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Author Topic: Stribild (QUAD) and Food  (Read 3901 times)

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Offline Scarnes46

  • Member
  • Posts: 3
Stribild (QUAD) and Food
« on: February 20, 2013, 04:06:10 PM »
I have been on Stribilld for a little over a week now. 

So far this pill is awesome! I have had stronger side effects from vitamins! 


I am trying to get to the point where I take my pill with breakfast.  Right now I am gettng a very strong brain fog for about 4 hours after I take the pill.  I hope that this goes away with time.

Soooo... I am taking it now between 3 to 4 am after first sleep but before second sleep

http://en.wikipedia.org/wiki/Segmented_sleep

Stribild is really boosted by a high fat meal. 

Relative to fasting conditions, the administration of single dose STRIBILD with a high fat meal (~ 800 kcal, 50% fat) increased the mean systemic exposure of elvitegravir and tenofovir by 87% and 23%, respectively.

The issues is trying to find a healthy 400+ calorie 50% fat snack to eat when taking the pill at this time.

Any suggestions?


diagnosed 1/14/13
VL 94,000
CD4 411
CD4%  21%

Offline Jeff G

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  • How am I doing Beren ?
Re: Stribild (QUAD) and Food
« Reply #1 on: February 20, 2013, 04:21:19 PM »
Hi Scarnes . I have moved your topic into the suitable forum and removed the same post in from another board . Its not necessary to post the same topic in more than one forum . Thanks .   

Offline texaninnyc87

  • Member
  • Posts: 247
Re: Stribild (QUAD) and Food
« Reply #2 on: February 20, 2013, 05:01:55 PM »
I am also on stribild. The "fog" goes away. I've been on it for a month and a half now. after 3 weeks my VL went from 129,000 to 80 and my cd4 went from 280-350 with a percent increase of 6 (from 20%-26%). super effective!

I had never heard about the high fat boost. I take mine with breakfast every day, during the first few weeks i found that working out about an hour i took it helped with the fogginess. I usually take mine with eggs and toast or yogurt, mixed with protein powder and flax cereal (if im going to be working out). Both of these barely meet 400 calories but the effectiveness of the pill remained strong so i wouldnt worry too much.
Dxd: 9/11/12
Blot confirmed: 11/12
12/12 cd4: 280 (20%) vl: 129,000
1/13 $tribild
2/13 cd4: 350 (26%) vl: 80
4/13 cd4: 510 (29%) vl:: 35
6/13cd4 350 (31%) vl: 21
9/13 cd4 492 (30%) vl: ud
12/13 cd4 846 (36%) vl: 100
1/14 cd4 480 (31%) vl: UD
3/14 cd4 650 (33%) vl: UD
6/14 cd4 410 (35%) vl: UD
9/14 cd4 439 (38%) vl: UD

Offline Scarnes46

  • Member
  • Posts: 3
Re: Stribild (QUAD) and Food
« Reply #3 on: February 20, 2013, 09:39:10 PM »
Hi Tex,

It is buried deep in the prescribing information packet that comes with the drug.  That giant thin piece of rice paper that folds out to poster size.

Section 12.3  Pharmacokinetics, Effect of Food on Oral Absorption.  Pg 25.

Here is the link to the PDF of the doc.   :)

https://www.stribild.com/Content/pdf/stribild_prescribing_information.pdf

Thanks

Steve

Offline texaninnyc87

  • Member
  • Posts: 247
Re: Stribild (QUAD) and Food
« Reply #4 on: February 20, 2013, 09:59:44 PM »
Look at that! That percentage increase is intense. Theres no way I could take it with 800 calories! It is rare that eat even 1500 calories on a given day, much less when i first wake up. I talked with my doctor and we decide morning was the best time for me to take it because it is the only time of the day where i consistently eat. I often dont really eat lunch or dinner but snack lightly throughout the day. The only time i even come close to an 800 calorie meal is probably when i eat out, which is very rare. I'll make sure to talk to my doctor about this. The pill seems to be working remarkably well for me, but it is kind of worrying that I'm not getting the most I can out of it.

