Greg Jefferys Hepatitis C blog deals with all the issues associated with hepatitis C
One of the BIG issues in the current Hep C treatment world is the relapse.
Statistically about 1 in 40 people treating with Sofosbuvir 400 mg + Velpatasvir 90 mg (Epclusa) will relapse.
Why this happens is not entirely clear however factors such as fibrosis level, previous treatment history and length of treatment are certainly factors.
Another factor, one that we can directly control, is what food and supplements we consume during treatment with Epclusa.
In this post I will talk a little about relapse and give you some tips that might help make a small difference, but which might make the difference between clearing the Hepatitis C or relapsing after treatment.
Firstly I will mention treatment times.
If you have failed a previous Hepatitis C treatment then you should seriously consider do the maximum Epclusa treatment period, which is generally considered to be 24 weeks.
One of the reasons for this is because it is likely that the Hepatitis C virus in your body has developed some degree of resistance to treatment. If you can not afford to do 24 weeks you should seriously consider at least 16 weeks treatment. The length of treatment time is something you should discuss with your doctor.
If you have high liver fibrosis levels, F3 or F4, your should also consider doing a longer treatment period.
Epclusa is a very effective treatment for all Hepatitis C genotypes and it is particularly good for treating Hepatitis C genotype 3. However because genotype 3 has proven to be a difficult genotype of Hep C to cure it is worth considering doing more than 12 weeks treatment with Epclusa if you are treating genotype 3. The rule of thumb is “The longer the treatment time the higher the cure rates.
8 Weeks 90%>
12 Weeks 95%> (+5%)
16 Weeks 97%> (+2%)
20 Weeks 98%> (+1%)
24 Weeks 98.5% > (+0.5%)
The first thing to understand when taking Epclusa is that Epclusa is two drugs, Sofosbuvir and Velpatasvir. Velpatasvir is not a water soluble chemical. That is to say it does not dissolve easily.
Sofosbuvir is very soluble, Velpatasvir is not very soluble.
Velpatasvir relies heavily on the stomach acids to dissolve it and make it easy for the body to absorb.
This is why you must never take antacids when you are taking Epclusa or any other substance that might neutralise your stomach acid.
On the instructions that come with the bottle of pills it says that Epclusa can be taken with or without food.
However there is now a general agreement that it is better to take your pill with a small amount of food.
Because having a small amount of food in the stomach will stimulate the stomach acids and assist in the absorption process.
The Epclusa is absorbed in the stomach, through the stomach walls.
Not a large amount of food, not a huge meal, because some of the Velpatasvir is going to get caught up in the mass of food.
Also I would not suggest drinking a large amount of water right after taking your pill.
For the same reason.
We want that Velpatasvir to hang around in some nice strong stomach acid for a while, not get washed away in a flood of H20.
Certain herbal supplements will speed up the rate that the active ingredients in Epclusa are removed from the blood stream, which can lead to ” under dosing” .
Sofosbuvir and Velpatasvir are removed from the body by enzymes created by your liver. These enzymes are from a family of enzymes called CYP Enzymes, which are created to breakdown and remove toxins from the blood. Certain herbs, such as St John’s Wort cause the body to create a lot of CYP enzymes, which in turn will cause the Sofosbuvir and Velpatasvir to be broken down much faster than normal. Because we do not know how many herbal supplements will effect CYP enzyme levels it is wise not to take any form of herbal supplement during your Hepatitis C treatment.
Coffee, or rather caffeine causes the body to produce CYP enzymes because the liver considers caffeine to be a toxin and wants to remove it. If you drink large amounts of coffee while doing treatment with Epclusa it is possible that this may effect treatment outcomes. Please remember that it is the caffeine, not the coffee, that is the problem this means that any drink containing high levels of caffeine should be consumed in moderation during treatment with Epclusa.
One or two cups of coffee a day is not a problem but if you are drinking ten or more cups of coffee a day you should consider reducing this whilst taking Epclusa. The same applies to energy drinks containing high levels of caffeine.
It is also a good idea to get a seven day pill box. This is a small plastic box with a compartment for each day of the week. If you lay out your pills for the week in the pill box you will not miss a day or accidentally double dose.
So in summary:
Take your pill at about the same time each day.
Take it with a small amount of food.
Don’t drink too much water immediately after taking your pill.
No antacids and its probably a good idea not to take magnesium supplement during treatment.
No herbal supplements during treatment
Epclusa And Coffee, Epclusa Contraindications, Epclusa Cure Rate, Epclusa Effectiveness, Epclusa Efficacy, Epclusa Interactions, Epclusa Treatment
Greg Jefferys’ blog is provided for informational purposes and is not intended as Medical advice, diagnosis, or treatment.
Whilst Greg Jefferys is doing a PhD it is not in medicine. Any advice offered is offered in good faith and based on an extensive general knowledge of Hepatitis C and access to generic Hepatitis medicines Greg Jefferys has acquired through his work as an advocate and activist
The Hep C Buyers Club is not a company or corporate entity but simply a loose structure intended to offer a free information to people with Hepatitis C
Click here for other books by Greg Jefferys.
I have converted this diary into a kindle book for folk who might like it in that format. I have added a lot more depth than the original diary contains, it’s more of a complete story in book format. I have priced it as low as Kindle allows me to @ 99 cents. If you are interested just click here to go to the Kindle page.
