TOPIC: Adherence

How important is it to take your medication at EXACTLY the same time every day?
is there a window of 1 hour either side of your regular time?
Can HCV become resistant to the drugs in the same way that HIV can if HIV drugs are not strictly taken in the same window period each day?

I will aim for the same time each day, I'm just wondering if I am unable at any stage, how dramatic will the consequences be.

I missed one.
I took mine late at night because I figured (and this is not backed up by any medical knowledge) if I was sleeping then the drugs could work with no interference and hopefully I wouldn't feel any side effects.
I get up early every morning, either for swimming or Yoga, and I realised when I got up and I took the missed pill then.
After that I took to counting the remaining pills and counting back to when I started the bottle, so then I knew I was on track.
I read in one of Dr James's posts that pretty much everyone misses the odd one, also it takes a few days for the drugs to leave your system.
I think you just need to work out a system that works for you. Like maybe set up a reminder on your phone.

Took mine every morning with phone alarm before getting up. (Important I feel). There is still a little confusion as to if I missed one dose or took 2 once by mistake ! I forget the details now and I had some confusion swapping to different meds & dates changing etc... I had a 7 day pill box with days of the week on too. I think the odd day is fine as beaches says.

It's when I went away from home I used to get anxious, what if transport didn't get me home on time? (very common in England!) so I used to take an extra one, just in case I was detained by the power of public transport!

Hi JamesF,

Here's a link to Dr James' comments. fixhepc.com/forum/questions-and-answers/...take-extra.html#9328

As the others say, it is a good idea to take at the same time each day so it is a habit. I took mine when I got up and used a 7 day pill box so I didn't lose track. That always sat on my place at the dining table where my cereal bowl needed to go so I had to move it to eat meals which made it difficult to forget to take my dose. As beaches says many set their phone alarm as a reminder.

Great. thanks, guys!

yes, I'm using my phone alarm.
i take mine in the morning as i take other meds at night.

Hi James,

I took mine at night as I guess initially I wanted to give the medication a clear run and I wasn't sure what the side effects would be (minimal as it turned out). There were a couple of times when I realised I'd forgotten just when I was drifting off to sleep and had to get out of bed to take the tablets. I missed twice when I was travelling and took them the next morning. There does seem to be some margin for error.

If I had to take the medication again (and who knows - I'm waiting for my 12 week SVR results) I would probably take them in the morning to give my memory a better chance. I think the phone alarm is a great idea.

Hi James,

Don't sweat it too much. I do suggest setting an alarm but you blood levels do this when you take once a day medications:




So you can see they go up and down every day, and increase fast to start with and then slow.

The high point is called the peak and the low point the trough. If you are late with a dose all that happens is that the trough level falls a bit more. Provided that the trough is still above the MIC (Minimum Inhibitory Concentration) then the virus gets no opportunity to capitalise. The standard dose gives you plenty of wiggle room on the MIC and the only circumstance it might matter even a little bit is a long delay in the context of some pretty nasty RAVs.

So, do take it as close to the same time each day as you can, but don't panic if you're a bit late, or even if you miss a day (most people do this).

I had one patient - GT2 to be fair so easy to cure - who took his meds for 4 weeks, forgot them for a 2 week holiday, took them for another 4 weeks and then just left the rest in the bottle. Lucky bastard still got SVR12 which seems totally unrighteous, but there you go.

JamesF wrote:
I forget where I read it at but it's safe to stay within a 3 hour window, meaning if you gotta take it later that's fine. I take mine at night time, sometimes 10pm, sometimes 12pm, maybe a little later but never more than a 3 hour window. Reason I follow that rule is simply b/c of a blood pressure concern. When I first started, like the first week or two my blood pressure skyrocketed. Other than that and a weird pain feeling in my legs at around 6 weeks, after that not too many sx's at all.

Thank you. It is my aim to be as adherent as possible, but I like to be informed.