Ibrance (Palbociclib)
Comments
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Hi Hildegunn,
He probably wants you off the grapefruit juice as it interacts with a number of cancer meds. I was bummed when I found this out initially as I do enjoy grapefruit. Then I found out pomegranate is a no no with Ibrance (as is green tea). I love pomegranates! Darn...
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Nkb. I'll be getting faslodex and Zometa on Monday also. I also get an extra infusion of gamma globulin each month to help with an immune disorder I have. Just bought knitted poncho because I get so cold during the infusion. Anyway, I'll be with you in spirit.
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Grapefruit juice increases the amount of Ibrance in your blood and is a definately no no. This drug is very dose sensitive. I remember some time back one of the ladies here was put on a reduced dose and tried to empty some out of the capsules that she had. I forget who it was but it ended up to not be a good idea.
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JFV...My oncology facility provides "hot" blankets -- right out of an "oven" for those having infusions. I think they are heated to 180 degrees. It is wonderful.
Hope
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Thank you everyone for your happy support of my scan, I think hearing of these results is so reassuring and a boost to well-being- like we are on a good path that seems to be working for many.
JVC- 50sgirl recommended doing the Zometa infusion over at least 30 minutes instead of the usual 15 and I am going to try that on Monday. Also getting the Faslodex infusion over 1.5-2 minutes each side has made a huge difference for me. I know it is a long time to stand there humming to yourself, but I have ended up with fewer painful month long lumps, not to mention the discomfort of someone forcing a thick fluid into my muscle over 30 sounds. Someone posted an article from an oncology nursing magazine that recommended injecting it over 2 minutes. Also room temperature seems better. It's also my week off palbo-should be a fun week! (but, then it's over)
Liwi- I never did get a second opinion. I also live in the east bay and considered seeing Hope (forget last name) at UCSF. I mostly didn't get one because I was getting very aggressive treatment that I saw seemed like the standard of care throughout this site and elsewhere and my mother was gravely ill while I was on chemo and I just didn't have the energy to gather all the reports, possibly repeat stuff and go through the whole process. My mom went to UCSF for her treatment and I just wasn't overly impressed. I also loved and trusted my first oncologist and my new one as well. I do think that if it weighs on you a lot you should do it- even if it only confirms that you are doing what is best for you already.
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I'm noticing a pattern that when I eat or drink anything with a good amount of lemon juice, I end up with mouth sores all along the roof and sides of my mouth. Took three times for me to get it lol. I love lemon, dang it but these mouth sores are awful.
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sadiesservant - wait, no green tea? I have a cup of green ginger every night to settle my stomach so I don't cough. I hadn't heard no green tea so that makes me sad.
Liwi, when is your retest? You and I are at the same level. My test is on wed so let me know how you do. I will root for your numbers
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Txgatata - I won't be getting my next blood test until July 18th because of a previously planned getaway next week to the coast in Mendocino. Otherwise it would have been Wednesday like you are doing. Hope your numbers are good!
Casun, Nonahope and Nkb thanks for your feedback on 2nd opinion. I really like my MO and her team. She is very responsive and from what I've seen my treatment is consistent with the current standard of care. But I think I will feel more comfortable with a 2nd opinion from an oncologist who specializes in breast cancer and is involved with current research even it just confirms my current treatment.
Sadieservant I saw your comment about no pomegranate and I think I saw that somewhere else. That's unfortunate, it's one of my favorite foods. I asked about ginger tea (just ginger) and was told that it is ok. But never asked about green tea.0 -
I'm trying to find where I read this but I was surprised at the time. A lot of the literature only lists grapefruit as a problem but other sources list grapefruit, pomegranate and star fruit as issues. Very confusing.
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Happy Football Sunday....
Jennifer...I love lemonade and drink "Simply Lemonade" on a daily basis...so far, so good.
Liwi...I understand wanting to have an oncologist who specializes in breast cancer. My oncologist does just that. Good luck with your second opinion.
I made it through working a couple of hours yesterday at my granddaughters dance studio. I felt so much better engaging in something other than sitting on my rear -- which seems to have become a really bad habit.
Today, I'm going to venture out to Coney Island Amusement Park with my daughter, sister, niece and great nephew who is 7 years old and will have fun riding the rides. I feel like I'm finally getting over the "gloomy" diagnosis and moving forward - slowly, but surely. How long did it take you to get out of the "diagnosis funk"???
Have a wonderful day!
Hope
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Hello All,
Well I'm off Ibrance. My RO said I have profound progression, mostly in my hips/pelvis, thoracic and now the cancer has moved around my rib from T-10 spine area to the front right along my bra line. A cancer highway if you will. I had a cold last week and sneezed a few really hard sneezes, and I fractured that rib. My MO is conferring with a researcher as far as genomic testing and further treatment and already emailed me with lots of questions. I will let all of you know if it is something down the pipeline or useable now. Feeling better off Ibrance already and taking advantage of being off all meds so that my body can get ready for for the next avenue of treatment.
