinary torturer you! 2:30 AM and now ... i gotta go in the kitchen and root around in there hoping I find ANYthing even CLOSE to the (I slaver and tremble as I visualize it ...) ew, ah, oh so-gooey Maple syrup imbued and gooed cinnimon buns, I'll eat 5's share OK, I think she isn't allowed cinnamon. Oh please let me find some of your buns in my kitchen, or, even ice cream maybe? .... see ya's later.   C.

I made gooey yummy cinnamon buns with maple syrup goo for my evening pills and bananas and yogurt for my morning pills ......which said take with food...so I did 

hm 5  - I thought we already covered a lot of this, about taking PPI's, antacids, sups and other drugs, food, baking soda water, stomache ph, etc., etc., etc., .... but good lamassu and you and everybody keeps reviewing it - because review is always good, and repeating and clarifying things always helps the next person coming along too when they read it or re-read it.

All the monographs for almost every drug anyone could possibly be prescribed for HCV is here and available on this site (the "on-line" monographs, originally created by the drug manufacturers). The "on-line" monographs versus the "paper" version of your drug package insert, in some cases, may actually offer even further, more in-depth info about your drug, than what is shown on the paper insert. So, search for the actual on-line version of the monograph as well as the paper insert. Read both the insert that comes with your drug package AND the manufacturers "on-line monograph", explore the extra/further "link" and reference info you may find in the "on-line" version and read it all.

My reading differs in some key areas, but not that much from lamassu's. If one makes the effort to do a lot a reading, you will find out why "some drugs" should best be taken with a "moderate fat content meal", and why it might be recommended that this be done. Many times (depending on the regime) it will simply say "take with food",  or, it will simply say "can be taken with or without food", but further info about that and why, may be available via that companies more in-depth monograph info.

I have said this before, overriding all of this, one basic premise to consider, is that any drug, depending on the drug, and if not contraindicated to do so, I (personally) would choose to take it with food (versus without food), and of course, with lots of water all day long. Not only may one find it potentially "easier on the stomache and gut" to take a drug with food, but sometimes drugs are better absorbed this way, if taken along with food - but (not in all cases) - one has to read the specific drug monograph. 

But back to some of the regimes which "require/dictate" you should take it "with food"? - you will find (mostly) it is any regime (whether that be a double, or triple, or more, regime) which contains a NS3/4A as a component, a "P.I.", as in "protease inhibitor" (such as voxilaprevir - Vosevi, glecaprevir - Mavyret) - these are the more current P.I.'s, as well as grazoprevir - Zepatier. There have been quite a few older NS3/4A's (P.I.'s) used in the past, some out-of-use or less/rarely in-use now ... ritonavir, paritaprevir, simiprevir, boceprevir, telaprevir, asunaprevir.

If the taking of food is "required/recommended" in the monograph (as is with almost all the NS3/4A containing regimes), then the food-taking with the drugs is (mostly), in our cases, is for setting up the correct ph environment for drug absorbtion, a ph situ which may require a fat component to the meal to orchestrate this. We often (at best) just see it say "take with food" but one may also find and read monograph info specifically about it being a "low, moderate or high fat content meal", to generalize .... when it says "with food" and the regime you are taking contains a NS3/4A, I would always opt to take my dose with a moderate fat content meal.

If you delve further into any of the available links (inside the manufacturers on-line monographs), you may find the researched/specified differences between the drug absorptions with and without food.

For regimes (mostly the NS5A/NS5B double combo's) - such a Epclusa, Harvoni, Daklinza - they will say you can take them with or without food, the pharmaceutical company has studied the effects of food or no food (and PPI's, and many other drugs and potential interactions and contraindications), and have found if there is a lack of food intake with the drug, it held NO significant effect. There may be a difference in absorbtion, but it would NOT be significant enough to affect any change from what is intended for adequate absorbtion. It may still hold true that you may well absorb an amount more of ... say ... ledi or vel, the NS5A's in Harvoni or Epclusa respectively (when taken with a moderate fat content meal), but regardless, when they SAY you CAN take these NS5A/B doubles without food, you should still be able to very adequately absorb enough of the NS5A/5B to effect the cure even without taking the dose with a moderate fat content meal - the drug and the course length have been designed to do just that, allow you to absorb enough drug without food!

If your monograph says "can be taken with or without" food you may do either safely and be perfectly cured (personally I would just always opt to take it with food and food being a moderate content fat meal). And, even if you have not quite adhered to a "take with food" requirement (if there is one), I doubt anyone would fail due to minor transgressions, pharmaceutical companies have designed a bit of "just right overkill" (sufficiency/efficacy) into these drugs by dosage and by duration, I think that it would be rare indeed for failures to be occuring with minor slip-ups. 

Following medical advice while on treatment is paramount, and keeping yourself aware of what is good or not is everyones job.  C. 

Epclusa, Viekira, Mavyret and Vosevi should be taken with food. Food enhances the absorption of all the active ingredients. If you take without a real meal: protein, fat and carbohydrates you may be getting only half the actives absorbed.

You don't want your treatment to fail so read the package insert that came with your DAA. Your Hep C Dr should also make it clear to you that those drugs need to be taken with a balanced meal with fat. Harvoni, Sovaldi, Daklinza and Zepatier can be taken with or without food. Hope this helps.

Hi-5!

I'm on Mavyret, and I take all 3 pills with food. I've been taking mine with dinner, in case I have any side effects (that way I sleep thru them!) 

I've also followed several groups/forums, before beginning treatment, so I could pick up any and all tips that I could. Most say with the Mav, that you're to eat a substantial/healthy meal, that includes a healthy fat. I've chosen avocados as my healthy fat, and I eat a half one with my dinner. I've done well with this method, with very little side effects.

~Heidi~