Why should medication be taken daily

Just diagnosed or new to the community
1

Why do we have to take the medication daily and not weekly or monthly. Can something be done about the daily dosage ?

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The current oral medications need to be taken daily because of the half life of the approved drugs. Half life is the amount of time it takes for the drug concentration to reduce by half. The currently approved treatments have relatively short half lives (maybe some of the science experts could give you exact figures), but basically researchers determined that daily dosing is needed to keep the levels of the drug in your system consistent over time.

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Taking the medicine daily is not an issue for me. The painful thing is to have the shots of interferon, it causes serious skin issue for me.:expressionless_face:

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Are you taking both oral medication (Tenofovir?) and Interferon? Why is that if I may ask?

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Hi @Yawson,
Great point raised by @et5656. Similarly, I think we take it daily because the current treatment doesnā€™t have delayed-release or extended-release mechanisms; the medication is slowly released over time into our bloodstream. This means they donā€™t remain longer in our bloodstream because they are quickly absorbed by the body. We donā€™t have such a mechanism with any of our current antivirals, hence the daily recommendation. That is my take on your question. Thanks, Bansah1

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Yes, I agree with this answer to @Yawsonā€˜s great question and just wanted to give a bit more context. When giving medications, we want to avoid any side effects as much as possible (so we canā€™t dose too much at a time) and we want to maintain the levels in the body at a high enough level to make sure it inhibits the virus. So thereā€™s a window that we need to stay within. As soon as we give any medications they are secreted out of the body at a certain rate and we need to replace it while staying in this window.

Itā€™s like rowing a canoe - we want to maintain a certain speed window, not too high not too low. So what we do is time our strokes to match the rate that we are slowed down by the water.

There are new medications for HIV that have been developed where you only need an injection every 6 months/1 year to suppress virus replication. These agents do not not affect Hep B though. There are some researchers who have tried to develop long-acting antivirals for hep B (see here for a review - Long-Acting Treatments for Hepatitis B - PMC ) but I havenā€™t seen much progress. There would be better chance of these sort of treatments being available with greater push for the affected community and showing that thereā€™s real demand for them.

Hope this helps,
Thomas

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Thank you @ThomasTu ! I hadnā€™t heard about the research into long acting HBV antivirals. I will have to read that. That being said, the ones that exist for HIV are given via injection, which some patients may not want (needle phobia). Still, it would be nice to have options available so that people can choose what fits their lifestyle best.

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Hi all,

Developing long acting drugs is actually very difficult. First, the compound has to be extremely potent so that only very small amounts are needed to have their effects. That makes the injection or long-acting pill small enough to be practical. Second, the compound needs to be removed from the body slowly so that very little is needed to replace what is lost. Third, the compound must be stable in the body (ie, not be degraded by the body or decaying naturally due to body heat, pH, etc). All three of these issues are governed primarily by the chemical nature of the drug itself, and it is usually not possible for a given drug to have properties acceptable for all 3 of these requirements.

In addition, clinical testing of such drugs is very time consuming because the researchers need to wait longer to see how the drug lasts in the body, and if it causes any safety issues at the site it is located in the body (called the ā€œdepotā€ in the field).

Drug developers in both academia and in industry are very well aware of the many advantages that long-acting drugs bring when treating chronic illnesses or infections, and they always want to get there if they can. Unfortunately, that is impossible in the very large number of cases.

I hope this helps.

John

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