I recently read a piece on the National CML Society website about food and herbal interactions with Gleevec. The part I found interesting was that some of the foods and botanicals listed were new to me regarding TKI interactions. A lot of this is familiar to me, but several things listed were not and given that I ingest some of the listed items (garlic, teas) as part of my daily diet I certainly found this information interesting to say the least. However; I have been doing so for many years, so not too concerned, but interested in knowing others' experiences with items on this list. Anyone read anything on food or herbal interactions with Gleevec or other tkis that validates this information?
The information below was copied directly from the CML Society Website:
Food Interactions
There are a variety of foods that have the potential to affect the absorption and/or serum levels (the level of drug in a person's bloodstream).
Citrus - citrus fruit, and other items containing citrus, has the propensity to increase serum levels dramatically. This results in the potential for too much drug to be in your system. If you are taking any of the TKIs (Tyrosine Kinase Inhibitors), care should be taken with citrus fruits, particularly grapefruit, grapefruit juice, or grapefruit extract.
Pomegranate - is also known to interact with TKIs and should be avoided.
Lactose Intolerance - Nilotinib (Tasigna) contains lactose (milk sugars) and should not be taken prior to discussing with your doctor.
Herbs, Botanicals, and Other Products
Some herbs are known to affect the serum level (amount of drug in the blood stream) of therapy agents used in treating CML.
- Johns Wort - known to DECREASE the serum level of TKIs in the blood stream. This herb should be avoided to alleviate the possibility of hindering the activity of your therapy drug.
The following herbs are known to INCREASE the serum level of TKIs in the blood stream. These herbs should be avoided as they may inadvertently cause accidental overdose of your therapy drug.
Black Cohosh
Cat's Claw
Goldenseal
Kava Kava
Milk Thistle
Valerian Root
There are additional herbal products that interact with TKIs, however the exact interaction has yet to be fully determined. It is suggested that you refrain from the use of the following herbs due to the potential to cause adverse reactions:
Dong quai
Garlic
Genistein
Gingko
Gingko biloba
Ginseng
Ginseng, Siberian
Glucosamine chondroitin
Green Tea
Saw palmetto
Teas (dandelion, pepperment, chamomile)