Author Topic: Harvoni and Omeprazole (Read 16541 times)

kate7154 · « **on:** September 28, 2015, 12:49:00 pm »

I am on day three of Harvoni treatment. I have been struggling with acid reflux issues ever since the first of two wretched rounds of interferon w/ riba. I finally had it completely under control with Dexilent 60mg daily. I KNOW I can't take Dexilent, so I switched to Omeprazole (same as prevacid, I think) 20mgs. So far I have been setting the alarm for 4am to take the Harvoni and Omeprazole together on empty stomach and then going back to sleep for a couple hours.

First two days I had regular sides of headache, fatigue, and slight stomach issues...but nothing terrible...just blah. Today I feel really quite good

.

My big concern is if I am taking a gamble with the Omeprazole. Should I just tough it out with NO Acid Control meds? Nurse at Gilead said the way I'm taking it should be fine. I am so worried I will be in that 4-5% who don't clear. Anybody else in this situation who has completed treatment? Should I take the Omeprazole for overall ease of treatment or do without? I don't want to take any chances.. $:-\$

lporterrn · « **Reply #1 on:** September 28, 2015, 01:02:17 pm »

I don't know anything about Dexilent. Harvoni's info re omeprazole says you can take 20 mg or less safely if you are fasting (no food an after taking - 2 to 3 hrs post meal).

Perhaps you will only need to be on it 2 weeks...

Why are you getting up at 4 AM?

kate7154 · « **Reply #2 on:** September 28, 2015, 01:09:21 pm »

I guess 4am is a bit overkill...but I didn't know exactly what "under fasting conditions" meant. I was erring on the side of caution. You say I can take the Harvoni and Omeprazole together two to three hours after eating, but then how long should I wait until I eat again?

lporterrn · « **Reply #3 on:** September 28, 2015, 01:39:54 pm »

Ah. It means you don't take with food. Harvoni you can take anytime, with or without food. So, you could take the omeprezole when you get up, and then eat an hour later (45 mins is probably OK) You can take the Harvoni anytime - with/without the omeprazole. You could even take Harvoni at bedtime - omeprazole has a very short half-life, so that way there would be nearly no interaction. You could also talk to your pharmacist or My Support Path about what they recommend.

To answer your question - in this case, an empty stomach means you don't eat for an hour after you took your prilosec. If you eat, then you wait 3 hrs before taking it and then wait another hour before eating.

kate7154 · « **Reply #4 on:** September 28, 2015, 01:51:33 pm »

Thank you Lucinda,
Now I am more confused, as the nurse at Gilead and "Accredo" Anthem's specialty drug pharmacy said the ONLY way to take Omeprazole was simultaneously WITH the Harvoni on on empty stomach (or under fasting conditions). I wonder if there are stats on responders vs. nonresponders of patients who took acid reducers (PPIs) during treatment.

lporterrn · « **Reply #5 on:** September 28, 2015, 02:04:55 pm »

That is the only way they can legally tell you since that is strictly out of the PI, so go with that. But skip the 4 am wake-up - just take them together an hour before you eat in the moring and you will be fine. (and no, there aren't stats on those conditions) And remember, you can always try getting off the prilosec after 2 weeks - then restart it if your symptoms come back.

kate7154 · « **Reply #6 on:** September 28, 2015, 02:19:46 pm »

Okay, that's what I'll do. My husband thanks you for vetoing the 4am alarm! I think I will take the Omepr. for a few more days until the few sides from Harvoni dwindle (optimistically)... then try without. It will be good for my bones to take a break (ha) from the PPIs too.

lporterrn · « **Reply #7 on:** September 28, 2015, 03:00:02 pm »

Talk to your doc/nurse before stopping on your own, but generally prilosec is taken for 2 weeks, then followed with more 2-week courses when indicated. The short amount of time you may need them shouldn't hurt your bones.

julu49 · « **Reply #8 on:** September 29, 2015, 10:51:58 pm »

So strange that we all seem to get different instructions as to when we take our Harvoni and Omeprazole. I take the "O" for my pancreatic enzymes to work properly. .....daily. I was told to take them at the same time. Also to take the Harvoni any time, with or without food as long as it's the same time every day. I've no idea if there is a correct way, but how I'm doing it is working for me. Undetected at 4 weeks. I have 4 to go on a 12 week stint.

