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TOPIC: Please check for medication interactions (+ website link)

Please check for medication interactions 3 years 4 months ago #8530

  • Chejai
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Thanks for that info LG. I have read about Alpha Lipoid Acid before and wondered about taking it. I spend a lot as it is on supps so I didn't rush out to get any. So, you sound like you recommend it?
I know when things 'work' for me because when I run out of something and can't afford to buy any for awhile I will notice the difference with my symptoms. e.g. Omega 3 and Multi B.
Although I am trying to keep things to a minimum while on Tx, antioxidants really are vital.
QLD Australia ☀️
G3a HCV 35 yrs Tx naive
Started Sof/Dac 13/01/16

Dec '15
AST 70
ALT 89
GGT 124
Fibroscore 8.5
F1-F2
13 Feb'16 VL UND #woohoo!
AST 24
ALT 26
GGT 50H
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Please check for medication interactions 3 years 4 months ago #8599

  • LondonGirl
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Hi Chejai, I have definitely found ALA helps. Positive results have shown in my bloods twice (ALT raised when stopped taking them and lowered again whe restarted) - along with VitD by natural warm sunshine.

When in hot weather with plenty of sun , I don't take Extra VitD - but as I am currently in England and it's January, I am back on them !

Re ALA - I truly believe they help, but this is just my belief and one size does not fit all.
What I do know for sure, is that a reputable make is very important.

So my 3 suppliments currently while on tx are : VitB12, VitD & ALA. having a break from all on Sundays.
I Take these later in the day to the meds.
I am still investigating which B12 to take, it seems rather complex.

Can anyone answer? Is it just VitB12 we need or Vit B12 complex with added Folic Acid/B6 etc ?

It is interesting that pregnant women are advised to take Folic Acid. I did whe I had a successful,pregnancy after quite a few miscarriages. How does this relate to tx?
Complex!
GT1a Dec14 F2/8.7 VL 900000-2.5M
Jan16 Hepcivir-L MonkMed/Redemption
Baseline: VL 913575 Alt 76 Platelets low
Wk2 VL1157 Alt 23
DET Wk 8 VL 32 Alt19 'In the slow lane'
June16 Fibro 5.7 F0/1 LIF 1.5
Wk 11 VL<12 Alt 13 Det/Unq
Extending tx 12 wks Mylan Sofo/Dac MonkMed
Wk 14 VL <12 Det/Unq
Wk 16 VL UNDETECTED
Wk 22 + 4 Wks Sunprevir FixHepC
Wk 24 UNDETECTED Alt 13
Wk 12 post tx SVR12 Wk 26 SVR24
Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC
Last Edit: 3 years 4 months ago by LondonGirl.
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Please check for medication interactions 3 years 4 months ago #8721

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Hi LG, if your blood work shows you are deficient in B12 - then usually a B12 shot from the Dr is recommended. Otherwise, my understanding is that the B's are better taken as a 'complex' - Multi B slow release. They don't all carry out the same functions and finding a good balance can be hard, its always recommended that B12 needs Folate (better form for absorption than Folic Acid) and B6; in a multi, choline and biotin are very important but often these things are left out in some brands, also since Vitamins B (and C) are water-soluble, any excess is flushed straight out of the body. So, taking a max dose multi that isn't slowly released into your system through the day means your body would digest it, assimilate what it needs and flush the rest out - big waste. If you just want B12 (with folate and B6) on its own the sub-lingual forms and liquids are assimilated faster.
As you say it's all very complex :P Come on you did intend the pun didn't you :)
QLD Australia ☀️
G3a HCV 35 yrs Tx naive
Started Sof/Dac 13/01/16

Dec '15
AST 70
ALT 89
GGT 124
Fibroscore 8.5
F1-F2
13 Feb'16 VL UND #woohoo!
AST 24
ALT 26
GGT 50H
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Please check for medication interactions 3 years 4 months ago #8739

  • sabrecat
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Hi CJ, and others,

many years ago (1998) I was told Betacarotene was helpful. I was told Interferon cured HepC as well, but.......

