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  • in reply to: Q’s about timing of blood pressure pill and meds #9482
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Getting your local GP to tinker with BP Meds is a great idea. Show him/her the interactions checker and it should be simple.

    Happy to sort it online if you buy a BP machine.

    Taking the Amlodipine first and the Sof an hour or two later would be fine too if you want to separate them.


    YMMV

    in reply to: Drug that costs $1200, and sells for $5 in India #9481
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Here is the Phase 3 for UNITY-2

    http://www.natap.org/2014/AASLD/AASLD_23.htm

    So the results are ok but Daclatasvir+Asunaprevir+Beclabuvir appears to need RIBA to get to the results delivered by other combinations.


    YMMV

    in reply to: Merk’s new hep C drug (Grazoprevir/Elbasvir) #9440
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    As per the party line Sof+Led+Sim increase blood levels. This could be managed with dose reduction but would be experimental.

    100% cure and pan genotypic profile of Sof+Dac+Sim makes it a very attractive option.

    The only problem with Simeprevir is that it is even more diabolical to make than ledipasvir and more or less unavailable as a generic. We have some but it was triple the price of ledipasvir.

    It is there for retreatment but people will be paying over 3x the price of Sof+Dac chasing the last few % if used as the first line treatment.


    YMMV

    in reply to: Merk’s new hep C drug (Grazoprevir/Elbasvir) #9439
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Summary

    Coadministration with ledipasvir/sofosbuvir has not been studied and is not recommended. Coadministration of simeprevir (150 mg once daily) and ledipasvir alone (30 mg once daily) to 22 subjects increased ledipasvir Cmax and AUC by 81% and 92%. Simeprevir Cmax and AUC increased by 161% and 169%. Coadministration of simeprevir (150 mg once daily) and sofosbuvir alone (400 mg once daily) increased sofosbuvir AUC and Cmax by 3.16- and 1.91-fold, respectively when compared to historical data. The AUC of GS-331007 (the main metabolite) increased by 9%, but Cmax decreased by 31%. Simeprevir AUC and Cmax decreased by 6% and 4%, respectively.

    Description

    Concentrations of ledipasvir, sofosbuvir and simeprevir are increased when simeprevir is co-administered with ledipasvir/sofosbuvir. Co-administration is not recommended. Coadministration of simeprevir (150 mg once daily) and ledipasvir (30 mg once daily) increased simeprevir Cmax and AUC by 161% and 169%; ledipasvir Cmax and AUC increased by 81% and 92%. Coadministration of simeprevir and sofosbuvir decreased simeprevir Cmax and AUC by 4% and 6%, increased sofosbuvir Cmax and AUC by 91% and 216%, and decreased GS-331007 Cmax by 31% but increased AUC by 9%.
    Harvoni Summary of Product Characteristics, Gilead Sciences Ltd, November 2014.

    Concentrations of ledipasvir and simeprevir are increased when simeprevir is coadministered with ledipasvir. Coadministration of simeprevir (150 mg once daily) and ledipasvir (30 mg once daily) to 22 subjects increased ledipasvir Cmax and AUC by 81% and 92%. Simeprevir Cmax and AUC increased by 161% and 169%. Coadministration of ledipasvir/sofosbuvir with simeprevir is not recommended.
    Harvoni US Prescribing Information, Gilead Sciences, October 2014.


    YMMV

    in reply to: Can anyone help me understand test results? #9430
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    On my first freefall skydive I asked my jump master, Captain Ron Llywelyn SAS this question:

    Hey Ron, how long do I have to pull the ripcord?

    He said:

    Well James, I’ll tell you. You’ve got the rest of your f$&@ing life to pull that ripcord…

    Yesterday is the story that delivered you to today. In front of you is a blank page and you can write today’s story any way you want. You can scribble on the pages, tear them out, or write your masterpiece.


    YMMV

    in reply to: Can anyone help me understand test results? #9411
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    I’ve lost my youthful years, but to feel well, before I become old, will be a reprieve.

    We are all the product of all the people we have ever met, and the things we’ve done and have between now and whenever our time runs out to do whatever it is…

    My mum once told me something useful:

    “Life is not a trial run.”

    Get cured and find your new future, whatever it might be.


    YMMV

    in reply to: Melatonin #9408
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    You should find no GP resistance to writing a script for Melatonin 2 mg take one to three at night.

    They will probably be greatly relieved you are not after benzodiazepines. Ask.


