4 replies to this topic

[pamsouth]

Anyone that has been on Gleevec and switched to Sprycel, that required an EKG & lab x-ray before switching.

pamsouth Jun 23, 2013 9:49 PM

I thought it would be a good ideal to have an EKG AND chest x-ray before switching from Gleevec to Sprycel 50mg.  Oncologist said that is only necessary on Tasigna.  If I still wanted it, he would order it but I should check to see if insurance will pay for it.  So tomorrow I am calling the IU billing management.  Don't know why doc's nurse can't do that.  Medicare says they are making me do all their leg work.

Anyhow my brother died last year at the age of 61 with congestive heart failure.  First heart attack at age 39 & 3 defib, etc.  Long line of heart complications in my family.

Plus I have a bit of an irregular heart beat, that I have had for quite a few years, just gotten a little worse with age.

Thought since Sprycel often caused PE lungs/heart it would be good to have a baseline EKG & lung x-rays,, doc didn't think so.  Am debating whether or not to push for one.

Am off Gleevec right now switching to Sprycel 50mg in about a week?  So glad I am getting my colonoscopy next Tuesday before I make the switch.  Get it over with. Then kidney doctor should be seeing me.  I will be ancious to hear what they have to say about my GFR and med's.

The 1 1/2 years, I have been at Ind University Cancer center, my PCR / FISH have ran anywhere from 1% to 13 %.  Strange last week it dropped back down to 3 %.  Maybe I should not make the switch, Id on't know, not to late to change my mind. Not shipping the Sprycel until next Friday June 28th.

I am worried about losing my kidney's the GFR is stage 3 for CKD, I don't know if it from the Gleevec, Diurectics, old age 65 years, or all of the above.  Went on Gleevec 2005 lost my Gall bladder in 2007.  Surgeon said it looked like a darn good gall bladder perfect in every way, but test showed it didn't work right where the tube open and closing for the bile to pass.  Maybe my mind is working overtime, but I think I am losing my organs due to to much medicine and age. So maybe a switch will be good I don't know.  I don't know if one TKI is better at not bein so toxic on your organs, maybe just depends on the person.  I stayed with my friend in Florida on a dialyses 3 x a week, I don't see that for me.  So yes I think I will try Sprycel, not that my kidneys will recover but maybe they won't get any worse, just a gamble.

Will try the Sprycel at 50mg for a few months, if it doesn't work out, going back to Gleevec.

My former Oncologist use to order an EKG every  year on Gleevec, this doc says not necessary, even though I have an irregular heart beat.  Sometime hard to tell who to believe.

PamSouth

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[CallMeLucky]

They didn't do an EKG on me when I switched from Gleevec to Sprycel, they might have done a chest x-ray but I don't think so.  Hard for me to remember because I had a problem within a month or so (@100mg) and they had to do chest x-ray.  Not sure how important the x-ray is for PE.  Today you do not have a PE, and in the future an x-ray would either show you have one or you don't, I don't think comparison with baseline is necessary for PE.  EKG is done for Tasigna, not for Sprycel as QT prolongation is not generally seen with Sprycel.  If you have preexisting heart condition then EKG would probably make sense.

[hannibellemo]

I disagree, Lucky. I have an EKG 3 times a year at my oncs direction. Sprycel can cause QT prolongation. Tasigna is more closely associated with QT issues. Just like Sprycel is more known for causing pleural effusion, but all TKIs can cause pleural effusion.

My frequent EKGs probably aren't necessary any longer but I think he is extra cautious with me because he didn't catch my slight uptick in AST/ALT on Gleevec which Mayo checked three weeks later after I mentioned the increase to 80. By then, they were both over 1000.

Pat

[JeffJ]

When I changed from Gleevec to Sprycel my doctor had me get an EKG prior to starting, and a few weeks after.  I had been on Sprycel 100mg for about 20 months, but now due to pleural effusion will be off it for at least 4 weeks.  Doctor has me on water pills to get rid of fluid.  With the chest x-rays, he had another EKG done 3 weeks ago.  Better to be sure there is no problem with the heart. 

Jeff

[hannibellemo]

Hi, Jeff,

What is the plan after your PE resolves? The same thing happened to me around 2.5 years. I was off for about 10 weeks and have been at 50 mg. since. So far, so good.

Pat