Question
What food shall I eat with my combination?
22 November 2009. Related: All topics, Drug interactions.
Hi.
I actually have a couple of questions relating to my combination of ritonavir/darunavir and Truvada.
I know that my drug combo needs to be taken with or after food, but why is this the case?
Does “with food” mean a large meal, or can the combo be taken with a packet of crisps/chocolate bar?
I have read that the drugs are more effective with a high-fat meal, but is it just as safe to eat a low-fat meal?
My viral load has been undetectable for almost a year now, and I am pretty much spot on with my adherence. I guess I just want to have a greater understanding of how the drugs work because I get quite anxious if I am late with a dose or don’t have a big meal… I’m trying to lose a little weight, so want to minimise my fat intake, and wanted to know if it was safe to do this with my current drug regime.
Thanks so much for your help.
Answer
Some medicines need to be taken with food, so that their concentration reaches the concentration necessary to suppress the virus. Both tenofovir (one of the compounds of Truvada) and darunavir need to be taken with food.
When it comes to darunavir, you can take it either with a heavy meal, but also a light snack is perfectly OK.
Tenofovir is more difficult as the recommendations in Europe and the US differ. Although in the US you can take Truvada with or without food, in Europe the recommendation is still to take with food. This difference comes because the food interaction (food increases tenofovir levels by about 30%) was only discovered after the main trials were well underway. US and European regulatory agencies interpreted the results differently.
There is a very detailed reply to a question on tenofovir and food here.
Hope this helps.
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