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TOPIC: Foods that interact with Sof/Led?

Foods that interact with Sof/Led? 6 years 4 months ago #7008

  • Tomas_73
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Hi, i anticipate a treatment with sof/led soon, and am wondering if there are any dietary considerations one should be aware of. What I am wondering is: will my super healthy liver cleansing fruit and veg smoothies flush out medication before it has done it's thing?
HCV Genotype 1a, Infected circa 1993, Treatment naive.
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Foods that interact with Sof/Led? 6 years 4 months ago #7015

  • Gaj
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Welcome Tomas,

I probably wouldn't wash the pills down with your SHFV smoothies just in case as there are probably a lot of sugars and acids in them. Sof/Led and also Sof/Dac can be taken with or without food depending on preference. If you have either with food I would suggest a light, reasonably bland meal to get them absorbed into your bloodstream as quickly as possible. I take my Sof/Dac with a couple of sips of water in the morning then go for a 45 min walk to the shop to pick up milk and paper. So when I sit down to breakfast the drugs are pretty much absorbed already. But some find they need to have them with a bit of food.
You may want to have a look in the Experts Corner area of the site where there is a bit of info about vegetarian diets etc if you are on one.

However, I should warn that many of us find that once on treatment our careful, healthy diets go out the window! We can't help ourselves and start eating things we haven't had for years. I suspect part of this is that our bodies go into repair mode and we need extra protein and healthy fats to support that. Listen to your body and give it what it wants in moderation.....seems like a reasonable excuse to me? ;)
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:
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Foods that interact with Sof/Led? 6 years 4 months ago #7021

  • flyingfox66
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This is an interesting question. We've established that Dac interacts with several very common food stuffs...most notably grapefruit. Is there any similar issues with Ledipasvir? I've looked around but so far all I can see is pharma contraindications for Led.
My intuition would say the meds would work better on an easily digestible, not too heavy and fatty diet. Just because there would be less clogging in the liver to penetrate.
F49HepC25ysGT1a
"mild"
Harvoni 12 wks
Brisbane, Australia
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Foods that interact with Sof/Led? 6 years 4 months ago #7026

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Don't know about the Led interactions as I just checked Dac which I need.

My understanding with Sof, Led and Dac is that you want to get them into the bloodstream and from there to the liver as quickly as possible so either on their own or with a light, low fat, easily digestible meal is best. This is why I take mine prebreakfast allowing time for them to be absorbed. I also take Ribavirin which should be taken with food and preferably with fat to better absorb it. So I have those after breakfast which is cereal and full fat milk (that's new!) and again after the evening meal which I make sure has some fat either in the meal or as an extra. But that is just for Riba.
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:
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Foods that interact with Sof/Led? 6 years 4 months ago #7030

  • LondonGirl
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apparently, Seville oranges are a no-no along with the grapefruit.
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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Foods that interact with Sof/Led? 6 years 4 months ago #7031

  • flyingfox66
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I use limes a lot too, in my morning hot water. When i'm not using the grapefruit off my tree.
F49HepC25ysGT1a
"mild"
Harvoni 12 wks
Brisbane, Australia
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Foods that interact with Sof/Led? 6 years 4 months ago #7032

  • mgalbrai
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The Gilead team concluded that ledipasvir/sofosbuvir may be taken without regard to meals. They advised that ledipasvir/sofosbuvir may be taken with an H2-receptor antagonist "at a dose that does not exceed famotidine 40 mg twice daily." A proton pump inhibitor dose comparable to 20 mg of omeprazole can be taken with ledipasvir/sofosbuvir or up to 2 hours after ledipasvir/sofosbuvir.