Thanks for all of your support the past few months. Best of luck to all of you who have had good scans and keep on trucking ladies!
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OH, Lindalou, I'm sorry to hear your disappointing news! Please keep us posted, and good luck with the new treatment!!
xoxo
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Linda...I'm so very sorry to hear this. Know that you will not be alone on this next journey. All of us will be holding you up as you go through a new treatment plans. Many hugs and prayers being sent your way!!
Hope
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Lindalou-I am sorry to hear this- and rib fractures hurt a lot! Please stay in touch with us re the next step in your therapy. Best wishes!
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I too am in British Columbia. I spoke to the pharmacist from Phizer before starting Ibrance. She discussed grapefruit and pomegranate being forbidden but made no mention of green tea. I have read the prescribing physicians' monograph and the journal articles of Phase 11 and Phase III trials. None of theses documents suggest restricting green tea.
I had terrible heartburn during the first cycle and am on proton pump inhibitor. With that, my only side effect is fatigue. My white cell count is quite low but I have been able to continue on the full 125 mg dose. I am halfway through my third cycle.
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Before I started on Ibrance, I sought a second opinion from an oncologist in Vancouver, British Columbia. She is one of the principal investigators on the Ibrance trials. I asked about hair loss she that it was very rare, but some thinning could be expected. So far I have not experienced any thinning. I am currently on my third cycle of Ibrance.
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I understand your anxiety. Two cycles of any chemo are not enough to be sure that it isn't working. Abdominal pain is common with Ibrance. I think that you need to be patient. I too was due to have a CT in September after two cycles on Ibrance but persuaded my MO to delay the scan until the new drugs had time to work. Many women report being on Ibrance for several cycles before they see much change
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Lindalou, I pray that you enjoy this time off treatment and that your new regimen will be easily tolerated. Please stay with us and let us know how you're doing. God is good and he knows just what's coming next for you!
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Send to
J Pharm Pharm Sci. 2016 Apr-Jun;19(2):188-97. doi: 10.18433/J3MS5C.Inhibitory Effects of Eight Green Tea Catechins on Cytochrome P450 1A2, 2C9, 2D6, and 3A4 Activities.
Satoh T1, Fujisawa H, Nakamura A, Takahashi N, Watanabe K.
Author information
Abstract
PURPOSE:
Green tea is a traditional beverage that has been enjoyed by the Japanese to this day. Recently, there has been an increase in the consumption of green tea beverage having high concentrations of catechins, such as (-)-epigallocatechin-3-O-gallate (EGCG). Many people tend to ingest large amounts of catechins through the frequent consumption of green tea beverage, and this dietary habit may lead to unwanted interactions between the catechins in green tea and medicinal drug.
METHODS:
The inhibitory effects of eight green tea catechins on drug metabolizing enzymes, cytochrome P450 (CYP) 1A2, 2C9, 2D6, and 3A4, were investigated in human liver microsomes. Incubation was initiated by the addition of cocktail probe drugs that served as specific substrates for each CYP, and the resulting metabolites were analyzed by LC-MS.
RESULTS:
From a comparison of the fifty percent inhibitory concentration (IC50) values of the eight green tea catechins, it was found that non-gallated catechins did not inhibit CYPs, whereas gallated catechins inhibited all CYPs except CYP2D6. Among them, CYP2C9 was most strongly inhibited by (-)-catechin-3-O-gallate (CG) (7.60 µM), and CYP1A2 was most strongly inhibited by EGCG (8.93 µM). Catechin gallate exhibited non-competitive inhibition of CYP2C9, and its Ki value was 9.76 ± 0.47µM. The present study is the first to report the inhibitory effect of CG on CYP2C9. In contrast, EGCG showed competitive inhibition of CYP1A2, and its Ki value was 14.3 ± 0.09 µM.
CONCLUSION:
Previous reports had predicted that plasma EGCG concentration reached 7.4 µM after ingesting green tea having high concentrations of catechins. That concentration of EGCG is equivalent to one-half to one-third of its Ki value for CYP1A2 and CYP3A4 in this study. The ingestion of beverages containing large amounts of green tea catechins together with drugs that are metabolized by CYP1A2, CYP2C9, and CYP3A4 should be avoided. This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on ABSTRACT on the issue's contents page.
See drug interactions on FDA label of Ibrance:
https://www.accessdata.fda.gov/drugsatfda_docs/lab...
