Is gallon of water daily really the way to go?

[elias]

I keep reading here that its suggested to drink as much as a gallon of water daily while on these meds.

Is that to mitigate side effects?

Or is it actually to make the meds more effective?

I've read nothing like this apart from the Forum. What is this based on?

Personally, I havent found it helps me with sides. Some here say it does. So of course, that's a good idea in that case

But I also wonder how good an idea it is to dilute the level of the meds in the blood, and if hydrating to such a large degree might be diluting it some? This is  bit worrisome..

[FutureThinker]

Hi Elias, I completed my Harvoni treatment in May.  There isn't a certain volume for one to drink, i.e., 8 cups or a gallon / day, but you want your urine to be pale yellow.  You are right that drinking too much water can be detrimental, so it's difficult to say just how much one should drink. Go by the color.

Since you're taking Epclusa, perhaps this medication won't make you as thirsty as the Harvoni.  But I did find the increased water intake to help avoid headaches and constipation, and I was more thirsty than usual.

Take care, FT

[Lynn K]

My doctors office advised just to be properly hydrated as it can help with the mild headaches some experienced.

Properly hydrated is as was said your urine should be pale yellow. This is what everyone should be doing. Any excess fluid is urinated out it does not dilute your blood.

That being said it is possibke to drink too much fluid there was an incident a couple of years ago involving a contest on a radio station the winner was the one who could drink the largest amount of water in the shortest time. One person died as a result of water intoxication.

http://articles.latimes.com/2007/jan/14/local/me-water14

So there is such a thing as way too much water.

This is the recommendation from the Mayo Clinic

http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/water/art-20044256

"How much water do you need?

Every day you lose water through your breath, perspiration, urine and bowel movements. For your body to function properly, you must replenish its water supply by consuming beverages and foods that contain water.

So how much fluid does the average, healthy adult living in a temperate climate need? The Institute of Medicine determined that an adequate intake (AI) for men is roughly about 13 cups (3 liters) of total beverages a day. The AI for women is about 9 cups (2.2 liters) of total beverages a day.

What about the advice to drink 8 glasses a day?

Everyone has heard the advice, "Drink eight 8-ounce glasses of water a day." That's about 1.9 liters, which isn't that different from the Institute of Medicine recommendations. Although the "8 by 8" rule isn't supported by hard evidence, it remains popular because it's easy to remember. Just keep in mind that the rule should be reframed as: "Drink eight 8-ounce glasses of fluid a day," because all fluids count toward the daily total."

[elias]

Thank you Lynn and Future Thinker for detailed replies.

If all fluid intake including juices and soups are counted, I'm getting enough without adding much "pure water"

It does make me wake up often to go to the bathroom if I try to add a few  pints of water. For some odd reason I don't comprehend, other fluids don't  keep waking me as much. I have little in the way of headaches with Epclusa unless there's sleep loss.That's been a way out-of-control side effect of Epclusa for me. Trying to adhere to the 4 litres a day I've seen advised here does seem to make that worse. I'll try to use more juices and soups then

And my urine has been pale colored throughout this..regardless

[Lynn K]

And the article from the Mayo Clinic did say an adult male only needs 3 liters of fluid while a female only needs 2.2 liters. So you really don't need a gallon aka 4 liters you only need 3 liters

[Mw2324]

Elias,
  I am just curious in asking you, does the medication make you thirsty or do you consume water just because it's recommended? For me, I was so thirsty all the time I had no choice. I didn't drink because it was suggested, I had to. Just wondering. Thanks.

[elias]

Hi Mw:

No, the Epclusa doesn't make me thirsty at all.

  Some have said Harvoni had that effect. and I  know youve written that Epclusa does make u thirsty, so clearly increasing drinking is a good idea for you

What i needed clarification on here was if the recommendation I keep reading about to increase water is for side effects or to make the meds more effective. Seems from what I read here is that it has  little or nothing to do with medication effectiveness --positive or negative--and everything to do with side effects

[Mw2324]

Thank you for answering, I guess this just goes to show how everyone is affected differently. I don't think the amount of water intake really changes the efficacy of the meds. Everything I've read is like you've mentioned, to keep side effects at bay. Whether that works or not, I can't say but I definitely never drank a gallon of water in one day. 4 to 5 bottles a day was my normal. Hope you are feeling well.

[elias]

It's common thing about side effects that some dont show up in the clinical trial but only later when the meds are "in the wild" people report new SE's. Somehow that's supposed to be reported so that future product descriptions should include those new ones

I'm a bit disappointed in Gilead's Onward program  which I'm subscribed to, that they don't ask about this. Seems would be a good venue for them to learn more from us about those

[Mw2324]

I agree. I'm also subscribed. Not even my Dr asked about my side effects but I don't think he really cared either.

[andrew j]

I just drank however-much I felt like drinking.
That turned out to be quite a lot, because Harvoni has such a dehydrating effect (as FT said somewhere, recently).
I had got used to drinking quite a lot anyway, because I found it helped with managing the side-effects of Hep C.

I think our bodies are really good at self-regulating.

[FutureThinker]

Good morning, all -- I should have included in my post above that I had never been good about hydration, all my life.  I've never drank the "recommended" # cups of water, so when I knew I was finally going to get treatment w/ Harvoni and read the recommendations, that was my cue that I was going to need to step up on the water.  And, I felt the dehydrating effects very quickly, so between my poor history w/ adequate hydration and the medication, I increased my intake religiously to (3) 16.9 oz bottles/day, and have continued close to that even after treatment -- I feel better with it! So it turned out to be a good habit for me post treatment.  FT

[andrew j]

Yes.

[elias]

Might be good habit to cultivate in terms of liver health in general, especially for those with significant fibrosis. Just speculating here.

[andrew j]

I think it lowers toxicity.
That's a bit of a no-brainer, isn't it?!

I've found that drinking plenty of water really helps if I'm feeling wound-up or frazzled.
It can, quite literally, return me to sanity!

I generally don't eat breakfast; I sort-of drink water instead.
(But I drink plenty throughout the day, anyway).

[Gaj]

Might be good habit to cultivate in terms of liver health in general, especially for those with significant fibrosis. Just speculating here.

Like FT I was never very good about hydration, I only drank when I was noticeably thirsty and water was that stuff fish swam in. 

When I was diagnosed 5 years ago my specialist recommmended that to assist my liver I keep myself well hydrated at all times including the advice about urine being pale yellow. I followed his advice and regular glasses of water (or other suitable fluids) through the day have become a habit that I can feel helping my health now and no doubt into the future. I did find that increasing my water intake a bit more than usual during treatment helped compensate for the meds and any sides I felt.

[KimInTheForest]

I drank 1/2 gallon of water daily while on treatment (8 x 8-oz glasses). I drank that much water in addition to the milk, juice, tea I was drinking. My pee was pale yellow but did not turn clear on that amount of fluids. (If your pee is clear, you are drinking too much.)

I found treatment quite dehydrating, but then I had ribavirin along with the Harvoni, and I think ribavirin is especially dehydrating. I weigh 120 lbs. A bigger person may need more water. I agree with (and followed) the advice about drinking half your body weight in pounds... converted to ounces of water... So 1/2 x 120 lbs = 60 oz of water daily. I was drinking 64 oz.

I found that staying well hydrated on treatment made me feel a lot better.

kim

[Lynn K]

 I read somewhere that as we age we are less aware of thirst and tend not to drink enough water so the drink if you are thirsty may not work that well for older adults