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发表于 2018-12-4 11:01 |只看该作者
还想征询一下大家对于服用ETV期间的食物和药物禁忌的问题:
我的医生告诉我服药期间,除了烟酒不能碰以外,动物内脏中的肝脏和肾脏也是不能吃的,其他倒没有提到什么特别禁忌的食物,当然我相信饮食尽量清淡也应该是基本要求。不知道大家还有什么补充?
对于药物禁忌,因为ETV是个长期抗战过程,其中不排除某些情形下必须要服用一些其他药物?一般来说,哪些常用药物不影响ETV的服用?哪些药物必须绝对避免和ETV同期服用?这方面也请教了一下自己的医生,他回答比较模糊,只是说尽量避免。希望大家不吝分享这方面的经验。谢谢!

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发表于 2018-12-4 11:35 |只看该作者
你问的怕不是中医吧,只有中医才会有这样的禁忌。
按现代科学知识,吃的是蛋白质,碳水,等等
如果吃的猪肝鸡肾是安全的食物,并没有这个禁忌。
至于其他药物同吃是否有影响,建议再细读一遍药品说明书,西药一般有啥禁忌都列在说明书上。

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发表于 2018-12-4 15:17 |只看该作者
回复 ematrix 的帖子

我问的不是中医,就是长征医院的缪晓辉教授。肝肾是动物主要的排毒解毒器官,少吃或不吃也是合理吧。就算从现代科学的化学元素的角度去考虑,这类器官会有更多重金属或其他有害物质累积,也是说得通吧。
从化学元素的角度考虑,食品和药物都是由化学元素组成,药物间有禁忌,那么食物间有禁忌也是正常的道理。

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发表于 2018-12-5 02:56 |只看该作者
pourvivre 发表于 2018-12-4 09:56
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我不建议中国人出国移民,把中国劳工的血汗凝成的财富带出来,对不起民族。除非 ...

楼主很幸运,第一个贴子 就有这么高质量的跟贴。围城啊,刚刚获悉好朋友海归后再婚,现在的妻子乙肝未发病,加拿大移民刚批,准备登陆。我说他们还拆腾啥,可人家充满向往!
谢谢Pourvivre 分享。

在国内易过份治疗,出来后相反。

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发表于 2018-12-5 08:41 |只看该作者
本帖最后由 pourvivre 于 2018-12-4 19:59 编辑

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这里是我吃的药的详细信息,你可以找到你需要的信息
(药物相互作用,要点见红色字体)
DIN (Drug Information Number)
02396955 APO-ENTECAVIR 0.5 MG TABLET
How does this medication work? What will it do for me?
Entecavir belongs to a group of medications called antivirals. It is used to treat people with chronic hepatitis B infection and evidence of active hepatitis B virus replication (reproduction). It works by stopping the hepatitis B virus from reproducing. There is no cure for hepatitis B infection. Entecavir can decrease the amount of hepatitis B virus in the body and may reduce the damage done to the liver by the hepatitis B virus.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?
The usual recommended dose for adults and adolescents 16 years of age and older is 0.5 mg once daily. People who have experienced active disease while taking a similar medication called lamivudine may need to take 1 mg once daily. People with reduced kidney function may require a lower dose, as directed by their doctor.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Entecavir should be taken on an empty stomach, at least 2 hours before a meal or 2 hours after a meal. The tablet should be swallowed whole with water.

If you are taking the oral solution, use a measuring device (e.g., an oral syringe or a measuring spoon) that is marked for accurate dosing. You do not need to dilute or mix the oral solution with water before taking your dose.

If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

What form(s) does this medication come in?
Each white, triangular, film-oated tablet engraved "APO" on one side and "0.5" over "ENT" on the other contains 0.5 mg of entecavir. Nonmedicinal ingredients: lactose monohydrate, microcrystalline cellulose, crospovidone, copovidone, and magnesium stearate. The tablet coating contains hydroxypropyl cellulose, hydroxypropyl methylcellulose, titanium dioxide and polyethylene glycol 8000.

Who should NOT take this medication?
Do not take entecavir if you are allergic to entecavir or any ingredients of the medication.

What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
diarrhea
dizziness
drowsiness
fatigue
headache
heartburn
nausea
trouble sleeping
vomiting
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

rash
signs of liver problems, e.g.:
dark urine
diarrhea
loss of appetite
nausea
pale stools
vomiting
weight loss
yellowing of the skin or whites of the eyes
symptoms of infection such as fever, chills, cough, or sore throat
Stop taking the medication and seek immediate medical attention if any of the following occur:

signs of a serious allergic reaction:
difficulty breathing
hives
swelling of the face, lips, eyes, or throat
symptoms of lactic acidosis:
abdominal pain
coldness of arms and legs
dizziness
nausea
shortness of breath
unusual muscle pain
vomiting
weakness
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Cancer: In animal studies, entecavir caused certain types of cancers. It is not known if these results will apply to human beings. Talk to your doctor if you have any concerns.

Hepatitis B transmission: Treatment with entecavir does not reduce the risk of passing on hepatitis B to other people through sexual contact and blood transfer. You should continue to take measures to prevent giving hepatitis B to other people (e.g., using condoms) while taking this medication.

Human immunodeficiency virus (HIV): People with HIV infection should discuss with their doctor how this medication may affect their medical condition. If you are taking entecavir for chronic hepatitis B and are not taking any medications for HIV at the same time, some HIV medications that you take in the future may not work as well to treat HIV. Entecavir has not been studied for the treatment of HIV. Your doctor may test you for HIV before beginning treatment with entecavir. If you think that you might have HIV contact your doctor immediately to get tested.

