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All TopicsForum: Hormonal Therapy - Before, During and After → Topic: What Foods Interact with Tamoxifen?

Topic: What Foods Interact with Tamoxifen?

Forum: Hormonal Therapy - Before, During and After — Risks and benefits, side effects, and costs of anti-estrogen medications.

Posted on: Feb 1, 2009 07:41PM

Jo_Ann_K wrote:

Hi!

The first time I knew that grapefruit is contraindicated when taking Tamoxifen was on here. I haven't seen it anywhere in the literature and when I called Poison Control, they confirmed it. I asked whatever foods interacts but they didn't have time to tell me, and I can't find that information online.

Please..please, if anyone has access to this information, can you post here?

Thanks,

Jo Ann

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Feb 1, 2009 07:44PM awb wrote:

grapefruit and grapefruit juice are the only two things I was told that weren't allowed--they decrease the efficacy of the tamoxifen (I just finished my 5 years up about 3 months ago),

anne

"I don't know what the future holds, but I know who holds the future"

Dx 9/5/2003, LCIS, Stage 0, 0/0 nodesSurgery 09/16/2003 Lumpectomy (Right)Hormonal Therapy 10/30/2003 TamoxifenSurgery 04/05/2005 Prophylactic Ovary Removal (Both)Hormonal Therapy 02/28/2009 Evista
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Feb 1, 2009 09:08PM Northstar wrote:

I'll be starting tamoxifen as soon as it arrives from the mail-order pharmacy, and I'd like to know, too.  Even my onc said that MDs don't have a lot of knowledge about what foods interact with it.  I'm thinking of resveratrol, among others, which is found in grape skins, juice, red wine, and now people are even taking it in supplements for anti-aging effects. I think flaxseed oil may be a no-no, but wonder if anybody has heard that? 

Has anybody seen a list out there in internet land??  Northstar 

DX 8/15/08, ILC, 5.1 cm, Stage IIb, Grade 1, 0/2 nodes, ER+/PR+, HER2-, Oncotype DX 11.

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Feb 1, 2009 11:14PM priz47 wrote:

I am not sure abt exact foods. My onc told me that red wine could make my hot flashes worse, so I might want to be careful. It would benice to know what does interact. I don't eat grapefruit cuz of my bl pressure meds.

D

Dx 4/22/2008, ILC, 1cm, Stage II, Grade 3, 0/1 nodes, ER+/PR+, HER2-
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Feb 2, 2009 07:54AM hopefor30 wrote:

Soy is also not recommended -- it is hard to avoid as it seems to be in many processed foods, but I spend a lot of time reading labels and trying not to eat it.   The hardest foods to find without it are bread, mayonnaise and salad dressings, but you can find them if you look hard.   I have also heard flaxseed was not recommended, but a lot of this info I have gathered by researching and from others on this site.   My onc didn't mention anything, but when I asked, I was told soy was OK in small amounts, but nothing concentrated like soy protein drinks etc.   It would be nice if there was a definiitive list, but how much diet can affect breast cancer still seems to be a gray area.  

M.

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Feb 2, 2009 01:04PM, edited Feb 2, 2009 01:05PM by rumoret

AVOID WHILE ON TAMOXIFEN
Herbs to Avoid - Estrogen Effects

What are the herbs to watch out for? For women who have had breast cancer, the following herbs have been found to have estrogen-like effects and should be avoided:


    •    red clover (trifolium pratense)
    •    chasteberry (vitex agnus castus)
    •    hops (humulus lupulus)
    •    ginseng
    •    soy
    •    dong quai (angelica sinensis) and licorice (glycyrrhiza glabra) also have estrogen-like effects, but they are not as great as the other above herbs.


Women taking the drug tamoxifen are even more likely to use herbs and soy because of hot flashes. However, tamoxifen has an anti-estrogenic effect (it's used for estrogen-dependent breast cancers), so people taking tamoxifen should take special care to avoid the above estrogenic herbs.

If you're taking tamoxifen you must avoid grapefruit and pomegranate and SSRI-type antidepressants. These items knock out an important enzyme that converts tamoxifen to its active form. Grapefruit and pomegranate can disable the enzyme for 3 days from a single dose.

ST. John's Wort - has grapefruit in it....don't take.

