8 weeks is an economy measure to reduce the government costs of these medications.

12 weeks works better.

Get 12 weeks.

The problem in the US is that pretty much no doctors are willing to prescribe.

A pragmatic solution would be medical tourism to a country where you can get a prescription and access to the medications.

I am aware of people doing just that.

In Australia our personal importation laws mean you would need to see a doctor like me online then setup the import with the expectation it could take up to 4 weeks to be available here.

Looking to India, where Sof+Riba suitable for GT2 is currently available you could just go now.

Most people are GT1 (54%) or GT3 (37%) so need Sof/Dac (1 & 3) or Sof/Led (1 only).

There was Sof/Led in Bangladesh but stocks are low. Sof/Dac will become available within weeks.

The usual dose of Ribavirin depends on weight

< 75 kg 1000 mg (5 x 200 mg a day) > 75 kg 1200 mg (6 x 200 mg a day)

The daily dose is split into morning and evening – so 3 tabs twice a day for > 75 kg

You are taking 800 mg which is below the recommended dose, but will still be having a useful impact. We do reduce the Ribavirin dose where side effects are becoming problematic.

Hello Ahmad,

This is not a very clean spectrum but probably has more to do with the technical execution of the test than the API.

You can find spectral data for Daclatasvir here:

http://orgspectroscopyint.blogspot.com.au/2015/07/daclatasvir.html

1H NMR (400 MHz, DMSO-έfc, 80 ⁰C): 8.02 (d, J=8.34 Hz, 4 H), 7.97 (s, 2 H), 7.86 (d, J=8.34 Hz, 4 H), 6.75 (s, 2 H), 5.27 (t, J=6.44 Hz, 2 H), 4.17 (t, J=6.95 Hz, 2 H), 3.97 – 4.11 (m, 2 H), 3.74 – 3.90 (m, 2 H), 3.57 (s, 6 H), 2.32 – 2.46 (m, 2 H), 2.09 – 2.31 (m, 6 H), 1.91 – 2.07 (m, 2 H), 0.88 (d, J=6.57 Hz, 6 H), 0.79 (d, J=6.32 Hz, 6 H);

Putting that in an simplified format (first number is ppm on x axis, second is expected y axis value)

8.02 (4 H),
7.97 (2 H),
7.86 (4 H),
6.75 (2 H),
5.27 (2 H),
4.17 (2 H),
3.97 – 4.11 (2 H),
3.74 – 3.90 (2 H),
3.57 (6 H),
2.32 – 2.46 (2 H),
2.09 – 2.31 (6 H),
1.91 – 2.07 (2 H),
0.88 (6 H),
0.79 (6 H);

So if you look at your spectrum you see 12.66 @ around 0.85 ppm – this represents 2 peaks (0.79 & 0.8 merged into one due to instrument power limitations. You can continue on for other peaks, but your spectrum is not great one for teaching NMR basics.

I have attached a pdf showing the impact of concentration on the Daclatasvir spectrum. This was a dilution of exactly the same sample so the only thing different was more solvent. Notice that despite the fact it remained the same API there have been changes to the spectrum.

You won’t need leave. You will feel better than you have within 7 days of starting treatment, unless you’re F4 and need Riba in which case I withdraw that but do say you will feel much better than if you were having PEG, and should still be able to work but won’t feel 100%

Pop in again tomorrow afternoon when I get back from this wedding and I will route you through an availability zone with the right contact on your way home. You should be able to pick up in transit and I will be able to confirm the manufacturer is good by the time you get home.