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Does Sofosbuvir Interact With Ribavirin?
Question: Hello Doctor,
Thanks for your early reply to my query regarding my Father's Hepatic Encephalopathy.
He was treated for that and he is Good now. After all this we are planning to start sofossbuvir from next week, and my worry is whether he will respond to the treatment because last time when he was taking Interferon85+Ribavarin600(as per the body weight) he was not able to tolerate and dose was decreased to Interferon50. Somehow after some infections he had completed 48weeks and Viral count is still positive.
Now my question is
1) Will he be able to tolerate Sofossbuvir+Ribavarin combination for 24 weeks?
2) What will be the side effects expected from this combination?
3) Is there a chance that Hepatic Encephalopathy can reoccur again?
Latest report :- Diagnosed with Gradeiii esophageal Varices mild congestive Gastropathy Endoscopic banding done.
Thanks for your early reply to my query regarding my Father's Hepatic Encephalopathy.
He was treated for that and he is Good now. After all this we are planning to start sofossbuvir from next week, and my worry is whether he will respond to the treatment because last time when he was taking Interferon85+Ribavarin600(as per the body weight) he was not able to tolerate and dose was decreased to Interferon50. Somehow after some infections he had completed 48weeks and Viral count is still positive.
Now my question is
1) Will he be able to tolerate Sofossbuvir+Ribavarin combination for 24 weeks?
2) What will be the side effects expected from this combination?
3) Is there a chance that Hepatic Encephalopathy can reoccur again?
Latest report :- Diagnosed with Gradeiii esophageal Varices mild congestive Gastropathy Endoscopic banding done.
Brief Answer:
Only side effect can be anemia with sofosobuvir and Ribavarin combination
Detailed Answer:
Welcome back. Good to hear that your father is well now.
I want to know his recent reports of complete haemogram and serum creatinine, and also the reason why the dose of ribavarin was decreased if he had developed decrease in Hb and to what extent while on therapy with Inf and Ribavarin
Sofosobuvir is very safe medicine with minimal side effects, he will tolerate this well. Only problem with this combination of sofo and Riba can be cuased by Riba that is drop in haemoglobin. As the dose of ribavarin was reduced with previous regime of Inf and Riba I can assume that his Haemoglobin was reduced. However the chances of drop in haemoglobin is more with combination of Interferon and ribavarin, that may not be in case of sofo+ Riba combination. So I am not sure completely whether he will be able to tolerate Ribavarin, but it appears that he will do.
Another option is wait for few more months Ledipasvir will be launched in combination with sofosobuvir which is more effective and with minimal side effects. I am not sure but there is new that this combination may come in January 2016 in XXXXXXX You may discuss with your doctor regarding this
Hepatic encephalopathy can recurr but with some precautions chances can be reduced :
1. Make sure that he passes 2-3 stools/ day by titrating the dose of syrup lactulose
2. If he developes any complaint like fever, increase sleep abdominal pain. Take him to doctor as soon as possible
3. Dont give him any medicine for sleep or to relieve anxiety
4. Dont give any medicines without consulting your doctor even pain killers
5. He should be in close follow up of Gastroenterologist as advised by your doctor
6. Give him hygienic diet, more fruits and vegetables, high caloric and high protein diet
Banding is done to prevent bleeding. That may be required every three weekly till the varices are eradicated. Usually in 4 to 5 session the varices are eradicated
I hope I have answered your query and this will help him. Wish him a good health
Only side effect can be anemia with sofosobuvir and Ribavarin combination
Detailed Answer:
Welcome back. Good to hear that your father is well now.
I want to know his recent reports of complete haemogram and serum creatinine, and also the reason why the dose of ribavarin was decreased if he had developed decrease in Hb and to what extent while on therapy with Inf and Ribavarin
Sofosobuvir is very safe medicine with minimal side effects, he will tolerate this well. Only problem with this combination of sofo and Riba can be cuased by Riba that is drop in haemoglobin. As the dose of ribavarin was reduced with previous regime of Inf and Riba I can assume that his Haemoglobin was reduced. However the chances of drop in haemoglobin is more with combination of Interferon and ribavarin, that may not be in case of sofo+ Riba combination. So I am not sure completely whether he will be able to tolerate Ribavarin, but it appears that he will do.
Another option is wait for few more months Ledipasvir will be launched in combination with sofosobuvir which is more effective and with minimal side effects. I am not sure but there is new that this combination may come in January 2016 in XXXXXXX You may discuss with your doctor regarding this
Hepatic encephalopathy can recurr but with some precautions chances can be reduced :
1. Make sure that he passes 2-3 stools/ day by titrating the dose of syrup lactulose
2. If he developes any complaint like fever, increase sleep abdominal pain. Take him to doctor as soon as possible
3. Dont give him any medicine for sleep or to relieve anxiety
4. Dont give any medicines without consulting your doctor even pain killers
5. He should be in close follow up of Gastroenterologist as advised by your doctor
6. Give him hygienic diet, more fruits and vegetables, high caloric and high protein diet
Banding is done to prevent bleeding. That may be required every three weekly till the varices are eradicated. Usually in 4 to 5 session the varices are eradicated
I hope I have answered your query and this will help him. Wish him a good health
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Above answer was peer-reviewed by :
Dr. Prasad
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