While on tamoxifen avoid:
prozac, paxil (antidepressants)
fluconazole (for yeast infections),
amiodarone ( a heart medication),
benadryl,
cimetidine/Tagamet,
ranidatine/Zantac,
dexamethasone (steroid)

Hugs, Terry 

Hugs to my Sisters,

Dx 4/13/2006, IDC, 2cm, Stage IIa, Grade 3, 0/15 nodes, ER+/PR+, HER2-
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Feb 2, 2009 01:16PM ChrisNM wrote:

Dear Terry-

This is helpful information.  Can you refer me to a web site that lists this so I can point it out to my doc?  Thanks!

Chris in NM

DX 3-08, IDC, ,1cm, Stage I, Grade 2, ) nodes, ER+, PR+ HER2-

First diagnosis: March 2008, IDC stage 1 grade2, 0/1 node, ER+/PR+ HER2-

Dx 12/2011, IDC, <1cm, Stage I, Grade 2, 0/6 nodes, ER+/PR+, HER2-
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Feb 2, 2009 04:03PM kerry_lamb wrote:

Girls, www.drugs.com  is the site to get very specific info about the drugs you are taking. I discovered it whilst trying to nut out some details about femara. XX

Go hard or go home :)

Dx 2/15/2008, IDC, 3cm, 2/8 nodes, ER+/PR+, HER2-
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Feb 2, 2009 04:58PM saluki wrote:

Here Chris-- This should be of help to you

http://meeting.ascopubs.org/cgi/content/abstract/24/18_suppl/504

jop.ascopubs.org/cgi/content/f...

jco.ascopubs.org/cgi/content/a...

Susie, member since Jan. 2003

Dx 12/12/2002, IDC, 2cm, Stage IIb, 0/1 nodes, ER+/PR+, HER2-
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Feb 2, 2009 05:03PM Lucy47 wrote:

wow!!! I never knew that pomegranates were on the list ....I love them and I do eat them every so often :( . The only think my doc told me was to stay away from soy.....I don't care about grapefruits ...because their not my favorite....but pomegranates .....say it isn't sooooooooooooFrown

Lucy

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Feb 2, 2009 05:12PM saluki wrote:

To Rumoret's list I would also add Vitamin E

http://www.surgjournal.com/article/PIIS0039606006003928/abstract

Also, possibly the supplement I3C (Indole-3-Carbinol)

www.journals.elsevierhealth.co...

Susie, member since Jan. 2003

Dx 12/12/2002, IDC, 2cm, Stage IIb, 0/1 nodes, ER+/PR+, HER2-
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Feb 2, 2009 07:31PM ChrisNM wrote:

Thanks everyone.  This has been really helpful information.  I feel armed and ready for the next appointment!

 Chris in NM

 DX 3-08, IDC, <1cm, stage 1, 0 nodes, ER+, PR+, HER2-

First diagnosis: March 2008, IDC stage 1 grade2, 0/1 node, ER+/PR+ HER2-

Dx 12/2011, IDC, <1cm, Stage I, Grade 2, 0/6 nodes, ER+/PR+, HER2-
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Feb 3, 2009 07:59AM Rosemary44 wrote:

Here's the Flockhart Table that is helpful.  Look for the drug your taking in whichever column and scroll down:

http://medicine.iupui.edu/flockhart/table.htm

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Feb 3, 2009 02:26PM rumoret wrote:

Sorry......been to long to know where I got information......

Hugs,

Terry 

Hugs to my Sisters,

Dx 4/13/2006, IDC, 2cm, Stage IIa, Grade 3, 0/15 nodes, ER+/PR+, HER2-
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Feb 5, 2009 01:19PM PinkVelvet wrote:

Saluki,

Thank you for the references.  I found them very interesting.  I just started Tamoxifen 2 weeks ago and have been taking Lexapro (ssri) for many years.  I will talk to my onc about this, as I don't want to be taking Tamoxifen for nothing.

Jen 

Dx 4/4/2008, IDC, 2cm, Stage IIb, Grade 3, 1/14 nodes, ER+/PR+, HER2-
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Mar 4, 2009 10:47AM Annie62 wrote:

Wow, I'm glad I saw this. I've been adding a splash of pomegranite blueberry cranberry 100% juice to my seltzer for flavor and health benefits. Had no idea I was counteracting tamoxifen. I also didn't know about the reversterol. I don't drink much now but over the years I've been on tamox, I have drunk a lot of red wine. Sheesh. My onc even recommended red wine to me!

