TOPIC:

Ive just started re treatment with Sof/Dac and 600 mg riba twice a day .it says to take the riba with food .I normally get up at 6-00 and have 2 strong coffees with milk then I dont eat until mid day .can these coffees be classed as the food element.Whats the technical reason the with food instruction ?

A two coffee breakfast certainly does not count as food Keith. Arguably however you can class a large mug of coffee MADE entirely with milk as food, because it has a decent quota of your daily protein and carbohydrate requirement. Cafe au lait!

Hi Keith,

My understanding from when I was on riba is that there are two reasons for the food, one is that riba can make some people nauseous on an empty stomach. The other, probably more important, is that riba is absorbed by our bodies better in the presence of fats. I'd suggest at least a light snack containing some fat. Some toast and PNB or maybe cheese and crackers with your coffee?

Hi Keith, Those breakfast suggestions from Gaj sound nice, but if you cannot face solids in the morning, drinking a big coffee made almost all with full-fat milk provides a decent amount of fat. In 300mls of 4% fat milk there is the same quantity of butterfat as on two slices of averagely buttered toast. Good luck with your Riba.

thanks mnem i think gaj answered it with the fat

Thanks gaj I don't have problems with nausea and I understand about the fat now, that's the diet out of the window then

My big problem is I'm trying to diet I really need to lose 30 -40 lb from around my middle for various reasons
what I do is count every calorie and weigh everything don't laugh I know it's sad but this is serious for me and this is the only way I can do it
the forum is full of precise numbers, viral counts, LFT results etc what I want to know is just another number
how many grams of fat, carbs whatever else should I take with my Riba assuming saturates unsaturates and polyunsaturated's can all be added together if I know that value can regulate my intake to suit my diet and the Riba
I understand 1g of fat I understand 10 g of fat but to say 'some' fat means nothing I need a number
I've consulted Dr Google and some other forums one of which was saying 50 g of fat!!! Surely not
hope someone can point me in the right direction

Hi Keith, This is a dilemma for you, to have a sufficiently high fat meal to maximise the bioavailability of your ribavirin dose yet simultaneously maintain a weight reduction diet. And that suggested 50g fat dose would be a crazy amount for just one meal with all you have going on.

This research paper mentions ribavirin bioavailability increasing by up to 46% if consumed with a high fat meal [ref: Wade JR, Snoeck E, Duff F, Lamb M, Jorga K. Pharmacokinetics of ribavirin in patients with hepatitis C virus. Br. J. Clin. Pharmacol.62, 710–714 (2006)]. Annoyingly I could not find its definition of high fat.

Back in 2006 it was pre-DAA days, so the need to get every ounce of benefit out of the ribavirin would have been pre-eminent. I wonder if it is not such a priority now we have our DAAs?

A moderate fat breakfast like those mentioned further back in this conversation may be the best thing for now. That way, you get sufficient fat to assist ribavirin absorption, without giving yourself a heart attack. With any luck someone else here knows more about this topic. Cheers

Hi Keith,

Here's a copy of my eBook on weight loss.

To be frank you barely need Ribavirin so I would not stress too much. Just take it with food.