Interesting study. http://www.ntkinstit...t_uids=22531634 Frank
Ibuprofen and Gleevec
Started by
Sneezy12
, May 30 2012 07:06 AM
27 replies to this topic
#2
LivingWellWithCML
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Posted 30 May 2012 - 12:05 PM
Wow, I haven't heard of any issue like this before with Ibuprofen. I was taking some to reduce swelling from a running injury (400mg/day for about 2 weeks), but then I switched to 220mg/day Naproxen (Aleve) which seemed to do a better job of helping my foot heal. It's certainly concerning to think that these things could affect response [assuming I'm reading this correctly].
Dan - Atlanta, GA
CML CP Diagnosed March 2011
Gleevec 400mg
#3
Trey
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Posted 30 May 2012 - 05:17 PM
Useful information. Based on this I would avoid Ibuprofen (Motrin) while taking Gleevec, and maybe the other CML drugs.
For those having a hard time understanding the article, it says that Ibuprofen reduces the amount of Gleevec that gets into the leukemic white blood cells, which is the only way Gleevec works. Since Sprycel and Tasigna are not taken into the cell in exactly the same way as Gleevec, it may not apply to them, but that is not known.
#4
Pin
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Posted 31 May 2012 - 01:34 AM
This is interesting news indeed. I don't take any typical painkillers any more, but I do take Voltaren (diclofenac) every now and then to help with muscular pain and injuries and I was worried about the potential interaction with Gleevec.
Perhaps I need not be so worried after all...
Diagnosed 9 June 2011, Glivec 400mg June 2011-July 2017, Tasigna 600mg July 2017-present (switched due to intolerable side effects, and desire for future cessation attempt).
Commenced monthly testing when MR4.0 lost during 2012.
2017: <0.01, <0.01, 0.005 (200mg Glivec, Adelaide) <0.01, 0.001 (new test sensitivity)
2016: <0.01, <0.01, PCRU, 0.002 (Adelaide)
2015: <0.01, <0.01, <0.01, 0.013
2014: PCRU, <0.01, <0.01, <0.01, <0.01
2013: 0.01, 0.014, 0.016, 0.026, 0.041, <0.01, <0.01
2012: <0.01, <0.01, 0.013, 0.032, 0.021
2011: 38.00, 12.00, 0.14
#5
Happycat
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Posted 01 June 2012 - 03:42 PM
I was at a seminar a week ago, one of the topics was drug-drug interactions. Interesting statistic they provided was about the number of drugs you take and the chance of interactions. If you take 6 different drugs, there's an 80% chance of some sort of interaction, including interference.
They had a nice graph showing the interactions probability increasing with number of drugs. I wanted to know if that included natural supplements, like vitamins, fish oil, or sennokot.
Traci
#6
Tedsey
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Posted 01 June 2012 - 05:56 PM
I was thinking about the same thing with supplements, especially iron, the Pill, and SSRIs . As for ibuprofen, I have not taken any NSAIDS since dx (over 2.5 years ago now), with the exception of Tylenol, (I was coerced into taking it once when having a blood transfusion). Because my continuing low PLT issue, I, more or less, have to stay away from these drugs, (except maybe acetaminophen, but don;t want to destroy my liver now that my marrow is limping along and taking Sprycel). Anyway, I did not do well on Gleevec with absolutely no NSAIDs. It appears there are many here that are doing great despite taking NASAIDs regularly, even better than I. So it is probably only an issue if a person is on G, taking NSAIDs regularly, or a lot, and getting a suboptimal response. And it probably depends on the person. Nevertheless, the abstract was good food for thought.
Teds
#7
Marnie
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Posted 01 June 2012 - 06:33 PM
I have avoided ibuprofin (mostly) while on TKIs, but recently did a number on my shoulder while lifting weights. Tylenol was totally worthless for that sort of pain, so now I'm in a quandary. Getting older, lots more aches and pains, I've torn something in my shoulder, and it hasn't healed up in 3 months. . .not quite sure how to deal with the pain. I guess the answer might be to quit kayaking and motorcycling since that makes it hurt. But I am not ready to put my arm in a sling and sit around eating bon bons. Yet. Advil used to do the trick, but now I'm a little afraid to use it even sparingly. Guess I'll see what the onc thinks next month. Disappointingly, when I asked him about advil the last time I saw him, he seemed surprised when I suggested that I probably shouldn't be taking it. Gosh darn. My 4th oncologist and I'm starting to doubt him. It didn't help that he came into the room not having seen my test results and then couldn't find them on the computer. He had to call the lab across town to get the results (this after I had gotten the results from his p.a. a few days earlier).
