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Hepatitis C Treatment and Drug Interactions

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4 Comments

Lucinda K. Porter, RN

Hi, Assuming you are on a 12-week regimen, you are in the final stretch, and it is just plain hard because of ribavirin. You have my sympathy. Although echinacea is not specifically contraindicated, its mechanisms of action are such that I would definitely not take it. At this point, I suggest lots of fluids, short walks or other light activity as often as you can squeeze in, and perhaps caffeine (coffee, tea), matcha green tea, or mate (go gentle on this). Perhaps talk to your doc about B12. Be sure you are sleeping enough, because that too can cause fatigue. An afternoon nap may also help.

July 10, 2015

Joy

Hello, I read your article wondered if you have any info on taking echinacea while on sovaldi/ribapak?? My GI doctors said a multivitamin is fine, but looks like I've developed a bit of anemia and want some natural recommendations, which they don't provide! Any help appreciated! I'm starting my month 3 of meds and running out of energy for work and daily living.

July 10, 2015

Lucinda K. Porter, RN

I have not seen any that specifically address that type of relapse, but if you do an internet search you will see documentation that SVR shows improved fibrosis. Perhaps ask this question on the Hep Forums (http://forums.hepmag.com). However, I would think that the mere fact that you are at F3 is sufficient to win your denial. Here is what the HCV guideleines say: http://www.hcvguidelines.org/full-report/retreatment-persons-whom-prior-therapy-has-failed "Based on limited data, the addition of weight-based RBV (1000 mg [<75 kg] to 1200 mg [>75 kg]) to ledipasvir/sofosbuvir is recommended for patients without cirrhosis in whom prior treatment with the HCV protease inhibitor simeprevir plus sofosbuvir has failed." "Emerging data suggest that approximately 10% to 15% of patients with HCV genotype 1 infection treated for 12 weeks with simeprevir plus sofosbuvir will experience treatment failure, typically due to viral relapse after discontinuing therapy. Treatment failure appears to be more common in persons infected with HCV genotype 1a and those with cirrhosis. Data from the COSMOS study indicate that treatment failure following a regimen of simeprevir plus sofosbuvir is associated with resistance to simeprevir and cross-resistance to other HCV NS3 and NS4A protease inhibitors such as paritaprevir, telaprevir, and boceprevir. On the other hand, sofosbuvir RAVs were not observed in the COSMOS trial and are likely to be rare in clinical practice." (I recommend reading the entire section that applies to you)

July 6, 2015

C Deisch

Please reply if there is documented studies that show improved fibrosis after relapsing from sovaldi/olysio. In the midst of Acaria/bcbstx/express scripts denial based upon f2 score in 2015 and a f3 score in 2014. Any documentation for appeal process?152

July 5, 2015

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