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  • #29165
    felts j
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    • Novice
    @felts-j

    I took my last dose of Mavyret yesterday. I have 2b GT. I have been taking it for two months. My VL was 30 at the end of my first month. Now I am wondering how long it will take for the Mavyret to be out of my system and when I will begin to feel better. Has anyone else taken this medicine?

    #29175
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hello felts j,

    Sorry to hear you are not feeling better already.

    The medication leaves your system quite quickly according to what is called half-life. There are 2 drugs in Mavyret. Glecaprevir has a half life of 6 hours and Pibrentasvir has a half life of 13 hours.

    After 1 half life we have 1/2 as much left. So for Glecaprevir:

    6 hours 1/2
    12 hours 1/4 (1/2 of the remaining 1/2)
    18 hours 1/8 (1/2 or the remaining 1/4)
    24 hours 1/16 (1/2 of the remaining 1/8th)
    2 days 1/256
    3 days 1/4064
    4 days 1/65024
    5 days 1/1040384
    6 days 1/16 million
    7 days 1/256 million

    For Pibrentasvir it takes longer

    12 hours 1/2
    24 hours 1/4
    2 days 1/16
    3 days 1/64
    4 days 1/256
    5 days 1/1024
    6 days 1/4064

    So it’s pretty quick to exit your system.

    While not feeling better could be related to side effects from the drugs it could also be related to:

    1) On treatment failure (30 is quite high for a viral load at the end of the first month)

    The quick check for this is the complete metabolic panel. If your liver functions were elevated prior to treatment, back to normal after the first month, we would see them rise in this case

    2) The development of either diabetes or hypothyroidism – both of these are about 3 x more common in patients with Hep C and can happen before, during or after treatment (less likely after) – a simple blood test is a good idea

    3) Vitamin B12 (or other vitamin) deficiency particularly in vegans – B12 is involved in the immune response to HCV so probably consumed at higher rates than usual

    4) Activation of Chronic Hep B – if you also have chronic Hep B (core antibody positive, surface antibody negative) this weed can start growing once you weed out the Hep C

    5) Something else – treating for Hep C provides 0% protection from pretty much all the other diseases that afflict the human condition

    So one approach might be to eat a healthy diet, get enough fluids, do some exercise, get enough sleep and wait and see for a week or so. Maybe try some vitamin B12 as it’s cheap.

    If things are not settling get a CBC, CMP, Blood Sugar, Thyroid function. If you don’t know your Hep B status checking HBV surface antibody, core antibody and surface antigen is relevant.


    YMMV

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