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Hepatitis C Main Forums => On Hepatitis C Treatment => Topic started by: mrl914 on December 07, 2015, 12:32:23 pm

Title: Morning or evening?
Post by: mrl914 on December 07, 2015, 12:32:23 pm
I'm starting Harvoni tomorrow and have been told how important it is to always take it at the same time each day.

Reading posts on the forum, some folks get energized and some fatigued. If energized then morning makes sense, if fatigued, then evening. Without knowing which, if either, I'm going to get, how should I choose my dosage time??

I picked 9:00 pm so that I could sleep through minor side effects. Is that a reasonable/rational approach?

Title: Re: Morning or evening?
Post by: nxs450 on December 07, 2015, 06:43:23 pm
 I just started Harvoni in the morning yesterday. I have already noticed feeling tired earlier I can not sleep until later in the afternoon. I don't know if it will stay this way or not.
Title: Re: Morning or evening?
Post by: Lynn K on December 08, 2015, 02:07:46 am
The most important thing is to pick a time you can stick with be consistent and not forget to take your meds.

If the time doesn't work for the reasons you mentioned of being either tired or energized you can adjust the time as needed just as long as the new time works to always remember to take your meds.

Good luck on treatment
Lynn
Title: Re: Morning or evening?
Post by: taliah on December 08, 2015, 07:30:01 pm
I take it in the morning. Having to bring it with me when I travel and/or have early morning appointments is annoying, but better than evening, since sometimes I don't get home until quite late. (More often staying out late than leaving early.) I want to make sure I don't forget a dose.

I'm energized immediately afterward. Fatigued during the day. And have trouble sleeping at night.

Not sure taking it at night would be better.

But I'm already 4 weeks in, and I figured it doesn't really matter during vacation time. So it's not worth fussing around to change it.
Title: Re: Morning or evening?
Post by: gnatcatcher on December 08, 2015, 08:11:29 pm
I'm starting Harvoni tomorrow and have been told how important it is to always take it at the same time each day. . . . some folks get energized and some fatigued. If energized then morning makes sense, if fatigued, then evening. Without knowing which, if either, I'm going to get, how should I choose my dosage time??

I picked 9:00 pm so that I could sleep through minor side effects. Is that a reasonable/rational approach?
Yes, that is a rational approach. I chose 6 a.m. because my schedule varies so much from day to day that I wanted a time that I could count on being home (not wanting to carry around a pill with a list price of $1,125). I guessed right, since Harvoni energized me, but as Lynn said, it's possible to adjust the time if you guess wrong. People have reported being told to adjust by 2 hours/day or something similar until they had arrived at a better time than they had originally chosen.

I logged every pill taken -- not mandatory, but some people who didn't do so reported having to count all the remaining pills in the bottle if they weren't 100% sure they'd remembered to take one.

-hope you have as easy a ride as I did (very few, mild, intermittent side effects).

Gnatty
Title: Re: Morning or evening?
Post by: mrl914 on December 08, 2015, 08:49:11 pm
Thank you all for your good advice.

10 minutes before lift-off after 30 years.
Title: Re: Morning or evening?
Post by: The Terminator on December 08, 2015, 11:53:58 pm
i choose 9am and set my ph alarm clock to ring every morning at 8:56am,i choose 9am seemed like a great way to start the day,i havnt had any side effects at all,of coarse everyone is diff,take my pill at 9 do my 3mile walk everyday,just find your groove and keep on the move
Title: Re: Morning or evening?
Post by: jakas on December 09, 2015, 05:58:54 pm
Planning to take mine at 7.30 pm, will try and sleep thru it. Morning need to take the blood pressure meds and then to work.
Title: Re: Morning or evening?
Post by: laublair on December 09, 2015, 07:54:06 pm
I am on Harvoni 14 days with zero side effects!  I take it around noon.  I vary times maybe 1/2 hour.  As long as you keep it in your bloodstream I think it is fine.  I set my iPhone to remind me everyday.  I do not want to miss a dose.  Good Luck   Maybe you will have minimal side effects as well.
Title: Re: Morning or evening?
Post by: jakas on December 10, 2015, 05:13:26 am
I hope so.
I have been approved for 12 weeks Harvoni but with a score of F4 I dont know if the doc will add ribavirin after a while. He wanted to do a biopsy to check for cirrhosis BUT I refused.
I have not had an alcoholic drink for 13 years so free of the booze.
He will check the bloods after the initial 4 weeks and do an MRI scan.
But what I am confused is how my Fibroscan score from 14.8 kpa. shot to 26 + in six months time.
Title: Re: Morning or evening?
Post by: Lynn K on December 10, 2015, 10:21:24 pm
Hi jakas

Harvoni for 12 weeks is the recommend treatment for most per the prescribing information sheet. For treatment experienced patients with cirrhosis the recommendation is 24 weeks Harvoni or 12 weeks with ribavirin as an option to the 24 weeks.

https://www.gilead.com/~/media/Files/pdfs/medicines/liver-disease/harvoni/harvoni_pi.pdf

Genotype 1
Treatment-naïve with or without cirrhosis 12 weeks*
Treatment-experienced** without cirrhosis 12 weeks
Treatment-experienced** with cirrhosis 24 weeks†

* HARVONI for 8 weeks can be considered in treatment-naïve genotype 1 patients without cirrhosis who have pre-treatment HCV RNA less than 6 million IU/mL [see Clinical Studies (14.2)].

**Treatment-experienced patients include those who have failed a peginterferon alfa + ribavirin based regimen with or without an HCV protease inhibitor.

† HARVONI+ribavirin for 12 weeks can be considered in treatment-experienced genotype 1 patients with cirrhosis who are eligible for ribavirin [see Clinical Studies (14.2)].

Not sure why your doctor wanted to do a biopsy to check for cirrhosis. Your fibroscan on December 8th confirms F4 cirrhosis.

As far as how it could change in 6 months, my understanding the fibroscan is less precise in the mid ranges but a good indicator of advanced liver damage. The devise is also somewhat dependent on the operator. I suppose it is possible you were actually higher in April.

I doubt you will be adding ribavirin being treatment naive as that is not what the prescribing information recommends.

Good luck on treatment
Lynn
Title: Re: Morning or evening?
Post by: jakas on December 11, 2015, 12:49:41 am
Thanks, I really dont want that ribavarin. Being treatment naive and a viral load less than 1 million I think I should be fine with 12 weeks of Gileads Harvoni.