Ibrutinib and citrus

[ENAMP]

I’m in Ibrutinib since 7 months ago, after 23 years in watch and wait.

I know that can’t eat Sevilla oranges and grapefruit. Please can you tell me if I can eat another citrus as lemon and oranges?

[cajunjeff]

The fact that Seville oranges and grapefruits are specifically excluded implies to me those fruits not excluded are okay.

When in doubt, consult your pharmacist or doctor. I get my ibrutinib from a speciality pharmacy. Each time they call to renew my monthly prescription, they ask me if I have any questions for their staff pharmacist. You might see if your pharmacy has such a person available.

I eat other citrus fruits. It never occurred to me to ask if that’s okay, I assumed any food not specifically excluded is okay. It can’t hurt to ask.

[ENAMP in reply to cajunjeff]

Thanks for your answer. Regards.

[Newdawn Administrator]

Although not specifically citrus, the starfruit which can taste citrusy is also off the menu according to the list I received.

Newdawn

[AussieNeil Partner Administrator]

Grapefruit and Seville oranges are particularly high in an enzyme that inhibits the pathway by which Ibrutinib is processed by our bodies. Consuming these can result in extended periods of high serum levels of Ibrutinib, increasing the risk of serious side effects. I've not officially heard of other citrus fruit having this effect, though per

pharmacist.com/juice-intera... limes and pomelos should also be avoided. Other varieties of citrus, such as oranges, lemons, mandarins and kumquats aren't mentioned.

"All forms of grapefruit, including freshly squeezed juice, frozen concentrate, and whole fruit, can reduce the activity of intestinal CYP3A4. As little as 200 mL of grapefruit juice, the amount in a whole grapefruit, may be sufficient to cause clinically relevant increased systemic drug concentrations and subsequent adverse events. In addition, since administration of grapefruit causes irreversible inactivation, the effects of consuming these products can last as long as 72 hours. Therefore, separation of medications and grapefruit products by a few hours is usually not helpful.

:

Seville oranges, limes, and pomelos produce drug interactions similar to grapefruit by inhibiting intestinal CYP-3A4. "

Neil

[ENAMP in reply to AussieNeil]

Thank you Neil

[caven]

If toast-with-marmalade is a favorite ... beware! The best marmalade is made almost wholly from seville oranges

Caven

[country76]

I love lemons and squeeze the juice on many foods even eating whole. I have noticed that I get mouth sores more frequently when I eat citrus fruits. Maybe a coincidence?

[J_88]

I just wanted to comment on you being on Watch and wait for 23 years thats awesome.

[ENAMP in reply to J_88]

I began with 13.000 lymphocytes in 1997 and judgement of several doctors was start treatment inmediatily. We learned about CLL in internet and started with Ibrutinib in July past year. Change doctors a lot of times because there are not specialists in Chile where I live. I had anemia(Hb=6), low platelets(60.000) and 350.000 lymphocytes,

Now Hb=14; 110.000 platelets and 30.000 lymphocytes.

Thanks for your comment.