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Author Topic: Morning or evening?  (Read 7442 times)

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Offline mrl914

  • Member
  • Posts: 16
Morning or evening?
« 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?

M/68 yr
Genotype1b
1985 Diagnosed acute non a/non b
1992 Diagnosed chronic HCV
1993 Interferon monotherapy failed
June 2015 ALT 73 (0-44)
June 2015 AST 94 (0-40)
June 2015 HCV RNA 3.1 million
Nov 2015 ALT 76 (12-72)
Nov 2015 AST 113 (19-55)
Nov 2015 HCV RNA 1.2 million
Fibroscan 10 (F2-3)
Harvoni 12 wks - start date 12/08/15
Jan 2016 ALT 18 (19-72)
Jan 2016 AST 33 (19-55)
Jan 2016 HCV RNA No Virus Detected
March 2016 ALT 22 (19-72)
March 2016 AST 31 (19-55)
March 2016 HCV RNA No Virus Detected

Offline nxs450

  • Member
  • Posts: 10
Re: Morning or evening?
« Reply #1 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.
Hep-C, geno type 1b
failed Interferon/Ribavirin tx 6/23/2000
start Harvoni 12/6/15

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,543
  • Get tested, get treated, get cured, fight Hep c!
Re: Morning or evening?
« Reply #2 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
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 taliah

  • Member
  • Posts: 19
Re: Morning or evening?
« Reply #3 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.

Offline gnatcatcher

  • Member
  • Posts: 1,372
Re: Morning or evening?
« Reply #4 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
9/29/71 transfusions
HCV genotype 1a
7/09/15-9/30/15 Harvoni

Before treatment:
Viral Load 9,490,582
FibroScan 19.5 kPa [F4]
ALT 262
AST 217
ALP 183

Most recent:
VL still UNDETECTED (SVR 102)
FibroScan 7.6 kPa [F1-2]
ALT 15
AST 20
ALP 85

Offline mrl914

  • Member
  • Posts: 16
Re: Morning or evening?
« Reply #5 on: December 08, 2015, 08:49:11 pm »
Thank you all for your good advice.

10 minutes before lift-off after 30 years.
M/68 yr
Genotype1b
1985 Diagnosed acute non a/non b
1992 Diagnosed chronic HCV
1993 Interferon monotherapy failed
June 2015 ALT 73 (0-44)
June 2015 AST 94 (0-40)
June 2015 HCV RNA 3.1 million
Nov 2015 ALT 76 (12-72)
Nov 2015 AST 113 (19-55)
Nov 2015 HCV RNA 1.2 million
Fibroscan 10 (F2-3)
Harvoni 12 wks - start date 12/08/15
Jan 2016 ALT 18 (19-72)
Jan 2016 AST 33 (19-55)
Jan 2016 HCV RNA No Virus Detected
March 2016 ALT 22 (19-72)
March 2016 AST 31 (19-55)
March 2016 HCV RNA No Virus Detected

Offline The Terminator

  • Member
  • Posts: 21
Re: Morning or evening?
« Reply #6 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

Offline jakas

  • Member
  • Posts: 265
Re: Morning or evening?
« Reply #7 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.
M/57 yrs.
Contracted (Unknown) 10-20-30 yrs back ??
Treatment Naive
Geno 1a&1b
VL  17+ million
ALT 200+, AST 170+
Fibroscan F4 ( 26+ kpa ) on 8th Dec. 2105
Started Tx 11th Dec.2015 ( 12 wks. Gilead Harvoni)
7/1/2016 :Viral Load|<25 UND.
23/1/2016: ALT 34 , AST 35, ALP 143
8 week NO labs done
EOT:03.03.2016 ( 84 pills eaten )
ALT 26, ALP 124, BIL .54
V/L <25 UND E.O.T.
4 weeks E.O.T. V/L UND::: SVR 4
SVR 12 and  SVR 24 on 16/8/16
Fibro 24.5kpa 23/05/16
SVR 63 05/17
Fibro 17.03.2020 kpa 6.3

Offline laublair

  • Member
  • Posts: 22
Re: Morning or evening?
« Reply #8 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.
exposed 1970    Dx  2001  HCV type 1a  Treatment Iferon/RIba 2002  relapsed   On generic harvoni from Australia  Nov 23, 2015   12 wk regimen   F2  recent fibroscan    Have not had blood test since 2009  Colorado, USA   Virus undetected at 4 wks and 4 wks post treatment

Offline jakas

  • Member
  • Posts: 265
Re: Morning or evening?
« Reply #9 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.
M/57 yrs.
Contracted (Unknown) 10-20-30 yrs back ??
Treatment Naive
Geno 1a&1b
VL  17+ million
ALT 200+, AST 170+
Fibroscan F4 ( 26+ kpa ) on 8th Dec. 2105
Started Tx 11th Dec.2015 ( 12 wks. Gilead Harvoni)
7/1/2016 :Viral Load|<25 UND.
23/1/2016: ALT 34 , AST 35, ALP 143
8 week NO labs done
EOT:03.03.2016 ( 84 pills eaten )
ALT 26, ALP 124, BIL .54
V/L <25 UND E.O.T.
4 weeks E.O.T. V/L UND::: SVR 4
SVR 12 and  SVR 24 on 16/8/16
Fibro 24.5kpa 23/05/16
SVR 63 05/17
Fibro 17.03.2020 kpa 6.3

Offline Lynn K

  • Global Moderator
  • Member
  • Posts: 4,543
  • Get tested, get treated, get cured, fight Hep c!
Re: Morning or evening?
« Reply #10 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
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 jakas

  • Member
  • Posts: 265
Re: Morning or evening?
« Reply #11 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.
M/57 yrs.
Contracted (Unknown) 10-20-30 yrs back ??
Treatment Naive
Geno 1a&1b
VL  17+ million
ALT 200+, AST 170+
Fibroscan F4 ( 26+ kpa ) on 8th Dec. 2105
Started Tx 11th Dec.2015 ( 12 wks. Gilead Harvoni)
7/1/2016 :Viral Load|<25 UND.
23/1/2016: ALT 34 , AST 35, ALP 143
8 week NO labs done
EOT:03.03.2016 ( 84 pills eaten )
ALT 26, ALP 124, BIL .54
V/L <25 UND E.O.T.
4 weeks E.O.T. V/L UND::: SVR 4
SVR 12 and  SVR 24 on 16/8/16
Fibro 24.5kpa 23/05/16
SVR 63 05/17
Fibro 17.03.2020 kpa 6.3

 


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