    YMMV

    in reply to: FixHepC – Party Playlist #9388
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Tina, how about a Pacific fusion tune

    [video]https://www.youtube.com/watch?v=9Nbxryb5YHc[/video]


    YMMV

    in reply to: FixHepC – Party Playlist #9387
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    How about this for a bit of awesome solo guitar – Fun2 – wait for it

    [video]https://www.youtube.com/watch?v=2xjJXT0C0X4[/video]


    YMMV

    in reply to: FixHepC – Party Playlist #9382
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    So these 3 left a real impression the first time I heard them

    [video]https://www.youtube.com/watch?v=Y2Ta0qCG8No/[/video]

    [video]https://www.youtube.com/watch?v=gxEPV4kolz0[/video]

    [video]https://www.youtube.com/watch?v=h0ffIJ7ZO4U[/video]


    YMMV

    in reply to: Melatonin #9378
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Metalonin (real prescribed NOT fake homeopathic) , at a dose of 2-6 mg, about 1-2 hours before you want to go to sleep can help, particularly in the context of shift work/jet lag.

    Here is a post of mine over on blogspot called “How do I fix my insomia?” that contains the full range of routine sleep hygeine advice and medication options.

    http://gp2u.blogspot.com.au/2015/02/how-do-i-fix-my-insomnia.html


    YMMV

    in reply to: Can anyone help me understand test results? #9360
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Tomas,

    For somebody with HCV it really does not get better than that prior to treatment.

    With low fibrosis you chances of cure are at the higher end. No 100% cast iron guarantee but good reason to be optimistic.


    YMMV

    in reply to: F3 to F1 in 12 years while still HCV positive? #9359
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Bloot, you are cheating by treating!

    Fibrosis does improve post treatment:

    http://fixhepc.com/forum/experts-corner/106-liver-cirrhosis-does-not-disappear-in-12-weeks.html

    The fibrosis seems to be mediated by LOXL2

    http://fixhepc.com/forum/media-news/338-good-news-for-cirrhotic-patients.html


    YMMV

    in reply to: Hetero … Sof, Sof/Led Combo #9356
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Thank you Paul.

    Here are a few facts:

    1. In India these medications are listed on Schedule H which is, like Australia’s Schedule 4 ie prescription only https://en.wikipedia.org/wiki/Drugs_and_Cosmetics_Rules,_1945
    2. The fact that it is possible to get these medications in India without a prescription does not make that legal – I can for example get MS Contin on the street in Australia without a prescription and that is not legal either
    3. As a rule, if laws are being bent or broken it’s not a very sensible idea to make a fuss about that on a public forum

    India also has a Schedule X, similar to Australia’s S8 in terms of lock and key storage, and extensive record keeping. Consider that in 2014 India rescheduled Ketamine onto Schedule X http://timesofindia.indiatimes.com/city/goa/Ketamine-drug-brought-under-Schedule-X-to-curb-abuse/articleshow/28486002.cms and then consider if there might be very influential and cashed up organisations who might be lobbying for exactly that outcome to ensure compliance with licensing arrangements.

    It is fantastic that these medications can be accessed.

    Please don’t kid yourself that both accessing them and having them in your possession almost anywhere in the world is legal without a prescription. It is almost certainly not.

    The mortality rate on some of the trials has been > 1:100 (Velpatasvir was 1:177) so don’t kid yourself that these medications are completely safe and that you should just take them without having had a chat with a doctor to get your prescription.

    While I am inherently opposed to censorship please consider that websites that provide information on how to conduct illegal activity have historically been shut down.

    Please be prudent in your comments and consider that not everyone who reads them is a fan of our mission to see everyone, everywhere provided with timely and affordable access to DAA medication.

    To anybody who may be willing or able to provide medications without a prescription I would urge you to consider the wisdom of a) doing so and b) telling the world. Your next customer may be from the FDA/DEA or equivalent, so to be blunt get a clue and make sure your behaviour is compliant with all local laws.

    Sometimes saying less is more. Please don’t paint a target on yourself or this website.


    YMMV

    in reply to: Sofosbuvir & Ledipasvir Treatment #9210
    dope-on-a-rope.jpgDr James
    • Guardian Angel
    • ★★★★★
    @fixhepc

    Hi Hamilton I have three weeks to go of a 12 week course on Sof/Led. Only side effect was insomnia which resolved itself about half way through my treatment. Feeling much better now than before I started. Good luck with the rest of your treatment :)


    YMMV

Viewing 15 posts - 1,561 through 1,575 (of 1,968 total)