Home Forums Main Forum FixHepC Admin Q & A Foods that interact with Sof/Led?

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  • #8060
    Tomas_73
    • Topics: 4
    • Replies: 13
    • Total: 17
    • Acolyte
    • ★★
    @tomas_73

    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.

    #8068
    avatar876.jpegGaj
    • Guardian Angel
    • ★★★★★
    @gaj

    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:

    #8074
    Avatar photoflyingfox66
    • Guardian Angel
    • ★★★★★
    @flyingfox66

    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”

    #8079
    avatar876.jpegGaj
    • Guardian Angel
    • ★★★★★
    @gaj

    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:

    #8083
    Avatar photoLondonGirl
    • Guardian Angel
    • ★★★★★
    @londongirl

    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

    #8084
    Avatar photoflyingfox66
    • Guardian Angel
    • ★★★★★
    @flyingfox66

    I use limes a lot too, in my morning hot water. When i’m not using the grapefruit off my tree.


    F49HepC25ysGT1a
    mild”

    #8085
    Avatar photomgalbrai
    • Guardian Angel
    • ★★★★★
    @mgalbrai

    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


    Curehcvnow@gmail.com
    http://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

    #8086
    Avatar photoflyingfox66
    • Guardian Angel
    • ★★★★★
    @flyingfox66

    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”

    #8088
    Avatar photoLondonGirl
    • Guardian Angel
    • ★★★★★
    @londongirl

    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

    #8090
    Avatar photoflyingfox66
    • Guardian Angel
    • ★★★★★
    @flyingfox66

    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”

    #8091
    Avatar photoLondonGirl
    • Guardian Angel
    • ★★★★★
    @londongirl

    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

    #8096
    Tomas_73
    • Topics: 4
    • Replies: 13
    • Total: 17
    • Acolyte
    • ★★
    @tomas_73

    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.

    #8101
    avatar876.jpegGaj
    • Guardian Angel
    • ★★★★★
    @gaj

    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:

    #8106
    Avatar photomgalbrai
    • Guardian Angel
    • ★★★★★
    @mgalbrai

    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.

    http://www.gilead.com/~/media/files/pdfs/medicines/liver-disease/harvoni/harvoni_patient_pi.pdf?la=en

    Mike


    Curehcvnow@gmail.com
    http://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

    #8107
    Avatar photosonix
    • Guardian Angel
    • ★★★★★
    @sonix

    There was a thread a few days ago which addressed some of the food interactions with one of the main metabolising enzymes.
    http://fixhepc.com/forum/questions-and-answers/523-caffeine-codeine-noni-not-good-with-daclatasvir.html

    In particular was an included link to this pertinent article which mentioned other foods to be cautious of or avoid –
    http://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

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