So has anyone heard anything about hemp oil? I haven't seen anything about this but easily could have missed it. I've been wanting to add more omega 3's and don't want to use flax oil

Thanks,

Annie

Stage IV 8/2012 Bone, liver, pleural mets. Xgeva, Doxil. Past chemos - Gemzar, Navelbine, Xeloda, Faslodex Orig Dx 11/2004 Stage IIIc IDC 11/19 nodes AC and Taxotere. Tamox, Aromasin, Recurrence 2011 Abraxane and Gemzar , ER+/PR+ Her2- BRCA-

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Mar 4, 2009 10:53AM awb wrote:

the only thing my pharmacist said to avoid was grapefruit and grapefruit juice.

Anne

"I don't know what the future holds, but I know who holds the future"

Dx 9/5/2003, LCIS, Stage 0, 0/0 nodesSurgery 09/16/2003 Lumpectomy (Right)Hormonal Therapy 10/30/2003 TamoxifenSurgery 04/05/2005 Prophylactic Ovary Removal (Both)Hormonal Therapy 02/28/2009 Evista
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Mar 4, 2009 01:01PM Kleenex wrote:

No Benadryl with Tamoxifen? Why not? I hadn't heard that before...

Dx 6/19/2008, ILC, 2cm, Grade 1, 0/2 nodes, ER+/PR+, HER2-
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Mar 4, 2009 05:03PM cureme1 wrote:

Hey everyone. I've been on tamoxifen for 3 weeks and my sound and smell is so amplified. kicks in about noon. like scary loud. also extreeeme fatique after lunch. anyone else. I'm sure being a teacher doesnt help...

Dx 4/15/2008, DCIS, 2cm, Stage IIIa, 6/15 nodes, ER+/PR+, HER2-
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Mar 12, 2009 09:42PM Kleenex wrote:

FYI - I asked my oncologist about Benadryl and Tamoxifen - it's not a problem to take them both.

Dx 6/19/2008, ILC, 2cm, Grade 1, 0/2 nodes, ER+/PR+, HER2-
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Mar 13, 2009 09:16PM PT63 wrote:

OMG

I have been on Tamox. for 2 years and have never had anyone mention the grapefruit thing to me.  I looked through the paperwork that comes with the meds in the mail order and there is nothing mentioned.  I just started drinking grapefruit juice a month or so ago to get in all my recommended (8) daily fruits and vegetables.  I LOVE grapefruit juice.  I have got to look further into this.  I am soooo bummed.  No grapefruit juice and No benefit from Tamox. for a month!!! Will it never end???Frown

Dx: 11/2006, IDC, 1 cm, stage 1, grade 2, 0/6 nodes, ER+/PR+ Her2-, Bilat Mx, Tamox since 2/2007 - 2/2012

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Mar 13, 2009 09:35PM kle wrote:

I asked my oncologist also about grapefruit juice, after reading some negative stuff.  She said that it is not a problem with Tamoxifen and I can drink it.  Why then have I stayed away from it?  So many different views.  What's a grapefruit lover to do!

kle 

Dx 7/24/2008, DCIS, Stage 0, 0/2 nodes, ER+/PR+, HER2-
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Mar 14, 2009 06:02AM KathyNSW wrote:

Hi everyone

Does this mean you can't have a beer now and again on tamoxifen?

Dx 8/6/2008, ILC, Stage II, Grade 2, 1/12 nodes, ER+/PR+, HER2-
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Mar 14, 2009 02:16PM PT63 wrote:

My oncologist told me that "of course you can drink" even on Tamox. I love my glass of wine in the evening.  She told me that was fine as long as I don't over-do it.

Dx: 11/2006, IDC, 1 cm, stage 1, grade 2, 0/6 nodes, ER+/PR+ Her2-, Bilat Mx, Tamox since 2/2007 - 2/2012

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Mar 14, 2009 03:27PM idaho wrote:

I was told to also avoid black cohosh whick helped immensely with my hot flashes.  Tami

There's no place like home......There's no place like home

Dx 2/1/2009, IDC, 1cm, Stage I, Grade 2, 0/1 nodes, ER+/PR+, HER2-
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Mar 17, 2009 07:59AM Calif-Sherry wrote:

The drug list is interesting.  My gyne-onc gave me diflucan for yeast infection.  Isn't that the same as the drug listed above????

