Originally published July 1, 2015
I was recently looking on Facebook and the topic
was antacids and Proton Pump Inhibitors. It was interesting because
everyone had a different take on how and when to take them. As a
result I thought I would talk about what they are, when it is safe to
take them and a couple of other common topics such as—pregnancy
categories and herbal supplements.
The current standard of care for treating hepatitis C by genotype includes:
Genotype 1: Harvoni (sofosbuvir/ledipasvir) and Viekira Pak with and without ribavirin
Genotype 2 and 3: Sovaldi (sofosbuvir) plus ribavirin
Genotype 4: Sovaldi (sofosbuvir) plus pegylated interferon and ribavirin
The drugs listed above were approved by the Food
and Drug Administration (FDA). The approval process went through
vigorous testing that included testing to find out what type of other
drugs (drug-drug interactions) affected the absorption of the HCV
medicines into the blood stream. This could change how well these
drugs work and affect cure rates. This includes herbs since these can
be considered a type of medicine. It is important to remember that
herbs are not regulated.
• Harvoni/Viekira Pak:
Proton Pump Inhibitors are drugs that work by reducing the
amount of stomach acid made by glands in the lining of your stomach.
The package label specifically lists omeprazole (Priolsec)—talk with
your medical provider if you take this type of medication.
Check with your medical provider if you take any acid reducing
agents (antacids). There are specific times you can and can not take
• Herbal Supplements:
Harvoni/Sovaldi/Viekira Pak: Do not take St. John’s wort.
Note: People who are taking any
protease inhibitor (HIV or HCV protease inhibitor) should not take St.
John’s wort). People taking Olysio should not take the herb Milk
Harvoni, Sovaldi and Viekira Pak are classified as Pregnancy B
drugs. This means that there have been no studies in humans and that
they should only be used during pregnancy if the potential benefit
justifies the potential risk to the fetus or if needed.
Ribavirin is a Pregnancy X drug and as such
pregnancy has to be avoided. Women of child bearing potential and
their male partners can not receive ribavirin unless they are using two
forms of effective contraception during treatment with ribavirin and
for six months after treatment has concluded. Women should have a
pregnancy test before starting treatment, during treatment and the six
month period after treatment.
Comment: If a woman is
contemplating pregnancy most medical providers recommend HCV treatment
first and starting a family afterwards. Talk with your medical
provider about your options.
HCV Treatment FDA-Approved Prescribing Information:
Labels: antacids, patients first, pregnancy and treatment, proton pump inhibitors