Antibiotics

[tlcladygiraffe]

Which antibiotics interact with imbruvica....I am on 2 and my stomach is in agony..I also have an ulcer....brutal...will be off the one tomorrow....

[Cllcanada Top Poster CURE Hero]

Have you been tested for H.pylori... a gut bacteria... ? There is a large number of antibiotics that react with Imbruvica (ibrutinib)... but I have not seen an antibiotic only listing...

Hope you are advising your doctor of your problems and moving to the care of a gastro doc...

~chris

[Octavia17 in reply to Cllcanada]

You ahould be on anti ulcer medication to cover you for ulcers.

Also My husband takes Kefir, a type of yogurt good for good gut bacteria, which available from Polish shops

Good luck

[tlcladygiraffe in reply to Octavia17]

Will check out the kefir..thanks.

[tlcladygiraffe in reply to Cllcanada]

Yes I have been tested..I have a duodenum ulcer and have had it for years...was on Tecta but that causes stomach ulcer..went off it months ago.

[Jonquiljo]

Well, I am an old-time gut man (45 years of problems!). I've been told that H. Pylori (by a lot of Gastros) is not as common as many people believe. But anyway, it can be a factor. Hopefully it is not - as the standard protocol for H. Pylori removal is high dose antibiotics and PPI's for a couple of weeks or so. PPI's will (in excess) can mess with your Imbruvica.

Did they do an endoscopy and actually see an ulcer? If so, that would be H. Pylori for sure. I have heard that gastritis can be equally as painful. Imbruvica can cause stomach and GERD problems and gastritis can possibly result. It's hard to tell stomach vs esophagus as the pain can refer both ways.

You definitely need to see a gastroenterologist who can communicate directly with your Heme/Onc or CLL person. An ulcer is definitely not just going to go away. Good luck, and I am sorry to hear of your problems.

[Cllcanada Top Poster CURE Hero in reply to Jonquiljo]

H.pylori is fairly common in CLL actually, certainly more so than the general population as with many things in CLL. I had it in about year 5 post diagnosis, was treated over 3-4 weeks and there is also some linkage between H.pylori and ITP, thrombocytopenia....

~chris

[Jonquiljo in reply to Cllcanada]

OK ... makes sense. CLL patients must be more susceptible to H. Pylori infection. I've had a million upper GI problems, and my Stanford GI Dr. told me there was no real reason to look for it. He eventually did have to look for H. Pylori as a precaution when I had a esophageal RF ablation procedure to remove Barrett's esophagus tissue with dysplasia. A very successful and relatively minor procedure I might add. It didn't fix my GERD - it wasn't supposed to, but the damaged (with dysplasia) tissue was all removed.

[tlcladygiraffe in reply to Jonquiljo]

Thanks..I did have an endoscopy years ago....duodenum ulcer..had been fine until going on the imbruvica and going off the acid inhibitor...eating greek yogurt with probiotics to help the problem..thanks for your reply.

[NooNoo14]

I recently had to take a five day course of Ciprofloxacin for a bladder infection. It caused me severe acid reflux, stomach cramps and generally made me feel unwell. I shall be asking for an alternative if it happens again.

Netty

[tlcladygiraffe in reply to NooNoo14]

Agree..I would also...most antibiotics cause stomach problems..I have to crush mine and mix in honey so I can swallow them...the pills are huge....ridiculous

[Cllcanada Top Poster CURE Hero in reply to tlcladygiraffe]

Most pills are polymer coated to prevent stomach upsets so they open later in the lower stomach, small intestine.. etc... crushing them defeats this coating...

Possibly part of your problem ... perhaps look into Esophageal dilation...

[tlcladygiraffe in reply to Cllcanada]

These pills are not coated..I was told I can crush them.

[shazie in reply to NooNoo14]

Hi Netty. I am not 100% sure but I thought Cipro is not supposed to be taken with Imbruvica. If you live in US you probably get your Imbruvica from an oncology pharmacy. I get mine through Diplomat and their pharmacists know about these drugs more than my doctors. So please call them and check with them before taking any new meds no matter which doctor prescribed them.

[Cllcanada Top Poster CURE Hero in reply to shazie]

Cipro, should be avoided, or Imbruvica (ibrutinib) dose reduced to one capsule...

~chris

[ladyprescott in reply to Cllcanada]

Thanks, Chris.

[NooNoo14 in reply to shazie]

That's worrying as it was prescribed by the Trial doctor and I was told over the phone to go to the hospital pharmacy to pick up the meds. I was not told about changing the Ibrutinib dosage or actually spoke to anyone about it. I did ask the Pharmacist when I picked them up if it was ok to take with my meds (I was concerned more about my heart meds) but he said it was fine.

[Cllcanada Top Poster CURE Hero in reply to NooNoo14]

Drug label section 2.4

Reduce IMBRUVICA dose to 140 mg if a moderate CYP3A inhibitor must be used (e.g., fluconazole, darunavir, erythromycin, diltiazem, atazanavir, aprepitant, amprenavir, fosamprenavir, crizotinib, imatinib, verapamil, and ciprofloxacin) [see Drug Interactions (7.1)].

accessdata.fda.gov/drugsatf...

There is a new drug label and this quote has been generalized., but it is clear in the 2017 version cited above...

[NooNoo14 in reply to Cllcanada]

Thanks Chris, I will keep this for future reference.

The team are on top of my AF problems and meds have been tweaked in accordance with Ibrutinib guidelines but do tend to worry when additional meds are added and always check with the Pharmacist when I collect them. The last one obviously slipped through the net.

Netty

[ladyprescott]

Clindamycin is a drug that was prescribed to me last year before I was on Imbruvica. I could only take a day and a half before it was eating my stomach and I had to stop and I don't have stomach problems. The mycin drugs I understand are hard on the stomach. I don't know if they are compatible with Imbruvica, but no matter what, if prescribed Clindamycin, ask for something else. It was an awful experience.