Eat, drink and massacre those little shits........
Mike
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forums.delphiforums.com/generichcvtx

G 1a F-1
Started tx 10/23/15 (Meso sof & led) ALT 48 AST 28 v/l 1.6 mil
11/17/15 4 wk lab ALT 17 AST 16 <15
11/18/15 Started Harvoni
12/16/15 8 wk lab ALT: 15 AST: 13 V/l UND
1/14/16 Fin. Tx
7/07/16 UND SVR 24
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Foods that interact with Sof/Led? 6 years 4 months ago #7033

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In fact I'm sure the hot water with citrus added every morning (two pints!) is what has kept my liver functions normal.
F49HepC25ysGT1a
"mild"
Harvoni 12 wks
Brisbane, Australia
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Foods that interact with Sof/Led? 6 years 4 months ago #7035

  • LondonGirl
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Oh dear - I haven't got a clue what you mean Mike :(
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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Foods that interact with Sof/Led? 6 years 4 months ago #7037

  • flyingfox66
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Do you mean you can eat anything and everything or just that you don't need to eat a meal with the meds?
F49HepC25ysGT1a
"mild"
Harvoni 12 wks
Brisbane, Australia
Last Edit: 6 years 4 months ago by flyingfox66.
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Foods that interact with Sof/Led? 6 years 4 months ago #7038

  • LondonGirl
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Not sure ! but I read something about the drugs needing stomach acid to distribute through the body -
More details please mgalbrai ;)
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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Foods that interact with Sof/Led? 6 years 4 months ago #7043

  • Tomas_73
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Thanks for your kind and considered response.

Sounds like some conscientious timing is all that is required.

I'll probably take my pill with a double espresso and a bite of dark chocolate, 30 minutes before breakfast.
HCV Genotype 1a, Infected circa 1993, Treatment naive.
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Foods that interact with Sof/Led? 6 years 4 months ago #7048

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Bristol-Myers Squibb who invented Daclatasvir recommended against Grapefuit and Seville Oranges and marmalade containing either during the trials I participated in. The instruction was that Navels and Valencias would be fine. They made no mention of limes or lemons so presumably they are not an issue. I haven't read Gilead's instructions about meals but the rest of it relates to them being suitable for use with prescription antacid type products at up to certain levels for control of gastric reflux.

Otherwise avoid 'potent' inhibitors and inducers and if in doubt and you eat "a lot" of something like soy or miso or really anything else that you have concerns about it is probably best to at least reduce it particularly within a few hours of your medication, leave it out, or seek advice from above two companies or your specialist. Keep in mind that everyone who takes these medications reports finding their liver functions improving considerably and very quickly as well as the huge majority clearing the virus. So you may want to consider whether it is wise during treatment to use other additional methods of improving liver function which won't clear the virus but could effect the medication.

And check the drug interaction charts which also contain the "big" known food and herb items like grapefruit and St Johns Wort.

Hope that helps. :)
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:
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Foods that interact with Sof/Led? 6 years 4 months ago #7053

  • mgalbrai
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I am sorry. I was at school when I found the earlier info on Harvoni and food and drug interactions. I can't find that article now. This is what came with my "factory" Harvoni.

www.gilead.com/~/media/files/pdfs/medici...patient_pi.pdf?la=en


Mike
This email address is being protected from spambots. You need JavaScript enabled to view it.
forums.delphiforums.com/generichcvtx

G 1a F-1
Started tx 10/23/15 (Meso sof & led) ALT 48 AST 28 v/l 1.6 mil
11/17/15 4 wk lab ALT 17 AST 16 <15
11/18/15 Started Harvoni
12/16/15 8 wk lab ALT: 15 AST: 13 V/l UND
1/14/16 Fin. Tx
7/07/16 UND SVR 24
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Foods that interact with Sof/Led? 6 years 4 months ago #7054

  • sonix
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There was a thread a few days ago which addressed some of the food interactions with one of the main metabolising enzymes.
fixhepc.com/forum/questions-and-answers/...ith-daclatasvir.html

In particular was an included link to this pertinent article which mentioned other foods to be cautious of or avoid -
www.ganfyd.org/index.php?title=Inhibitors_of_CYP3A4

I would love to hear from Dr James on foods while on treatment, and an FAQ would be most helpful.
M 61yo HCV+ ~ 30 yrs Gt1a F2 VL 223,000 ALT 54 AST 42 Tx start Sof/Dac 17Dec15.
SVR4 at 7Apr16 ALT 22 AST 22
SVR12 at 9Jun16 ALT 23 AST 25
Melbourne, Australia
Last Edit: 6 years 4 months ago by sonix. Reason: spelling
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