Drug interactions with harvoni

Harvoni and Alcohol

A Common Question

One of the most common questions we get from our patients is about Harvoni and alcohol. “Can I drink while taking Harvoni?” “What side effects will alcohol cause while on treatment?” “It is okay if I only have one beer?… Right?”.

Here we will address your questions and concerns about the use of alcohol while you’re being treated.

There are some common things between Harvoni and alcohol, but obviously there are more differences in the two. If you decide to drink during treatment, it could be a terrible idea.

So, the only real similarity in the these two drugs is the fact that both of them must make their way through your liver. The major difference is that Harvoni is trying to stop HCV from wrecking your liver, while alcohol accelerates the process of destruction.

Most of the leading organizations in the Hep C community agree that you should not use any amount of alcohol while taking Harvoni. Most doctors will tell you not to consume any while on any medication.

But what if your doctor says it’s okay to have one beer here and there? Now we always tell you to follow the instructions of your doctor, but drinking is one the we advise against.

Just because your doctor says it will be fine in moderation doesn’t mean you should partake. There were many studies done on Harvoni before it’s release, but they were not targeted to test the safety of mixing it with alcohol.

Harvoni Side Effects With Alcohol

Harvoni does come with an array of side effects, some more common than others. But what about side effects that are only caused when drinking during treatment?

As of now, all we know is that alcohol will increase the side effects of Harvoni that all patients could face. Not only will it make them more intense, but the likelihood of having them goes up as well.

The manufacturer of the drug (Gilead Sciences) has no data and never tested for any other effects that alcohol would cause. So we will provide you with some more information so you can make your own informed decision.

Will Treatment Become Less Effective?

Of course we all know that drinking can cause cirrhosis, just like Hepatitis C can. What most people want to know is if it will hinder the effectiveness of treatment.

As mentioned above, clinical trials were not done with alcohol in mind. So all we can go off of is what we do already know about alcohol.

Alcohol does cause dehydration. While fighting off any type of infection, the amount of water in your body plays a significant role. The more water in your body the better.

Alcohol can take stress off your mind, but it does add stress to the liver. Even if you are not cirrhotic, your liver is a key component in keeping your body healthy. It is a wise choice to reduce as much stress to the liver as possible.

Conclusion

Just like there are certain foods to avoid while taking Harvoni, alcohol is something that would be best to avoid too.

Although some have gotten by with drinking beer or wine while taking DAA’s, it’s something you shouldn’t risk.

Even if you don’t have some dangerous unknown side effect from doing it, you do also risk the chance of the medication not working the way it should.

Harvoni cost alone is a good reason not to take the chance. Not only will you put your health on the line by drinking, but you could also waste your money in doing so. The cost of Harvoni in Canada is not cheaper either read more here.

Call our Health Advocate 24/7 at US phone number 858-952-1077, if you have any questions or concerns. You can also fill the form or click on the bubble bottom right.

Having a Beer After SVR

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Nicole Cutler, L.Ac., MTCM, Dipl. Ac. (NCCAOM)® August 29, 2014 After surviving the diagnosis, illness and treatment for Hepatitis C, those who are cured of this illness may once again be faced with a decision to drink alcohol.

The first instruction typically given to anyone diagnosed with Hepatitis C is to abstain from drinking alcohol. This is logical, since Hepatitis C is a viral infection of the liver and alcohol is a known liver toxin. In order to prevent Hepatitis C from escalating to an advanced form of liver disease, those with this infection must squelch any desire to consume a beer, glass of wine or other intoxicating spirit. Completing antiviral therapy and successfully conquering the Hepatitis C virus definitely hinges on a commitment to avoid alcoholic beverages.

However, does the same rigid rule apply after successful elimination of this virus?

The Hepatitis C virus has proven itself to be a formidable foe. Hepatitis C:

  • can persist for several decades in the body without revealing any symptoms despite progressively injuring the liver.
  • can eventually produce vague symptoms like fatigue, depression, joint pain and sexual dysfunction.
  • puts those infected at risk for liver fibrosis, cirrhosis, liver cancer and liver failure.
  • has demonstrated extreme resilience to medical treatment, complicating the campaign to end its destruction.

Treatment and SVR

Today, Hepatitis C antiviral therapy has evolved to consist of a combination of medications taken from 24 to 48 weeks. With triple drug therapy, the success rate of clearing the virus has risen from approximately 50 percent up to 75 percent. However, new pharmaceuticals in development promise to eliminate Hepatitis C in 8 to 12 weeks with a 90 percent or higher success rate.