Thanks for providing that link!
Dxd: 9/11/12
Blot confirmed: 11/12
12/12 cd4: 280 (20%) vl: 129,000
1/13 $tribild
2/13 cd4: 350 (26%) vl: 80
4/13 cd4: 510 (29%) vl:: 35
6/13cd4 350 (31%) vl: 21
9/13 cd4 492 (30%) vl: ud
12/13 cd4 846 (36%) vl: 100
1/14 cd4 480 (31%) vl: UD
3/14 cd4 650 (33%) vl: UD
6/14 cd4 410 (35%) vl: UD
9/14 cd4 439 (38%) vl: UD

Offline Scarnes46

  • Member
  • Posts: 3
Re: Stribild (QUAD) and Food
« Reply #5 on: February 20, 2013, 10:42:22 PM »
I know! I don't eat like that either.  I mainly eat fresh unprocessed organic foods.  Fruits nuts whole grains veggies and cheese.  I dont know if any of my meals would ever hit that 800 calorie number.

For now it is a Trader Joe's European style bread with big slabs of brie and a couple of slices of prosciutto for flavor but I am struggling to find another high fat alternative.

Offline oksikoko

  • Member
  • Posts: 680
  • Writing the congressman again
Re: Stribild (QUAD) and Food
« Reply #6 on: February 21, 2013, 02:28:52 AM »
Soooo... I am taking it now between 3 to 4 am after first sleep but before second sleep

http://en.wikipedia.org/wiki/Segmented_sleep

You sleep on Stribild? Wowsa! I've been on it since 12/14/2012. I've had about 7 hours of sleep since then, so I can't complain. ;)

Kidding. Mostly. I love that you read the PDF, though. I thought I was the only one, but I devoured it when I realized the doctor had told me nothing about this drug.

Good luck, and congrats on the low side-effect profile. I can't say the same, but it's better than the alternative. ;)
Code: [Select]
2013-10-03:                ☣ VL (?) off treatment ☣ CD4 (?) off treatment
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

If no one complains, nothing will ever change.

Offline Reishi

  • Member
  • Posts: 20
Re: Stribild (QUAD) and Food
« Reply #7 on: May 30, 2013, 02:50:43 AM »
The answer is very simple:  nuts or avocados.  Both contain healthy fats.  If you're taking your doses during the middle of the night, then a trail mix loaded with macadamia nuts would be a good idea.  They're high in good fats and should be easy to digest.

Incidentally, when I began taking Stribild 3 weeks ago, I was eating guacamole every day for several days.  This was before I was even aware that taking Stribild with fatty foods increases its absorption.

Personally, I'm not too concerned about the fat content of my meals.  The important thing is to take the meds with something.  Any food is better than nothing, is my way of thinking.

Here are the stats the OP was referring to:

http://www.drugs.com/food-interactions/cobicistat-elvitegravir-emtricitabine-tenofovir,stribild.html

Offline oksikoko

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  • Posts: 680
  • Writing the congressman again
Re: Stribild (QUAD) and Food
« Reply #8 on: May 30, 2013, 03:23:54 AM »
Scroll fail. I replied to this reply thinking it was another reply to my reply from February.

I'll leave it because the gods don't like deletion, but disregard the fact that I sound annoyed. I'm never annoyed. I just write that way.

Lee

Original below:

You're replying to a thread from February. ;)

I'm aware that people are *supposed* to eat with it. People are supposed to do a lot of things.

I've read the Stribild 'handbook'. I'm pretty much a veteran at this point since I was diagnosed about 50 days after it became available and went on it immediately. I don't generally eat with it. I'm doing fine - undetectable, CD4 of 1123. Everyone else should make their own decisions as to what and when to eat. If my numbers change, I'll consider eating with it.

Sincerely,
Lee
« Last Edit: May 30, 2013, 03:31:10 AM by oksikoko »
Code: [Select]
2013-10-03:                ☣ VL (?) off treatment ☣ CD4 (?) off treatment
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

If no one complains, nothing will ever change.

Offline Reishi

  • Member
  • Posts: 20
Re: Stribild (QUAD) and Food
« Reply #9 on: May 30, 2013, 09:24:30 PM »
Yeah, my reply was to the OP, who didn't seem to get the answer s/he was looking for.  Sorry if I didn't make that clear.

