Ibuprofen and Imbruvica

[12Caine12]

I read you shouldn't take ibuprofen when on treatment with imbruvica. I assume it's due to bleeding. Now is the concern that it could cause internal bleeding or make wounds on the skin more difficult to clot? Thanks!

[bachplayer13]

i take meloxicam which is a nsaid. if you are also on an anticoagulant therapy that's when you might have a problem. but my doc after reviewing my meds gave me the ok. they need to review your meds and let you know based on that. also if you are on a study they may have those type of requirments re avoiding nsaid

[Hidden in reply to bachplayer13]

which doc gave you the ok?

[bachplayer13 in reply to Hidden]

My oncologist at MD Anderson in the Leukemia department they also have their’s pharmacy doctor with you all my medicines including any supplements I would avoid tenant taking any additional supplements such as fish oil etc. if you strictly only take an NSAID oh no not on the anticoagulant therapy or taking any other supplements that’s probably fine but againHave your dock in the pharmacist to review your meds which is what I did

[starsafta in reply to bachplayer13]

Sorry, Bachplayer, my curiosity is getting the better of me after reading some of your posts. Are you dictating them, and Siri (or whoever it is you talk to) is going deaf?

[bachplayer13 in reply to starsafta]

yes some times i dictate to avoid typing and speech recognition is not real great on my phone.

[lankisterguy Volunteer]

Hi 12Caine12,

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I believe the answer is Yes to everything, including hemorrhages / hematomas anywhere in the body or brain, en.wikipedia.org/wiki/Hematoma, retinal bleeding, punctures, cuts and bruises.

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The clotting of blood is a complex process that involves 12 or 13 different protiens / factors which is not completely understood. en.wikipedia.org/wiki/Coagu...

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Lots of people have imbalances that are not known. There are dietary (e.g. Fish Oil, Vitamin K from Spinach etc.) and hereditary factors (e.g.: Factor 5 Lizen) that affect clotting, and like CLL, we are all different, and react to drugs differently.

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When Ibrutinib was first trialed in humans there were some serious reactions that were life threatening, so the prohibition/caution to avoid any and all blood thinners was implemented.

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Len

[bachplayer13 in reply to lankisterguy]

Good point to be absolutely sure one should avoid however I have significant joint pain and I’m taking the risk with my doctors and pharmacists permission

[AnneHill in reply to lankisterguy]

My consultant didnt object to me taking Naproxen which I have taken for years. I decided to stop taking it.

I had arthralgia from taking the Ibrutinib. I have painful arthritis, fibromyalgia and degenerative disc disease and take Tramadol for the pain.

I am anaemic and the consultant has booked me in for a gastroscopy to make sure I havent got internal bleeding. I have been taking Ibrutinib since 23rd June and despite stopping the Naproxen I have the possibility of internal bleeding.

Is it the Ibrutinib that causes the bleeding or is it the Ibrutinib plus the nsaid?

Either way I am in pain but I didnt want to take the risk. I will find out in a weeks time after I have the test.

[littledab]

Hi

I was told Tylenol is fine from my Oncologist!

I am also on Imbruvica.

But that is good to know thx for the information!

😊

[Shaheenji in reply to littledab]

NO not at all, please change your oncologist. Thanks

[Mldeterm in reply to Shaheenji]

My husband's CLL specialist has also ok'd it in moderation and the trial he is on even ok'd it as a pre med with his obinituzimab infusions (he's on ibrutinib and venetoclax too) because he doesn't take acetaminophen due to interference with his glucose monitor (he has type 1 diabetes too). So it is definitely ok in moderation in certain circumstances. As with everything consult your specialist.

[JuciyJ]

I am on Imbruvica and was told because of some back pain I could take 400-500 mg a day but the concern was more about too much ibuprofen and stomach irritation. I have low palates and get nplate injections as well. Always good to check with your doctors.

[tedrog]

kidney.org/atoz/content/pai...

[KevinCLLITP]

While on Imbruvica I had some very very serious joint pain amongst several other bad side effects. I have had some problem joints for quite some time which I have always used 3-6 Advil or 2-4 Aleve per day. I also have ITP so I don’t clot blood very well anyway and my platelets were 9k at last measure. My oncologist told me that the pain relievers were not an issue in those concentrations or levels of use but that if I felt I needed to have any more, then we should discuss. To date, I have not, but I developed some serious cardiac issues while on Imbruvica in my 7-8th month and had to stop the drug. I was off of it for about 12 days when I started Acalabrutinib, and I had immediate recurrence of my arrythymia. Be careful with these drugs, and if you detect ANYTHING in your chest or any greater evidence of bruising, call your doctor immediately.

[6468 in reply to KevinCLLITP]

Hello, I was on imbruvica for 3 1/2 mos. and stopped it. I also had bad bone and joint pains. (even 1/3 the dosage gave me issues) Lab results were good but I wasn't. Still in remission for 11 mos. Everyone seems to react so differently. Good luck to you and I hope your meds will work well. Such an unpredictable disease!

[dj02]

Us CLLers already have issues with reduced platelet aggregation with or without Ibrutinib. I came out in minor bruises and Im on W@W but was taking baby aspirin and so I researched it and found this very good article on the matter. Bottom line, be very careful but most bleeds are minor and if on Ibrutinib occur in the first month and tend to resolve after that

ncbi.nlm.nih.gov/pmc/articl...

[KevinCLLITP in reply to dj02]

My cardiologist told me yesterday that at 65, with no stroke or no heart attack that i should absolutely NOT take a daily aspirin of any type. My wife was with me and got into the discussions and she has now stopped her daily junior aspirin. The new guidance regarding aspirin has changed the thinking entirely and essentially only people who have experienced a serious cardiac event are advised to do so if they are under around 75.

[livinglifewell]

Hi Caine 12, I do not take ibuprofen or any other NSAID (non steroidal anti inflammatory) because my SLL infiltrated my kidneys years ago and left scarring, damage, and chronic insufficiency. Both Imbruvica and NSAIDs are very hard on the kidneys and I tend to the side of caution by avoiding NSAIDs at all costs. I also bruise easily from the imbruvica.

[BeckyLUSA]

My oncologist who also is my trial administrator and a CLL specialist has okayed it several times for me for short term usage. I would check with YOUR doctor.

[Mldeterm in reply to BeckyLUSA]

Same for us. Agree!

[Doremefasol]

Some anti-inflammatory medication more then others inhibit Prostaglandin synthesis. Prostaglandins are one of many kinds of molecules that aid blood clot formation hence the blood-forming mechanism would be affected. It could predispose the patient to excessive bleeding.