I think the reasoning was that it released as much Vitamin B??? as the body needed and the rest journeyed out in the urine?

Not suggesting Betacarotene!!

Tried search on this site and it is not mentioned.

Maybe someone else knows?

Yours and all the best with treatment,


J.
GT3a 1990 Failed Inter 1998, comb in 2000. HCC 2012
Started 24/52 Sof/Dac 27th October 2015.
1. Bloods 2 October 2015: AST - 165 (20-40), ALT - 265 (5-40), GGT 189 (5-50)
2, Bloods 20 November 2015: ALT etc normal; VL 19
3. Bloods 8 January 2016: AST - 40, ALT - 59, GGT 48 VL RNA UND
4. EOT 12 April 2016 - blood tests: all is well, CT scan: okay
5. AFP 11 June 2016: 4 ref< 11
6. VL July 2016: DET
7. Oct16 start treat - June17 UND
8. Jun 18, lfts okay, platelets a bit low.
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Please check for medication interactions 3 years 4 months ago #8788

  • LondonGirl
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Thanks Chejai, Very helpful

What pun?

;)
GT1a Dec14 F2/8.7 VL 900000-2.5M
Jan16 Hepcivir-L MonkMed/Redemption
Baseline: VL 913575 Alt 76 Platelets low
Wk2 VL1157 Alt 23
DET Wk 8 VL 32 Alt19 'In the slow lane'
June16 Fibro 5.7 F0/1 LIF 1.5
Wk 11 VL<12 Alt 13 Det/Unq
Extending tx 12 wks Mylan Sofo/Dac MonkMed
Wk 14 VL <12 Det/Unq
Wk 16 VL UNDETECTED
Wk 22 + 4 Wks Sunprevir FixHepC
Wk 24 UNDETECTED Alt 13
Wk 12 post tx SVR12 Wk 26 SVR24
Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC
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Please check for medication interactions 3 years 4 months ago #9104

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Hi Sabrecat, betacarotene ( a carotenoid) is the precursor to Vitamin A, it's what gives carrots, pumpkin, sweet potato, fruits etc., their yellow/orange colour, it is found in lots of greens too. It's absorbed in the stomach lining and converted to Vitamin A (retinol) - a fat-soluble vitamin (like E), not water-soluble like B & C, hence Vitamin A and E are stored in the liver and fat cells.
Vitamin A is important for healthy mucous membranes (e.g. mouth, throat, lungs), skin, eyesight e.g. for night 'blindness', and the immune system. Betacarotene is not an 'essential' vitamin ( vitamins and nutrients not synthesised by the body, required through diet) but Vitamin A is. It is an antioxidant, betacarotene from food will be absorbed only in the quantity the body needs, but supplements can cause build-up if too high.

Some vegans who get carried away with juicing carrots can end up with a nasty looking side-effect of orange skin! So, can people who take high doses of synthetic carotenoids. It shouldn't be taken at the same time as Vitamin B Complex because it reduces the effect of Niacin - vitamin B3. It's suggested Carotenoids are better taken with Vit C, E, Selenium and Zinc. It is safer to take betacarotene (either natural or synthetic) than Vitamin A if you have liver problems because of the risk of Vitamin A build-up in the liver is very toxic.

It interacts with cholesterol lowering drugs e.g. statins; weight loss pills.

Smokers, apparently should be very careful taking it as a supplement because some research has indicated higher risk of lung cancer, since smokers are already at 'high risk' it's difficult to analyse the reasons for this result. So, it's just advised that smokers don't take this supplement.

Therefore, given our HepC compromised liver function, it's best not to take Vitamin A supplements and if you really aren't eating your colourful fruits and veggies then betacarotene is safer.

Ok, enough of my waffling :)
QLD Australia ☀️
G3a HCV 35 yrs Tx naive
Started Sof/Dac 13/01/16

Dec '15
AST 70
ALT 89
GGT 124
Fibroscore 8.5
F1-F2
13 Feb'16 VL UND #woohoo!
AST 24
ALT 26
GGT 50H
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Please check for medication interactions 3 years 4 months ago #9153

  • sabrecat
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Very informative waffle - many thanks.

