TOPIC:

How long to eliminate drugs post treatment?

I’m jumping off the DAA train tomorrow and was wondering how long it might take for the medications to wash out of my system and haemoglobin levels return to normal. It has been three relatively easy months, but constant fatigue and lack of sleep have outworn their welcome.

Looking at the half lives, (active sofosbuvir metabolite - 27 hours, ledipasvir - 47 hours, plasma ribavirin - 12 days (40 days from red blood cells), it seems like it’s not going to be a fast process. After ten days, sofosbuvir and ledipasvir will probably be down by more than 90%, but seeing as it is likely that ribavirin is the main source of side effects, after 10 days, we’re only going to be down about 50% plasma concentration.

As a member of Hypochondriacs Anonymous (Regional Australian Narcissist subdivision), I was wondering if anyone of my association brothers (and sisters) here might have any information on how long it takes to begin to feel even a tiny bit better after putting down the ribavirin cocktail. I know that there is nothing I can do about it and that nature will take its course, but discussing numbers I barely understand makes me feel more empowered, which I believe is a state to which we should all aspire. Having an idea of what to expect makes the future more welcoming.

So does anyone have any useful news or advice regarding this time of transition that is about to be undergone by me? When will I start to feel less tired? When will the mood become less anxious and aggressive? When will the clouds all disappear? (Is it all actually normal feelings for person in second half of life?)

Especially welcome would be feedback and anecdotal information if you have first-hand experience of ribavirin side effects during and after ending DAA/ribavirin treatment.

PS Here is a very good article (well-illustrated as well) describing the dynamics of ribavirin-induced anaemia:

journals.plos.org/ploscompbiol/article?i...journal.pcbi.1001072

With the Sof it will go

1/2 1/4 1/8 1/16 1/32 1/64 1/128 every day so under 1% after 1 week.

With the led your 10% left is pretty close to the mark.

And with the Riba it will take a while but people seem to feel better earlier than the numbers suggest.

Some people suffer on Sof and sail through Riba so it depends what the cause is. I expect you will feel better every day and the trend will speak to how long.

Thanks for the information.

Of course you are right that eventually all will return to normal, but it is odd that there is such variance among people for what seems to be a fairly potent drug such as ribavirin.

But I guess that is the nature of genetic and physical variation between people.

In the end, I don't expect to feel a huge improvement after treatment as I think that being on the distal side of fifty and losing energy pretty much go hand-in-hand. The main bonus I am hoping for is a a bit more vitality, a slightly slower decline, and some delay of unpleasantnesses such as cirrhosis.

Death and sickness is going to get us in the end, but with a healthier body, the path there will be a little less onerous. And that is certainly worth a lot in itself!

Hi A.L.

I stopped the riba after 12 weeks but continued on with the DAA's. Here's my experience.
During the riba my haemo dropped from about 14 to 11.5.

After stopping, I started to feel a difference after 2 weeks, by which time the riba had reduced to 50%.
It was easier going with walking, less heart beating, easier breathing.

After 4 weeks my haemo was up again to 13, nearly normal. Breathing normal, heartbeats normal. Riba reduced to about 25%.
So I'd say to test your haemo at 4 weeks post and look for significant improvement based on that result.

As I'm still on the DAA's I still feel fatigue effects from them, so what I'm reporting here is due to stopping the riba only, not stopping all the meds.

dt

dointime wrote: Hi A.L.

I stopped the riba after 12 weeks but continued on with the DAA's. Here's my experience.
During the riba my haemo dropped from about 14 to 11.5.

After stopping, I started to feel a difference after 2 weeks, by which time the riba had reduced to 50%.
It was easier going with walking, less heart beating, easier breathing.

After 4 weeks my haemo was up again to 13, nearly normal. Breathing normal, heartbeats normal. Riba reduced to about 25%.
So I'd say to test your haemo at 4 weeks post and look for significant improvement based on that result.

As I'm still on the DAA's I still feel fatigue effects from them, so what I'm reporting here is due to stopping the riba only, not stopping all the meds.

dt

Thanks, dt, that is very heartening to hear! I'm more-or-less in the same haemoglobin park as you and finding the weakness and breathlessness far more unpleasant than the main condition itself, so it's good to hear that you found yourself on an upward trajectory and that your figures correlate with what we have read about the half life of ribavirin.

Just a matter of patience, I guess.

In any case, good luck with the ongoing side effects of the antivirals and best wishes for a healthy conclusion.

Hi A.L,

Just a matter of patience, I guess.

I agree. Don't push it. Listen to your body and if it goes into the discomfort zone then slow down until you can comfortably do the physical activity that you are trying to do. It won't be long before your haemo rebounds and then you can push it all you want.

dt

"Death and sickness is going to get us in the end, but with a healthier body, the path there will be a little less onerous. And that is certainly worth a lot in itself!"


Says it all for me too.

yours

J.