If you have any questions please reach out by email, or complete the below form.Greg Jefferys
3439 Channel Highway, Woodbridge, Tasmania, 7161.
Very informative. Ty
i just started my 12 week treatment 4 days ago
Thank you for the information
It is my pleasure to be of some assistance 🙂
please how can one join this group?
Just click on the Facebook link … it on most pages of this website. But here is the link https://www.facebook.com/groups/1522433207869738/
Thanks Greg would a slice of whole grain bread toasted, be considered a small amount of food while taking my Epclusa pill?
A one or two slices of toast is fine, with a little butter, or whatever, to stimulate the stomach acids
Greg can u eat grapefruit while taking epclusa? Thanks gretchen
Grapefruit has en effect that slows down the rate that the Sofosbuvir and Velpatasvir is removed from your body. By eating one grapefruit you will slightly increase the dose of Epclusa. Its probably not a bad thing.
Can I drink couple beers while on Epclusa?
Drinking a couple of beers while doing treatment with Epclusa will not effect the outcome of the treatment however it is wise to keep alcohol consumption to an absolute minimum during and after treatment to give your liver the best chance of healing.
Greg I was cured with 24 weeks of Harvoni in early 2015. The absorption of the ledipasvir component in Harvoni also requires a more acidic environment. I really found that some sensible exercise during treatment helped my digestion processes almost as much as a sensible diet with good hydration. My advice is that if you are capable of moderate exercise during treatment it will help greatly keeping the blood pressure down, relieve the mild headaches and do a great deal to aid with digestion during the treatment process. I noticed this when I had to do some hard work on the third day of treatment, a small amount of decent exercise relieved the headache almost immediately.
I certainly 100% agree with you. I found that adding some serious exercise to my post-treatment regime made a huge difference to me regaining 100% good health
I’ve text you in the past concerning my treatment which finally was approved for 12 weeks of generic epclusa with v arrival vyron per day. My problem is that I’ve been on acid reflux medication /omeprazole for 15 years. I’m almost through my second 4 weeks of treatment but steadily losing weight and throwing up due to high levels of acid. In my digestive system. I cannot get in touch with my hep c doctor to get any medication modifications to relieve some the distress I’m going through with this treatment. Also having severe migraine-like headaches constantly. My psych doctor told me to contact her if I needed any changes in my medication which I was on Klonopin twice a day which helped me a lot with dealing with the side effects and getting some sort of temporary, I’m in the midst of the storm. I called her nurse today to see if I could get refills early because it seems to help quite a bit as my living situation is not very conducive to a healthy mindset. The other two people that live here don’t have a clue as to what I’m going through. I’m just out here on my own no family support know any kind of support. If you have any tips on what I should do please let me know. I appreciate your help and concern that you were giving me I really do. Have a blessed and prosperous day my friend.
Is trans-dermal magnesium taken at the opposite end of the day from the med okay?
Yes that is fine, not a problem on any level
Best wishes for your treatment
I was on omeprazole for 20 years and my doctor switched me to Pepcid 20mg to take at bedtime to accommodate taking the epclusa. The omeprazole blocked the absorption of the med. Ask your gastro dr. about it.
are multivitamins okay greg? I also eat a lot of cayenne powder mainly in black coffee in the morning.
Probably ok but I would suggest taking your vitamins etc at the other end of the day to when you take your meds… just to be safe
Could you please give me a run down of a health diet that is beneficial while i am taking epclusa
Just a normal healthy diet that includes plenty of fresh fruits and fresh vegetables. Not too much red meat. Not too much fat or sugar. No processed foods or junk foods
I am contemplating NOT taking Epclusa because of all the terrible side effects it seems to give everyone.
How will I work? I still have to function and I have read that HEP C can actually work its way out of your system on its own. Some people develop other conditions they never had prior to taking it.
Most people suffer very few side effects from epclusa. The thing to keep in mind is that people who don’t get any side effects don’t write about it. People who get bad side effects are most likely to write about it. So searching the internet is not a good representation.
May I suggest you join my Hep C Facebook group where you will find hundreds of people who have done Epclusa treatment. Talk about it with them
My name is Pauline and I have hepatitis C I really need your help to order Epclusa to Mexico please let me know if you can help me to order it from you
Thank you so much I appretiate your kindness
I have replied to your email… there is no problem sending Hep C medicines to Mexico
i am on month 5 of treatment with epclusa, lately am having alot of leg muscle pain and did not have this before my legs hurt alot and sometimes my feet become very hot i dont know if this is epclusa side effect or not i tested negative in my last test from hep c now i have another test to do but in the passed i also had hep b and now am immune to it am a little scared because greg suggested to do 5 months on epclusa am thinking that is alot of time and might make hep b return also am having a lot of vision problems that i never had them before epclusa the top of my mouth feels sore and hahve a sore throat but whats worring me is this leg pain am having lately hope is epclusa side effect and not something else.
Hi, I am on day 40 of a 12 week regimen. I was told about not taking antacids. I don’t. However I am really worried that because I have taken melatonin or benedryl before bedtime that I may have put myself in jeopardy. Dang I have been sober 14yrs now but I drink alot of coffee. I am 51 yrs old. No cirrhosis. Do you think I have greatly reduced my chances at being successful?
Caffein consumption should be kept to below 5 cups per day. Black coffee is good for the liver… white coffee is not