J.
GT3a 1990 Failed Inter 1998, comb in 2000. HCC 2012
Started 24/52 Sof/Dac 27th October 2015.
1. Bloods 2 October 2015: AST - 165 (20-40), ALT - 265 (5-40), GGT 189 (5-50)
2, Bloods 20 November 2015: ALT etc normal; VL 19
3. Bloods 8 January 2016: AST - 40, ALT - 59, GGT 48 VL RNA UND
4. EOT 12 April 2016 - blood tests: all is well, CT scan: okay
5. AFP 11 June 2016: 4 ref< 11
6. VL July 2016: DET
7. Oct16 start treat - June17 UND
8. Jun 18, lfts okay, platelets a bit low.
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Please check for medication interactions 3 years 3 months ago #9603

  • Ariel
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Great info
I had my B12 checked before starting it was good
My iron too.
Does sof/led deplete the B12? I am aware of its importance in SVR
I don't use supplements never have but Thankyou for the info
Maybe I should take a vitamin B when on tx?
Xxx Ariel
Gen 1a
Peg/inf/riba 2012(!) stop @ Wk 43 potassium low +issues (rlps week 4 post tx, VL120,000) scnds eg. adenomas.
pre sof/led VL 240,000 Fibsc F0
Day 25 <30
Day 32 UND
Week 10 UND
EOT UND ALT11AST17GGT19
SVR4 UND ALT10 AST16 GGT13
SVR8 UND ALT <9 AST16 GGT15
SVR12 UND ALT14 AST19 GGT12 Bili 5
EOT +18 ALT13 AST20 GGT9 Bili 5
EOT +21 ALT11AST15
Cured SVR12
Dysplasia Adenomas RemvdAug '16
SVR24 UND ALT11AST16
ColonoscopyClear Nov17
LumpectomyClear ‘18
LithotripsyCytoscopyBiopsy 4/18
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Please check for medication interactions 3 years 3 months ago #9620

  • pat1
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story My blood pressure is rising on Tx. To be fair I think that is most likely a combination of stressful days at work and perhaps the meds. I went to my GP yesterday to have it checked and found it was 170/110. My doctor refused to discuss hepc as she said that she doesn't know anything about it but coldly asked my how much I payed for my Tx. My GP prescribed an additional blood pressure medication for me and checked for drug interactions according to her medical procedures. When I got home I did my own check on www.hep-druginteractions.org/checker and found that there was a possible contraindication with Amolodipine and Daclatisvir. I was feeling unwell and fortunately GP2U had after hours apts available and within 30 minutes I was speaking with Dr Amir who kindly prescribed a different and more compatible medicine for me. I also received assistance from GP2Uwhen there was difficulty presenting the script at my preferred chemist. grateful
gt 1a VL 6m
F2/3 FibroScan - 9KPa in 2011 and 7KPa in 2015
sof/dac 10 December for 12 weeks
pre tx alt 85 ast 51
4 wk alt 34 ast 31 UND <35
8 wk alt 29 ast 32 UND <15
12wk alt 25 ast 25 EOT 3.3.16
SVR24 UND KPa5.3 F0 in normal range
I am well
.forever grateful to fixhepc
Last Edit: 2 years 10 months ago by Hieupham.
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Please check for medication interactions 3 years 3 months ago #9623

  • Gaj
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Pat, so sorry to hear that your GP put you through additional stress at a time when they should be supporting you. :evil: :evil: :evil:

But glad to hear that GP2U were able to assist both with prescribing and support with your chemist. Thank goodness they were available for you and it is reassuring to hear that at least some medical practices still have their patients interests at heart. :)
G3a since '78 - Dx '12 - F4 (2xHCC)
24wk Tx - PEG/Riba/Dac 2013 relapsed
24wk Tx - Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx - 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 - 22/06/17 UND
SRV12 - 27/07/17 UND
SVR24 - 26/10/17 UND
:cheer: :cheer: :cheer:
Last Edit: 3 years 3 months ago by Gaj.
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Please check for medication interactions 3 years 3 months ago #9624