Marnie
#8
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Posted 01 June 2012 - 08:40 PM
Hi Marnie,
When I got pneumonia 3 weeks after dx. my temp was 103, and when I called my doc I was told to take 2 ibuprofin and get to the er. I was in the hospital 5 days and my temp kept spiking to 103, my onc ordered ibuprofin for me as needed (exm. 103 temp) otherwise I could ask for it if the symptoms from my lower fevers bothered me too much. I didn't ask for it very often, But for 3 years while I was on G about once a month I would run a high fever for a day and feel awful, then the next day it was just a low grade fever, then the third day I was fine. After 2 trips to the er, and 1 trip to the cc center, chest xrays and bw were fine. So onc told me I just had to live with it, plus a doc from the cdc. They could find no reason for these episodes, finally onc told me to take ibuprofin and call him if my temp went above 103. I guess that's just the way my body handled G, there was no other explanation. For about a year I had to get bw every 2 weeks, then every month, I still have to get it every month and I'm going on 5 years.And I get the full work up every 3 months. I have been getting joint pain, lately which I didn't have much of a problem with before, I told my onc I take ibuprofin occasionally, he said that was fine. I could get a script for pain medicine but I don't like pain meds. If I can get through an injury or problem without them I will, and I've been through surgerys and injurys clumsy accidents, I just hate pain meds. I just take ibuprofin when I really need it and it has always helped me, all my docs know this and I have never been told not to take it. But I always get the script filled in case I get a migrain, which I haven't had for years.
Don't be upset with your new onc about not having your bw results, that happened to me one time, and my onc was clearly upset, that's what they have their staff for, it hasn't happened again.
I've been going to the cc center every month now for 3 months,and getting the full panel bw. I went today again, I had my bw last week, my bcr is still 0 and my genetic whatever is also what it should be no bad cells in my body Yahoo, but my iron is low again and they are afraid to try infusions after my last allergic reaction last Sept. So I have to take those damn iron pills, 3xa day plus vit c! I've been feeling pretty crappy lately and sooo tired, that's why low iron. So at least now I have an excuse for sitting around like a blob. The GOOD NEWS is I'm down to 50mg Sprycel a day. So that alone should help with my anemia. But my bp is up again why doesn't somebody just shoot me? Guess I'm headed for bp med #5.
I finally got my e-mail problem straightened out, and my daughter no longer receives my e-mails, but I can, so you can use my old e-mail address again! That was weird my daughter could get my e-mails but I couldn't. But my history still shows somebody is looking at engagement rings on ebay! The computer technition told me yesterday it was a fluke everything was okay, no more problems! Well my fluke looked at 4 more engagement rings on ebay today. UGGG
I'm Just Cursed Love Billie
ps did you hear about James Pattersons new book called Middle School get me out of here!
#9
Happycat
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Posted 02 June 2012 - 08:26 AM
I just realized two things.
When I was first dx'd, I was taking so much ibuprofen for my neck injury that I was told to stop it because I had such awful bruising, they thought I was bleeding internally. So I'm kinda grateful for that, as I've used it sparingly since then.
However, because of my aspirin allergy, ibuprofen was the only NSAID I could safely use. If I need to switch to another one, I'll have to do it with my allergist, taking small amounts to show there is no reaction, until I can get up to a useful dose. Dang, this really complicates things for me.
I have to assume occasional use is fine with gleevec, but not the round-the-clock ibuprofen I was taking previously. I think I'm gonna have to get that paper and read the whole thing. I'm hoping we've got a subscription to it at work, or if not my company, then perhaps my dh can get it for me through his workplace.
Traci
#10
LivingWellWithCML
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Posted 03 June 2012 - 06:13 PM
I am trying Aleve (Naproxen) instead for a foot injury I've had from running. Does that fit in this category too?
Dan - Atlanta, GA
CML CP Diagnosed March 2011
Gleevec 400mg
#11
Happycat
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Posted 03 June 2012 - 07:43 PM
Dan,
Naproxen is an NSAID, so likely was part of the study, although it is not mentioned in the abstract. I sent the abstract to my DH, hopefully he can get it for me. Will post what I find out.
