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Author Topic: Anyone have trouble using a PPI and Harvoni  (Read 7677 times)

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Offline atomic dog

  • Member
  • Posts: 160
Anyone have trouble using a PPI and Harvoni
« on: March 26, 2015, 10:59:24 pm »
I was by my pharmacist that it's OK to take omeprazole with Harvoni if fasting (I usually eat within 30 minutes) and that seems consistent with what I've read elsewhere (though Harvoni needs an acidic environment to be fully effective). Since I am still at detected levels after 5 weeks I wonder if I should stop the PPI. Any one have issues that led to adjusting their PPI meds?
Infected 1969, dirty needle
Geno 1a
Stage 2 fib, some necrosis
TX naive
1/29/15 ALT61; AST43
2/16/15 Started Harvoni; VL 1.5 m;
2/19/15 ALT40; AST24
2/29/15 ALT29; AST25
3/9/15 ALT28; AST25; 
3/9/15 < 20 IU/mL (3 wks) HCV RNA remains 'detected'
3/24/15 ALT30; AST25;
3/24/15 <20 IU/mL (5 wks) HCV RNA
4/10/15 <20 IU/ml (7 weeks) HCV RNA
4/20/15 ALT36; AST27
4/20/15 UND
5/11/15 UND (EOT); ALT33; AST25
6/11/15 UND; ALT 34; AST 29
8/14/15 UND
11/15/15 SVR, 24-wk EOT

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,543
  • Get tested, get treated, get cured, fight Hep c!
Re: Anyone have trouble using a PPI and Harvoni
« Reply #1 on: March 27, 2015, 03:33:44 am »
The slightly detected doesn't really mean much as long as you had a significant drop in viral load. The only test that matters is the 12 week post treatment.

That being said as the prescribing information says you can take your PPI simultaneously with Harvoni on an empty stomach and eat at some time later so it really should not be a problem.

For me with my treatment history my nurse suggested to not take my Prilosec if at all possible (I have a hiatal hernia and GERD) so instead when I am going to sleep and the acid is in my throat burning so I can't sleep I chew a tums and drink some water which by then is many hours away from the time I would be taking Harvoni. So basically it has been a long burning 18.5 weeks with 5.5 to go.

So you can per the prescription keep doing what your doing or suffer for what ever time you have left until EOT. Whatever you think you need to do if it would make you feel better to skip the PPI if you can or just keep taking exactly per the instructions.

Or you can ask your doctor. I would think you would have had the PPI discussion before you started treatment. What did they say then?

Good luck on treatment
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline atomic dog

  • Member
  • Posts: 160
Re: Anyone have trouble using a PPI and Harvoni
« Reply #2 on: March 27, 2015, 10:09:46 am »
The slightly detected doesn't really mean much as long as you had a significant drop in viral load. The only test that matters is the 12 week post treatment.

That being said as the prescribing information says you can take your PPI simultaneously with Harvoni on an empty stomach and eat at some time later so it really should not be a problem.

For me with my treatment history my nurse suggested to not take my Prilosec if at all possible (I have a hiatal hernia and GERD) so instead when I am going to sleep and the acid is in my throat burning so I can't sleep I chew a tums and drink some water which by then is many hours away from the time I would be taking Harvoni. So basically it has been a long burning 18.5 weeks with 5.5 to go.

So you can per the prescription keep doing what your doing or suffer for what ever time you have left until EOT. Whatever you think you need to do if it would make you feel better to skip the PPI if you can or just keep taking exactly per the instructions.

Or you can ask your doctor. I would think you would have had the PPI discussion before you started treatment. What did they say then?

