11 replies to this topic

[thatguy]

Accidently overdosed on Tasigna last weekend and have experienced constant headache since. I researched and researched about which OTC painkiller I could take, and was led to Aleve and Ibuprofen. Now I've found more conflicting information. Fortunately the headache has finally subsided, but I worry my upcoming PCR results may be higher, along with my enzymes now.

 

I had spoken to a Walgreens Pharmacist about Advil, and he searched his computer and stated it would be ok, so that's what I took for a few days.

 

Anyone know which OTC painkiller / NSAID 's can be taken safely in combination with each drug?

 

I know I was prescribed baby Aspirin at diagnosis with Gleevec, if it helps anyone else who might get in this pickle.

[gerry]

I was on Gleevec, my doc said as long as my liver results were good I was okay to take any of the over the counter pain meds, which I did.

[roamingdoc83]

Gleevec can effect the stomach (one of the side effects prominently listed) and consequently 'any' irritant of the stomach (aspirin or ibuprofen) "might" aggravate that issue. I have serious osteoarthritis from two bad accidents (twice lucky) and it has been hard to find something to deal with the pain. I take some supplements that are supposed to help with pain, not much from my experience. And occasionally I take prescription strength Motrin (800mg). I also have hydrocodone but don't take it often or in full strength. I would say 'watch your gut' for anything untoward and you should be okay with OTC.

[gerry]

I am not able to take aspirin, diagesics etc, but that was an issue prior to CML. I am vomiting within half an hour of taking it. I keep my fingers crossed that I never have any blood thinning issues as I will wind up straight on the prescribed meds.

[Trey]

There isn't much firm advice on the issue, but there are suggestions.

 

This article covers many types of drugs, including NSAIDs.  See page e82 for NSAIDS:

http://www.bloodjour...so-checked=true

 

Some other literature indicates Ibuprofen (Motrin) may reduce Sprycel and Gleevec uptake. 

 

Tylenol is hard on the liver.  I personally avoid it.

 

My overall choice is Naproxen (Aleve). 

 

You were prescribed baby aspirin at diagnosis as a mild blood thinner due to the "thickness" of the blood.

Edited by Trey, 24 June 2016 - 12:39 PM.

[Antilogical]

A blood test showed that I had elevated liver function.  To narrow down the cause, my doc told me to avoid all nsaid painkillers, including meloxicam, which I had started taking daily.  He also discussed the issue with my onc to see if Gleevec might be involved.  Based on my follow-up blood test, which showed normal liver function, I was told to continue avoiding nsaids.  If absolutely necessary, I am to take 1 regular strength tylenol.

 

This seems odd to me.  I had been taking ibuprofen or naproxyn twice daily for several years, with no issues.  It's only when I was switched to meloxicam a couple of months ago that I developed a problem.  Tylenol is ineffective for my arthritis.  I sense that a frank and earnest discussion with my GP is on the horizon....

[thatguy]

Interesting, thanks for the replies everyone. Trey, so the ibuprofen effect of reducing uptake, only affects the Sprycel absorption mechanisms, not Tasigna's?

[Trey]

Gleevec, Tasigna and Sprycel are taken up into the cells in different ways.  Gleevec uses the cellular OCT1 pump, but Sprycel and Tasigna do not.  This is one reason why Gleevec does not work as well for some people, because they have low OCT1 activity, but Sprycel or Tasigna may work well for them.  Sprycel and Tasigna cellular uptake appears to be more passive, but actual uptake mechanisms are unknown. 

 

I have seen articles suggesting that Sprycel and Gleevec uptake into cells is negatively affected by ibuprofen (I left Gleevec out above since that was not the question, but I added it afterward to be more clear for future readers).  But I have not seen such articles for Tasigna.  So I do not know if there is an effect on Tasigna uptake.  A conservative approach would be to avoid ibuprofen when taking any TKI drugs.

[beno]

My oncologist said I can take ibuprofen in limited dosages.  No more than 400mg twice daily. She also said to not take the max dose every day for more than a day or two and not at the same time as Sprycel.

[TeddyB]

http://www.ncbi.nlm....pubmed/22531634

I also use naproxen when i have to....

[Lucas]

is there any problem to use  ibuprofen gel or diclofenac gel?

[Trey]

The NSAID gel forms do not put much drug into the body plasma so it is not an issue which you use.