Traci
#12
Sneezy12
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Posted 04 June 2012 - 08:25 AM
Naproxen and 8 other NSAIDS had NO effect on Imatinib. Frank
#13
0vercast
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Posted 04 June 2012 - 09:33 AM
Makes you wonder how many oncologists know about this? I was told that they would rather have me taking acetaminophen instead of ibuprofen for minor pain relief, but avoiding ibuprofen wasn't stressed. I've even seen advice on here that would recommend using ibuprofen instead of acetaminophen.
#14
Happycat
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Posted 05 June 2012 - 04:33 AM
That's because ibuprofen and other NSAIDs are antiinflammatories, whereas acetaminophen is not. If the pain you have is related to inflammation, then NSAIDS provide more relief. So docs more likely to suggest them.
Don't know if my onc is aware of it, but I plan to take the article to my next appt with him. I just need to nag my dh to get it for me.
Traci
#15
hannibellemo
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Posted 05 June 2012 - 05:21 AM
Overcast,
Tylenol is tough on our liver. That is why it is not recommended that we use it as these drugs are also metabolised through our liver.
Pat
Pat
"You can't change the direction of the wind but you can adjust your sails."
DX 12/08; Gleevec 400mg; liver toxicity; Sprycel 100mg.; CCyR 4/10; MMR 8/10; Pleural Effusion 2/12; Sprycel 50mg. Maintaining MMR; 2/15 PCRU; 8/16 drifting in and out of undetected like a wave meeting the shore. Retired 12/23/2016! 18 months of PCRU, most recent at Mayo on 7/25/17 was negative at their new sensitivity reporting of 0.003.<p>
#16
LivingWellWithCML
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Posted 05 June 2012 - 06:29 AM
Looks like I will be dumping Ibuprofen in the trash and keeping Naproxen around for my weekend warrior activities.
Dan - Atlanta, GA
CML CP Diagnosed March 2011
Gleevec 400mg
#17
LivingWellWithCML
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Posted 05 June 2012 - 06:35 AM
I'll be sending this to my onc as well. He "approved" a 3 week course of Ibuprofen for me to help with this tendon injury I've had from running, but I imagine he's not aware of this study. I've switched to Naproxen 220mg (smallest dose) and it actually helps my foot more ... you just have to make sure you take it with food, cause it can wreak havoc with the stomach.
I'm also trying to get a copy of this paper to review some of the details...
Dan - Atlanta, GA
CML CP Diagnosed March 2011
Gleevec 400mg
#18
Tedsey
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Posted 05 June 2012 - 08:50 AM
STAY AWAY FROM THE BON BONS! Just kidding. But I could never picture you on the sofa gorging yourself with chocolate, especially when there are awesome trails and waterways waiting for you to explore! Anyway, I am sad to hear about your shoulder. Just shy of a year, my husband has been recovering from a shoulder injury. He broke the front part of his scapula and had to have surgery. Physical therapy really helped. Maybe a script for PT would work? Have your tried it? I understand how bad the pain can be. My heart goes out to you. Sorry I have nothing of value to add. I just send you my best wishes and hope things get better very soon.
Take care!
Teds
P.S. How disheartening about the onc. I totally feel for you there too. My first onc was like that and even before she got any results back, it was always gloom and doom with her. Some people should just stay in the lab.
#19
Tedsey
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Posted 05 June 2012 - 08:53 AM
Billie,
I also got pneumonia right after being put on Gleevec. I have also heard of this happening to a couple other people. Wonder what is up with that? So happy to hear you are still at the big ZERO. Here is hoping you stay that way forever!
Thanks for all the laughs,
Teds
#20
Tedsey
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Posted 05 June 2012 - 09:04 AM
I would think unless they are a CML specialists or working directly with TKIs, probably not many. I didn't read the study to know if it is longitudinal (repeated, but not sure if it has to be, or even could be because TKIs are relatively new---I'm way out of the loop), but if not, it is only one study. So, out of the many that are published, I doubt a ton of oncs read this one unless there is some warning put out by Novartis and BMS. Besides, like Traci says. I am sure occasional use is fine. I think especially if someone is doing well on the drug and there is no interference with response.
My guess.
Teds
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