Good luck on treatment

Quote
Thanks. Yes, my doctor said the standard, that I can take the PPI with the Harvoni. I,m just trying to figure out if I'm doing something wrong. Why didn't your doctor switch you switch you to a PPI? Just curious.
« Last Edit: March 27, 2015, 11:00:34 am by atomic dog »
Infected 1969, dirty needle
Geno 1a
Stage 2 fib, some necrosis
TX naive
1/29/15 ALT61; AST43
2/16/15 Started Harvoni; VL 1.5 m;
2/19/15 ALT40; AST24
2/29/15 ALT29; AST25
3/9/15 ALT28; AST25; 
3/9/15 < 20 IU/mL (3 wks) HCV RNA remains 'detected'
3/24/15 ALT30; AST25;
3/24/15 <20 IU/mL (5 wks) HCV RNA
4/10/15 <20 IU/ml (7 weeks) HCV RNA
4/20/15 ALT36; AST27
4/20/15 UND
5/11/15 UND (EOT); ALT33; AST25
6/11/15 UND; ALT 34; AST 29
8/14/15 UND
11/15/15 SVR, 24-wk EOT

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,543
  • Get tested, get treated, get cured, fight Hep c!
Re: Anyone have trouble using a PPI and Harvoni
« Reply #3 on: March 27, 2015, 09:19:16 pm »
Hi
If you are following the prescription instructions, you doctors instructions and the pharmacists why would you be concerned that you are doing something wrong?

Not sure what you mean switch me to a PPI? Prilosec (aka Omeprazole) is a PPI. I am opting to not take the risk and suffer for 24 weeks with my chronic heartburn because I am a 3 time interferon based null responder, Sov / Oly relapser, GT 1a, with cirrhosis for over 7 years.

I expect I probably could have done the same as you are. Just take the Prilosec per the instructions and it would not change the outcome of my treatment. But as I will be again running out of options if this does not work I just did not want to even take the very small risk.

We also added Ribavirin to my treatment after I started. Treating for 24 weeks of Harvoni and adding on later 15 weeks of 1000 mg ribavirin is not really a standard protocol. But should I fail again what options do I have left and how much time before my liver might fail.

You should have no worries being GT 1a and only F2 treat naive you will be fine.

There has been some information posted here about even people with results like less than 15 detected at EOT are still able to make SVR 12 and 24. Some here think the test maybe picking up broken virus pieces or just unable to reproduce few remaining live virus we don't really know here but the point is even if you are slightly detected you can still be cured.

Best of luck
Genotype 1a
1978 contracted, 1990 Dx
1995 Intron A failed
2001 Interferon Riba null response
2003 Pegintron Riba trial med null response
2008 F4 Cirrhosis Bx
2014 12 week Sov/Oly relapse
10/14 fibroscan 27 PLT 96
2014 24 weeks Harvoni 15 weeks Riba
5/4/15 EOT not detected, ALT 21, AST 20
4 week post not detected, ALT 26, AST 28
12 week post NOT DETECTED (07/27/15)
ALT 29, AST 27 PLT 92
24 week post NOT DETECTED! (10/19/15)
44 weeks (3/11/16)  fibroscan 33, PLT 111, HCV NOT DETECTED!
I AM FREE!

Offline atomic dog

  • Member
  • Posts: 160
Re: Anyone have trouble using a PPI and Harvoni
« Reply #4 on: March 27, 2015, 10:59:37 pm »
Thanks Lynn, I always appreciate your consul.
Infected 1969, dirty needle
Geno 1a
Stage 2 fib, some necrosis
TX naive
1/29/15 ALT61; AST43
2/16/15 Started Harvoni; VL 1.5 m;
2/19/15 ALT40; AST24
2/29/15 ALT29; AST25
3/9/15 ALT28; AST25; 
3/9/15 < 20 IU/mL (3 wks) HCV RNA remains 'detected'
3/24/15 ALT30; AST25;
3/24/15 <20 IU/mL (5 wks) HCV RNA
4/10/15 <20 IU/ml (7 weeks) HCV RNA
4/20/15 ALT36; AST27
4/20/15 UND
5/11/15 UND (EOT); ALT33; AST25
6/11/15 UND; ALT 34; AST 29
8/14/15 UND
11/15/15 SVR, 24-wk EOT

 


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