A successful Hepatitis C outcome is defined as SVR, or sustained virologic response. An SVR is attained when genetic material of Hepatitis C is undetectable six months after therapy is completed. The equivalent of becoming Hepatitis C negative, SVR greatly improves liver function, life expectancy and quality of life.

According to Sanjeev Arora, MD, a professor of internal medicine at the University of New Mexico Hospital Center for Digestive Diseases, “In general, once an SVR is attained (sic), the liver disease progression completely stops.” Although SVR is cause for celebration, becoming Hepatitis C negative does not completely remove the risks of future liver disease complications.

Alcohol and Hepatitis C

There is no doubt that drinking excessive quantities of alcohol harms the liver. A large study published in a 2004 edition of the journal Hepatology clarifies that any amount of alcohol can harm someone with Hepatitis C. Based on this study of 800 people with Hepatitis C, researchers found that, while heavy drinking was linked with more severe liver problems, there was no “safe” level of drinking for people with this virus.

The medical community has recognized that alcoholic beverage consumption accelerates the progression of liver fibrosis with chronic Hepatitis C. The reasons are fourfold. Alcohol:

  1. enhances Hepatitis C viral replication.
  2. increases oxidative stress.
  3. induces cytotoxicity (cell death).
  4. impairs the immune response.

Despite knowing that alcohol fans the flames of liver injury and negatively affects overall health, many who have recently attained SVR are hoping to finally be able to enjoy an alcoholic beverage.

Alcohol After Hepatitis C

All of the reasons given for abstaining from alcohol with Hepatitis C are still valid – even after eliminating the virus from the body. The viral particles may no longer be present, but alcohol will still pose a threat to the liver’s health. During the course of time someone was infected with Hepatitis C, damage to the liver could range from minimal to severe. Those who escaped with little liver damage have a better prognosis than the majority who lost functioning liver cells:

  • The good news is achieving SVR appears to stop the progression of liver disease.
  • The bad news is alcohol consumption injures the liver – thus putting remaining liver cells at risk of damage.

To date, there have not been any comprehensive studies on the effect of alcohol post SVR. Though, having an alcoholic beverage with any level of liver damage is a gamble.

There are several variables in deciding the relative safety in this indulgence:

  1. Liver Disease Severity – Those with liver disease that advanced beyond mild fibrosis are taking a risk by drinking alcohol. After all of the effort invested in defeating Hepatitis C, an occasional glass of wine has the potential to cause the same type of damage as the ousted virus.
  2. Alcohol Dependence – For some with Hepatitis C, abstaining from drinking alcohol is a challenge due to some level of addiction. Returning to its consumption can easily trigger an addiction relapse. Such a relapse can lead to excessive drinking which is dangerous for anyone – especially someone who has a liver recovering from Hepatitis C infection.
  3. Questionable Degree of Liver Damage – After attaining SVR, few physicians will advise a liver biopsy. Thus, it is difficult to determine the degree of liver damage. Because of this uncertainty physicians typically advise those who have beaten Hepatitis C to continue with alcohol abstinence.

Even with all of the evidence just presented, there may be some individuals who have attained SVR from Hepatitis C and still want to drink alcohol. Ideally, this should be discussed with a medical provider to be certain that alcohol won’t jeopardize that person’s health.

Everyone’s ability to handle alcohol is different. Although excessive alcohol consumption is nearly guaranteed to cause liver harm, light drinking (no more than two drinks per week) might be okay for some. On the other hand, a significant amount of liver scarring or other health issue could render having an occasional beer to be a high risk activity.

If you have beaten the Hepatitis C virus and have no detectable liver injury from the virus, then one glass of wine per month is probably okay. However, putting alcohol back into the playing field for anyone else that achieved SVR is risky. To sum up, a tremendous effort was made by those who conquered Hepatitis C – an effort that could be wasted by choosing to consume alcohol, a known liver toxin.

http://cid.oxfordjournals.org/content/early/2013/04/23/cid.cit234.abstract, A risk for hepatocellular carcinoma still persists long-term after sustained virological response in patients with hepatitis C associated liver cirrhosis, Aleman S, et al, Retrieved August 23, 2014, Clinical Infectious Diseases, April 2013.

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