Kidney function: This medication is removed from the body by the kidneys. If the kidneys are not working properly, entecavir may build up in the body and cause side effects. People with reduced kidney function may need a different dose of the medication. If you have decreased kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Lactic acidosis and enlarged liver: Entecavir can cause a rare but serious condition called lactic acidosis (buildup of lactic acid in the blood) together with an enlarged liver and fat in the liver. If you experience any of the following symptoms, call your doctor immediately:

abdominal pain, swelling, or bloating
dark-coloured urine
diarrhea
fatigue
feeling unwell
light-coloured stools
loss of appetite for several days
nausea
shortness of breath
vomiting
weakness
weight loss
yellow skin or whites of eyes
Your doctor will periodically monitor you and perform laboratory tests to check your liver function.

Lactose intolerance: Entecavir tablets contain lactose. If you have been told that you are intolerant to lactose, contact your doctor before taking this medication.

Liver transplant: The safety and effectiveness of entecavir has not been tested in people who have had a liver transplant. It is not known if entecavir will interact with anti-rejection medications (i.e., cyclosporine, tacrolimus) commonly used after an organ transplant. If you have had a liver transplant, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Stopping the medication: If you stop taking entecavir, your hepatitis B infection could get worse. Take the medication exactly as prescribed by your doctor, and do not stop taking the medication without checking with your doctor first.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if entecavir passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. 'Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children less than 16 years of age.

What other drugs could interact with this medication?
There may be an interaction between entecavir and any of the following:

ganciclovir
[size=15.008px]更昔洛韦是2'脱氧鸟苷酸类似物。在体内首先被磷酸化为[size=15.008px]三磷酸[size=15.008px]活化物,竞争性抑制[size=15.008px]DNA聚合酶[size=15.008px],使病毒DNA延伸终止。
ribavirin 利巴韦林[size=15.008px]([size=15.008px]英语:Ribavirin[size=15.008px],俗称病毒唑[size=15.008px]),是一种[size=15.008px]抗病毒药[size=15.008px],属合成[size=15.008px]核苷[size=15.008px]类药,1970年由ICN制药公司Joseph T. Witkowski合成。对许多[size=15.008px]DNA[size=15.008px]和[size=15.008px]RNA病毒[size=15.008px]有抑制作用,其机理尚不清楚。[size=15.008px]美国食品药物管理局[size=15.008px](FDA)只许可用于配合长效[size=15.008px]干扰素[size=15.008px]治疗[size=15.008px]丙肝[size=15.008px]、[size=15.008px]人类呼吸道融合病毒[size=15.008px](RSV)[size=15.008px][注 1][size=15.008px],和某些[size=15.008px]出血热[size=15.008px](WHO)的治疗。
valganciclovir
缬更昔洛韦[size=15.008px](Valganciclovir)是[size=15.008px]鸟嘌呤[size=15.008px]类似物类[size=15.008px]抗病毒药物[size=15.008px],常用于[size=15.008px]巨细胞病毒感染[size=15.008px]。为更昔洛韦的L-缬氨酰酯。是更昔洛韦的[size=15.008px]前药[size=15.008px],口服后被[size=15.008px]胃肠道[size=15.008px]和肝酯酶迅速转化为更昔洛韦。
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

stop taking one of the medications,
change one of the medications to another,
change how you are taking one or both of the medications, or
leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2018. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Apo-Entecavir


小三男感染36年

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发表于 2018-12-5 11:26 |只看该作者
本帖最后由 chaotianjiao 于 2018-12-5 11:36 编辑

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非常感谢!说得非常详细,也容易理解。

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发表于 2018-12-6 12:08 |只看该作者
有上海的战友么?ETV可以进医保统筹支付吗?我先后开了6盒博路定盒3盒润众,看发票,都是现金支付10%,医保个人账户支付90%,没进统筹支付,有谁熟悉上海医保支付政策的麻烦解释下,谢谢!

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发表于 2018-12-8 21:40 |只看该作者
补记一下11月15日服用恩替前最后一次体检的数据:
肝功能十项:
总蛋白g/L               71     60-83g/L
白蛋白g/L               45     35-55g/L
前白蛋白mg/L         244   180-380mg/L
总胆红素μmol/L      14.1    4.7-24μmol/L
直接胆红素μmol/L   2.6   0-6.8μmol/L
胆汁酸μmol/L         2.3    1.0-10.0μmol/L
丙氨酸氨基转移酶IU/L       42    10-64IU/L
天门冬氨酸氨基转移酶IU/L 28     8-40IU/L
γ-谷氨酰基转移酶IU/L        16     7-64IU/L
碱性磷酸酶IU/L                 82     38-126IU/L

肾功能三项:
尿素mmol/L     5.0      2.5-7.1mmol/L
肌酐μmol/L      93       62-115μmol/L
尿酸μmol/L      293     160-430μmol/L

甲胎蛋白:2.21
2018年11月16日开始服用恩替卡韦进行抗病毒治疗。

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发表于 2018-12-8 21:47 |只看该作者
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检查了病毒量吗?
小三男感染36年

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发表于 2018-12-8 21:57 |只看该作者
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服药前最后一次检查病毒量是9月30日,结果是3.6*10的5次方。
乙肝两对半结果是:
HBsAG >250    <0.05IU/ml
HBsAB  0.66     <10 mIU/ml
HBeAG  0.4      <1 s/co
HBeAB  0.01     >1 s/co
HBcAB  7.51     <1 s/co
2018年11月16日开始服用恩替卡韦进行抗病毒治疗。
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