I have been on Ibrutinib for over three years now. It has with God’s help been a wonder drug for me. I was given a month to live three years ago and here I am today quite well.
Tonight I ate a small grapefruit, then remembered that it does not go well with Ibrutinib.
Can anyone tell me what will happen?
Grateful for any help,
Arnhild
Hi glad you are doing well in your Ibruitnib. I am on it to. It is a great drug,
As far as grapefruit goes I don’t know what the impact it has on us. I would call your CLL doctor or nurse for advice.
All the best
Ann
Hi Arnhild,
The grapefruit and other banned/proscribed foods have an CYP3a4 inhibitor that slows down the removal of Ibrutinib's active ingredient in your blood stream.
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Here is an easy to read explanation: webmd.com/drugs/2/drug-1654...
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How the interaction occurs:
Grapefruit and Seville oranges may slow down how quickly your body processes your cancer medicine.
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What might happen:
The amount of your cancer medicine in your blood may increase and cause more side effects than normal.
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What you should do about this interaction:
While you are taking this medicine, you should not eat grapefruit or drink grapefruit juice or eat Seville oranges (often found in marmalades) at any time. You may choose an alternative citrus (such as non-Seville oranges). In the event that you are instructed by a healthcare professional (e.g., doctor, pharmacist, or dietitian) to eat grapefruit or drink grapefruit juice, you should immediately discuss with your doctor the effects of grapefruit on the blood levels of this medicine
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And a CLL Society explanation by Tom Henry a CLL patient and Pharmacist
cllsociety.org/2017/09/thin...
Len
Probably no harm just the one time. Many people have to stop taking Ibrutinib for dental work or surgery, so if it gets disturbed one day, you should be fine. Mention to your oncologist next appt. 💕
Try high doses of vitamin C. Not ascorbic acid as that is synthetic, but tangerines, bell pepper etc and supplements.
There is something in grapefruit that cancells out the function of certain meds. It is ok. It will wear off and the ibruitnib will start working again. Ok for one night. Meanwhile, grapefruit had apigenin in it like parsley that is very good for anticancer. Parsley and grapefruit are two cancer superfoods.
I think the point here is that grapefruit causes an OVER concentration of Ibrutinib which can lead to toxicity issues, rather than stopping it working as you suggest.
As Aussie Neil made me realize, when you make a health suggestion we have to substanciate our advice with scientific research. All I know is someone told my mother that grapefruit will stop her meds from working. No idea if it is true. However I see that green tea and turmeric are Cox2 enzyme inhibitors. That's a good thing in our case because the Cox2 enzyme needs to be inhibited from giving inflammation, etc. I wouldn't be surprised if grapefruit inhibits somethings too, but what does it inhibit and how? While it is inhibiting it could be doing other great things with it's apigenin, a well known cancer fighter. Where do you get the idea that grapefruit causes an over concentration of ibrutinib. Too much ibrutinib is from too much ibrutinib, surely? Though it seems to help us a lot. Glad it exists, we will have longer life.
I just read what Hannah Hugo wrote and it seems to substanciate what you said about toxicity...
Well thanks for that.
Ibrutinib comes with a warning specifically about grapefruit and Seville oranges, as well as several other things. Always read the inserts you get with medications! I have a beautiful grapefruit tree, but haven’t eaten a grapefruit off of it forever, because three of my medications come with stickers on the containers warning against grapefruit, in addition to the warnings in the inserts.
If you have a 24 hour number to call, call and ask. Let us know what you find out.
Call your dr as soon as possible , he probably will tell you to delay the next dose .
Nothing dangerous , but Ibrutinib will be in your body for a longer time , as it can´t be metabolized by the liver .
If the liver doesn't metabolize ibrutinib, does that mean a liver cleanse is a good idea? What cleanses ibrutinib from the liver specifically? Maybe nobody knows yet. Dana
Further info in relation to lankisterguy’s comments:
“Even natural substances found in foods can affect CYP proteins, which in turn can alter drug responses. For example, grapefruit contains bioactive compounds such as bergamottin that can inhibit CYP3A4, an important CYP enzyme required to degrade several types of drugs, thereby increasing the risk of toxicity and adverse affects with those drugs. Drugs known to interact with grapefruit include statins, antiarrhythmic agents, immunosuppressive agents, and calcium channel blockers. It is generally advised that people on these types of medications avoid the consumption of grapefruit. Other bioactive foods that affect CYP3A4 enzymes include pomegranate juice and red wine, as well as St John’s wort extracts.”
Which rather puts the lie to natural = safe. If any substance (natural, modified natural or synthetic, it doesn't matter), has the capability to modify biological processes, it must also have the capability to do so in other areas than intended (so called side effects). Likewise it may enhance, reduce or interfere with other substances taken for their biological effect.
Neil
A little pink flower, Madagascar periwinkle, is said to have vincristine and vinblastine in it which shows up in places as a cure for Leukemia, no specific leukemia, and in other places it is considered poisonous. Scary! Many mushrooms are natural but we know not to touch them. You're right. It is not till we know the exact function of a phytonutrient that we know how to set it to work for us.
I question the value in taking anything that is the same thing ever day. Even egcg might do well to take a break on weekends and try some of the other Cox2 inhibitors of inflammation like rosemary, feverfew, scutellaria, oregano, ginger, Chinese golden thread, Japanese Knotweed, Tulsi. Tulsi is big in Indian traditional medicine. I'm looking for biodiversity. Will I go wrong on that course?
Dana
I have had vincristine its a standard treatment for DLBCL and Richter's transformation... not an easy drug and the side effects are 'all natural' peripheral neuropathy for life.
~chris 🇨🇦
What is DLBCL? Right! Thank you! I won't make any tea with the little pink flowers, then. Thanks cllcanada,
I'm trying to reduce radiation from my life. Have you any suggestions how to use my cellphone and hide from the radiation?
Dana
Hi, I'm on ibrutinib also. I am pretty sure one grapefruit won't hurt, but it's the ruby red grapefruit/juice and the Seville/blood oranges that need to be avoided. It is because there is a reaction between the two whereby the catalyst in the citrus potentiates the reaction of the drug. This means that it changes the way the drug is metabolized in your body, making it stronger and less predictable.
Grapefruit amplifies the components of certain medications. I had asked why we couldn't use more grapefruit and less medication and was told that grapefruit was unreliable in terms of measurements in dosage ratio.
Wow. i can't imagine how that must feel to be told one month and then to be given so many years on imbruvica more than that. That's wonderful. All I can add here is that if you miss the taste of grapefruit, perhaps you can get a white wine with strong 'notes' of grapefruit (while actually having no grapefruit in it, of course). This way you can recall the flavor with none of the effects.
fish testing or lack of
Ibrutinib Trial 
Any other members put on a lower dose of Ibrutinib after some extreme side effects? 
Tidings of Joy this happy time
Please can you tell me your symptoms and the levels of your WBC when you were started on Ibrutinib...