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I almost feel like ripping open the rant banana at the moment, but then I realise with sadness that in slightly less than 5 weeks Australian GPs like Pat's (and some others) will be able to prescribe DAAs on PBS either with a bit of extra training or in consultation with a specialist.....and I wonder about some of the specialists too. The omens as to the success of this do not look entirely bright to me for a couple of reasons:

- Maybe they are being honest in knowing nothing about HCV; in this case I suppose there is the possibility that they can learn about it but from the stories I've read here there doesn't appear to be any enthusiasm to do so.

- They are just anti-generics and will suddenly become knowledgable and compliant with the new requirements once they are able to supply PBS approved patented medications.

In either case, I sense a lack of care for their patients health and wellbeing mixed with what appears to be distaste and judgemental behaviour regarding patients with HCV. Not good signs!

OTOH I do know and hear of good GPs (and specialists) who are working with what we have now or watching with interest and learning as mine seems to be. I hope they turn out to be just the tip of the iceberg indicating the vast silent majority and in the future those with HCV can go to see their doctor with the expectation that they will be treated the same as someone with bronchitis or similar.

Edit: Rereading this 13 months later I realise I was far too pessimistic and that Australia's doctors have stepped up to the challenge admirably. From the latest available Kirby Institute report on treatment:
The total number of DAA initiations in 2016 (March-December) is estimated to be between 30,390 and 33,390.

www.ashm.org.au/Documents/Kirby_HepC_Newsletter_Issue6.pdf
G3a since '78 - Dx '12 - F4 (2xHCC)
24wk Tx - PEG/Riba/Dac 2013 relapsed
24wk Tx - Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx - 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 - 22/06/17 UND
SRV12 - 27/07/17 UND
SVR24 - 26/10/17 UND
:cheer: :cheer: :cheer:
Last Edit: 2 years 2 months ago by Gaj.
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Please check for medication interactions (+ website link) 2 years 2 months ago #23852

  • Grateful1
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Hmmm... thyroid med, levothyroxine comes back yellow on the dac. Should i quit taking it? Didn't quite understand what I was reading. The color code helps. B) thanks all. 25mcg take in the morning with blood pressure med, take sof/dac in the evening
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Please check for medication interactions (+ website link) 2 years 2 months ago #23854

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I'd just sent you this link in another thread.

I'm not a doctor so you should discuss this situation with one before stopping your medication. Reading the warning it seems that there is a possibility that Daclatasvir may (potentially) effect Levothyroxine rather than the other way round. It may be that you need closer monitoring of your thyroid condition during treatment and possibly a different dose of levothyroxine or maybe there is an alternative drug you could use that wouldn't interact? But you need advice from a doctor.
G3a since '78 - Dx '12 - F4 (2xHCC)
24wk Tx - PEG/Riba/Dac 2013 relapsed
24wk Tx - Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx - 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 - 22/06/17 UND
SRV12 - 27/07/17 UND
SVR24 - 26/10/17 UND
:cheer: :cheer: :cheer:
Last Edit: 2 years 2 months ago by Gaj.
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Please check for medication interactions (+ website link) 2 years 2 months ago #23860

  • DrJames
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Tyroxine does not interact with Sof/Led or Sof/Vel

For daclatasvir it says:

Coadministration has not been studied and thyroid metabolism is complicated. The major pathway is sequential deiodination (but there are few published data on the enzymes involved) and conjugation with glucuronides and sulphates also occurs. A few individual case reports indicate some potential CYP involvement but this is unlikely to be clinically significant. Data suggest that endogenous T3 and T4 may be transported by OATP1B1 which is inhibited by daclatasvir but it is not clear if this is likely to be clinically significant. Monitor thyroid function tests.

Which in English is "Don't worry about this, just test your thyroid levels (TSH) during treatment, say every 4 weeks"
YMMV
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