-- DRUG INTERACTIONS------------------------------ • CYP3A Inhibitors: Avoid concurrent use of IBRANCE with strong CYP3A inhibitors. If the strong inhibitor cannot be avoided, reduce the IBRANCE dose. (2.2, 7.1) • CYP3A Inducers: Avoid concurrent use of IBRANCE with strong and moderate CYP3A inducers. (7.2) • CYP3A Substrates: The dose of sensitive CYP3A4 substrates with narrow therapeutic indices may need to be reduced when given concurrently with IBRANCE. (7.3) See 17 for PATIENT COUNSELING INFO
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So I've just finished cycle 1 of ibrance/letrozole I have mets to bone only. Have seen conflicting reports on usage of cbd/thc with ibrance possibly causing increased levels of ibrance. My pain is minimal controlled with naproxen. My anxiety is ever present and causes insomnia. Should I pursue this route of using cbd/thc or wait until my cancer progresses? If so what is a recommend starting dose as I never used medicinal marijuana. I have appt with mo tomorrow but not sure how informed he is on use of cbd/thc. What have you all experienced?0
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I've used CBD/THC with ibrance with my doctor's knowledge and was not discouraged from doing so.
I eat the occasional grapefruit, especially on my week off or early in the cycle. I also love pomegranate juice. It increases the effective dose by slowing the metabolism of the drug. Grapefruit is just one of many foods that could potentially do that. IMO this is something to look at if you are having trouble with side effects. And if you do have issues, you have to dig into the issue a little deeper than not eating grapefruit.
Not sure whether green tea increases or decreases dose, but if you chased down all these food interactions you would probably not be eating much. Go with how you feel.
These are healthy tasty foods with many benefits. You have to consider the effect of not eating them as well.
>Z<
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thanks z. Those are my thoughts too. In the medical field we call it "chasing zebras". However can I ask what cbd/thc ratio you started with? I really have no idea where to start. It seems more complicated than just smoking a bowl. I just need my anxiety controlled and sleep more than a few hours at a time. I know some even claim it help with tumor shrinking. My only SE is low WBC and fatigue so far.
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Linda, I'm so sorry to hear of your progression. I'll be hoping for a great next treatment for you to beat the beast back
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There are a number groups that consult on line regarding the medical use of cannabis and, specifically, cancer. Aunt Zelda is one that I find pretty solid. Her group group has more data than others. They have been at it for a long time. Aunt Zelda herself comes from an engineering background, so she loves data. She has a 1 hour video on youtube where she discusses at a high level dosing for breast cancer specifically.
But I feel all alternative therapies need to be administered under the supervision of an experienced practitioner who specializes in cancer and has spent some time with your medical records. It's medicine even if the FDA somehow hasn't gotten its fingers into it. I would not google your way through forums for this information. I would find a qualified practitioner that you trust.
I will add that my naturopathic oncologist took me off cannabis. I was using it at relatively low doses to sleep. And boy did I sleep. But we monitored my sleep with my fitbit and I was not getting the REM/dreaming sleep cycles that I needed, so I was still tired. He said that can happen with cannabis.
>Z<
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Lindalou, so sorry to hear the news of your latest scan results. Keep us posted on your new treatment and wishing you the best of luck! Keep moving forward you got this
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I have been on Ibrance with faslodex for a year now and my Tumor markers keep rising . I'm freaking out ! I had a ct scan last week and find out tomorrow what's going on ,past scan show stable . Somebody please talk me down and tell me everything is going to be alright!
I plan on fight this stupid caner ! I know they are making progress Prayers to all
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Kimchee, take a deep breath and try to stop anticipating, if you possibly can. It will be okay. You just need to get to the results. Ibrance has worked for so many. Praying for you. Got my results last week, so I fully understand your trepidation. Hang in there....
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Linda,
Apparently this marks eight years since your metastasis diagnosis?! And the cancer is still confined to the bones? So yes disappointing and painful to crack a rib, but wow, this seems like a slow-growing rather dumb cancer!! And it would seem way time to change to some kind of different cancer-killing strategy! Maybe have a check to see if the cancer has now developed the PI3KCA mutation? That is the most common way ER-positive cancers become resistant to estrogen therapies, and there are some interesting inhibitors out in trials, or the old aromasin-affinitor combo. Please let us know what your options are for next treatments. Which therapies worked the best for you so far?
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Kimchee- It seems like tumor markers are only useful in a subset of people. Some people with lots of disease are normal, some with little disease are really high. I am not sure what to make of it. I will say that my tumor markers fell a lot at first. I just had my 3 month scan and had almost all regression or resolution of my extensive bone mets and bone marrow mets and no new lesions and my TMs went up! My MO just shrugged that off and said your TMs might not be useful to us-we will wait and see and repeat scan in 3 months. She said sometimes it goes up from tumor cells dying and releasing it into the blood stream.
Wishing good results for you on your scan!
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Thank you ladies I need to here this . I'll let you know how it turns out . Prayer for a cure
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