You give but little when you give of your possessions. It is when you give of yourself that you truly give. Sherry.....

Dx 12/13/2006, IDC, <1cm, Stage I, Grade 1, 0/4 nodes, ER+/PR+, HER2-
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Apr 20, 2009 04:27PM wallycat wrote:

I found this study.  Seems pomegranite is fine...

it does not use the cyp2D6 route...

J Clin Pharmacol. 2007 Mar;47(3):286-94.
Pomegranate juice does not impair clearance of oral or intravenous midazolam, a probe for cytochrome P450-3A activity: comparison with grapefruit juice.
Farkas D, Oleson LE, Zhao Y, Harmatz JS, Zinny MA, Court MH, Greenblatt DJ.

Department of Pharmacology and Experimental Therapeutics, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, USA.

The effect of pomegranate juice (PJ) or grapefruit juice (GFJ) on CYP3A activity was studied in vitro and in healthy human volunteers. In human liver microsomes, the mean 50% inhibitory concentrations (IC(50)) for PJ and GFJ versus CYP3A (triazolam alpha-hydroxylation) were 0.61% and 0.55%, (v/v) respectively, without preincubation of inhibitor with microsomes. After preincubation, the IC(50) for PJ increased to 0.97% (P < .05), whereas the IC(50) for GFJ decreased to 0.41% (P < .05), suggesting mechanism-based inhibition by GFJ but not PJ. Pretreatment of volunteer subjects (n = 13) with PJ (8 oz) did not alter the elimination half-life, volume of distribution, or clearance of intravenous midazolam (2 mg). Administration of PJ also did not affect C(max), total area under the curve (AUC), or clearance of oral midazolam (6 mg). However, GFJ (8 oz) increased midazolam C(max) and AUC by a factor of 1.3 and 1.5, respectively, and reduced oral clearance to 72% of control values. Thus, PJ does not alter clearance of intravenous or oral midazolam, whereas GFJ impairs clearance and elevates plasma levels of oral midazolam.

PMID: 17322140 [PubMed - indexed for MEDLINE]

Dx 4/07 1 month before turning 50; ILC 1.8cm, ER+/PR+, HER2 neg., Stage 1, Grade 2, 0/5 nodes. Onco score 20, Bilateral Mast., tamoxifen 3-1/2 years, arimidex-completed 4/20/2012

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Apr 26, 2009 12:15AM KathyNSW wrote:

Hi everyone

What about grape seed extract which has been added to a Beta Boost drink that

I take. ( only a small ammount of extract)?

Its called Percy's4Tphy  Beta Boost.

Thankyou and Take care

Dx 8/6/2008, ILC, Stage II, Grade 2, 1/12 nodes, ER+/PR+, HER2-
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Apr 26, 2009 10:57PM, edited Apr 26, 2009 10:59PM by rdrake0

Two questions:

1.  Anyone out there taking VEMA?  Would it be OK?

2.  Do these foods you are listing also interfere with Arimidex?

Dx 11/12/2008, IDC, <1cm, Stage IV, Grade 3, 0/1 nodes, mets, ER+/PR+, HER2-
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May 4, 2009 11:09AM sandy2009 wrote:

Just curious if white tea is okay when taking tamoxifen.  I enjoy this during the day, instead of coffee.  I do have 1 cup of coffee in the morning but enjoy the white tea during the day (2-3 cups).

Thanks, Sandy

Dx 11/10/2008, ILC, 6cm+, Stage IIb, Grade 2, 0/3 nodes, ER+/PR+, HER2-
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May 5, 2009 09:46PM McKenzie wrote:

Cureme1, I also started Tamox about 3 weeks ago.  OH MY GOSH, YES!! Yes, noise is driving me nuts.  I also have had the crazy feeling of being on a carnival ride.  No stomach nausea but the kind that you get from motion.  Oh, and caffeine makes this sensation so much  worse.  And I love my caffeine.  Anyone else notice this on Tamox? Hits me in the late AM/early PM.  I also had wondered if it played a role in blood sugar but man, I can't live with this dizzy feeling all the time.  Does anyone find that this eventually goes away? No hair loss, a little weight loss (that could be stress). I am almost 44 and premeno as well.

Dx 9/22/2008, IDC, 1cm, Stage Ib, Grade 2, 0/1 nodes, ER+/PR+

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