Lynn K · « **Reply #9 on:** September 30, 2015, 04:08:49 am »

The important thing is per the prescribing information if you take ompresole of other PPI proton pump inhibitors like nexium of Prevacid the have to be taken simultaneously on an empty stomach.

As long as you do that you won't interfer with the absorption of the ledipasvir component of Harvoni.

The problem is ledipasvir needs an acidic environment to be broken down so you can absorb the medicine so if you lower your stomach acid you basically won't be getting your full dose of medicine but by taking together you won't cause that because by the time the acid reduction has occurred from the Prilosec the Harvoni will have already been broken down and absorbed into your system.

Good luck
Lynn

lporterrn · « **Reply #10 on:** September 30, 2015, 11:27:40 am »

Thanks Lynn. I realized after I posted my first post that I was so focused on Kate's 4 am alarm, that I was overthinking it, doing half-life calculations, and the rest. Lynn is absolutely right - of course take them together on an empty stomach, wait an hour, and problem solved.

kate7154 · « **Reply #11 on:** September 30, 2015, 12:05:38 pm »

Thanks Lynn and Lucinda!
I am on day five taking the Harvoni and Omeprazole together an hour before I get up proper for coffee/breakfast. I have still had some heartburn breakthrough in the evening, so I chewed a couple tums which helped a little. The reflux has been a chronic condition for years (came close to a "fundoplication" surgery it was so bad). The dexilent was a miracle for me, but so far so good with the lesser dosage of Omeprazole. Doubt I'll try to go without it, unless there is indication that it's messing with the Harvoni. I'm only in my first week of treatment, but I can feel changes in the way I feel... in a good way. I think (hope, pray) it's working. I appreciate this group.
Kate

lporterrn · « **Reply #12 on:** September 30, 2015, 12:16:06 pm »

Great Kate. Lynn's explanation was so clear, and I am glad I didn't blow things by suggesting you could take these separately. My bad!

One thing that helped me with acid is that I switched to a low acid coffee and low acid cold brewing system called Toddy. It makes the best coffee, like French press only easier.

kate7154 · « **Reply #13 on:** September 30, 2015, 12:47:48 pm »

Thank you Lucinda. I gave up coffee for years, but haven't had a problem lately. I don't want to push my luck with just 20mg Omeprazole. I will indeed check out the Toddy coffee system!

julu49 · « **Reply #14 on:** September 30, 2015, 02:44:07 pm »

Thanks, Lynn K. This makes perfect sense to me now.

Lynn K · « **Reply #15 on:** September 30, 2015, 03:32:13 pm »

I have GERD and I have reflux a lot! I opted not to take ompresole and just did Tums as needed when I was in bed trying to sleep with a burning throat.

I was taking Harvoni a 5 pm so taking a Tums at midnight was well away from the Harvoni. The rule for acid reducers like Tums etc is no closer than 4 hours either before or after taking Harvoni.

I'll tell you what though when I finished TX the first thing I did was kiss my package of Prilosec and say "oh how I have missed you" lol that was the hardest thing about treatment for me

Best to all

Keithn8eb · « **Reply #16 on:** October 05, 2015, 01:57:54 am »

I have been taking Omeprazole, the generic for Prilosec, for over 15 years for reflux. I took it around 5pm so it was working "full force" at night when I had my worst problems. When I started Harvoni I was told it needed some stomach acid, so I took Harvoni with my morning meds around 5am. I didn't set an alarm for 5am, I just am normally awake at that time. I am 90 + days post treatment and am still none detected, so I guess my method worked for me - your mileage may vary.

pl1952 · « **Reply #17 on:** November 06, 2015, 08:19:01 pm »

Hi Kate,

I was told to take Omeprazole simultaneously WITH the Harvoni on empty stomach (or under fasting conditions) by both my doctor and I double checked with Gilead. I would take it at 7am and then eat breakfast an hour later. No problems and I'm SVR...

lporterrn · « **Reply #18 on:** November 07, 2015, 10:52:45 am »

pl1952 - you were told correctly
And congrats on your SVR
Care to share your hep story? It extends hope to others...http://www.hepmag.com/hep_stories.shtml

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Author Topic: Harvoni and Omeprazole (Read 16541 times)