I'm not a fanatic about taking it with food right that very second, but at least I try to make sure I have it with a snack.  Also, if I ate an hour before my medication time and my stomach still feels full, then I consider that "with food".

Offline thepostergirl

  • Member
  • Posts: 29
Re: Stribild (QUAD) and Food
« Reply #10 on: May 31, 2013, 07:00:54 AM »
I've actually asked my doctor about food absorption and my medication and the advice my doctor gave me was to eat just a little something - pretty much anything i want because that's the way stribild metabolizes in the system. High fatty foods aren't exactly necessary - just eating something and then taking your medication works well. It took me less than 6 months to become undetectable and I have no other side affects from this medication. Good luck - a lot of people have already given you some great advice~
Diagnosed : October 2012
CD4 count high
Viral load 19,600
Started Stribild
Viral load is now undetectable

Offline texaninnyc87

  • Member
  • Posts: 247
Re: Stribild (QUAD) and Food
« Reply #11 on: June 08, 2013, 12:17:55 AM »
ive started taking it with a spoonful of peanut butter when im in a rush or too lazy to make a meal. very high in fat, and also yum
Dxd: 9/11/12
Blot confirmed: 11/12
12/12 cd4: 280 (20%) vl: 129,000
1/13 $tribild
2/13 cd4: 350 (26%) vl: 80
4/13 cd4: 510 (29%) vl:: 35
6/13cd4 350 (31%) vl: 21
9/13 cd4 492 (30%) vl: ud
12/13 cd4 846 (36%) vl: 100
1/14 cd4 480 (31%) vl: UD
3/14 cd4 650 (33%) vl: UD
6/14 cd4 410 (35%) vl: UD
9/14 cd4 439 (38%) vl: UD

Offline Betelgeuse

  • Member
  • Posts: 163
Re: Stribild (QUAD) and Food
« Reply #12 on: June 28, 2013, 06:34:46 PM »
Does this mean that taking this medication on an empty stomach will render it useless? 
04/19/11 - Diagnosed positive
04/29/11 - CD4 188 @ 12.5% / VL 18k
05/03/11 - CD4 171 @ unk% / VL 7k
06/04/11 - Start Truvada/Isentress
07/11/11 - CD4 not tested / VL UD
09/07/11 - CD4 252 @ unk% / VL UD

Offline oksikoko

  • Member
  • Posts: 680
  • Writing the congressman again
Re: Stribild (QUAD) and Food
« Reply #13 on: June 28, 2013, 09:27:40 PM »
Does this mean that taking this medication on an empty stomach will render it useless? 

No, it will not be rendered useless, but two of the components of Stribild will be absorbed by the body in greater amounts if taken with certain types of food. Elvitegravir, the integrase inhibitor, seems particularly affected by food, more so with a fattier meal than with a light meal. Tenofovir is affected by meals, but the fat content seems to matter significantly less. I'm taking this information from the link provided by Reishi, paraphrased here:

When Stribild was given with a light meal (approximately 373 kcal; 20% fat), bioavailability of elvitegravir and tenofovir increased by 34% and 24%, respectively, relative to fasting conditions. When administered with a high-fat meal (approximately 800 kcal; 50% fat), it increased by 87% and 23%, respectively, relative to fasting conditions. The changes to cobicistat and emtricitabine, the other two components of Stribild, were not clinically significant with either meal.

I generally don't eat with my pill, but Stribild still took me to from 136,000+ to undetectable between readings. Would I do better if I followed instructions? Possibly. Or possibly my particular chemistry is suited to a lower dose of elvitegravir and tenofovir. Individual mileage may vary. Results not guaranteed.
Code: [Select]
2013-10-03:                ☣ VL (?) off treatment ☣ CD4 (?) off treatment
2013-10-03:                ☣ VL (=) undetectable ☣ CD4 (+) 1105
2013-05-23:                ☣ VL (=) undetectable ☣ CD4 (-) 945
2013-02-25:                ☣ VL (-) undetectable ☣ CD4 (+) 1123
2012-12-16: Enter Stribild
2012-11-20: HIV+           ☣ VL (→) 132,683      ☣ CD4 (→) 920
2012-04-01: HIV-
Dates in this signature file conform to ISO 8601. ;-)

If no one complains, nothing will ever change.

 


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