Melatonin

[Guinness4822]

Hi, I'm on Ibrutinib and have been for 5 weeks now, no side effects. I take melatonin each night along with cannabis oil which helps me sleep ( I've always been a poor sleeper). This combination really helps. Does anyone know if taking these 2 products could cause issurs with Ibrutinib and in 2 months time venetoclax.

[AussieNeil Partner Administrator]

While drugs.com doesn't report any interactions between ibrutinib and either melatonin or cannabis (CBD) oil, I'd advise strong caution with the cannabis oil. Per this study report, it may well be reversing the effect of the ibrutinib, forcing CLL cells back into your nodes: healthunlocked.com/cllsuppo...

Also, per Cannabinoid Interactions with Cytochrome P450 Drug Metabolism: a Full-Spectrum Characterization pubmed.ncbi.nlm.nih.gov/341...

Cannabis-based products contain an array of cannabinoids, many of which have limited data available regarding potential DDIs. This study assessed the inhibitory potential of 12 cannabinoids against CYP-mediated drug metabolism to predict the likelihood of clinically significant DDIs (drug-drug interactions) between cannabis-based therapies and conventional medications. Supersomes™ were used to screen the inhibitory potential of cannabinoids in vitro. Twelve cannabinoids were evaluated at the predominant drug-metabolizing isoforms: CYP3A4, CYP2D6, CYP2C9, CYP1A2, CYP2B6, and CYP2C19. The cannabinoids exhibited varied effects and potencies across the CYP isoforms. CYP2C9-mediated metabolism was inhibited by nearly all the cannabinoids with estimated Ki values of 0.2-3.2 μM.

What's at issue is that the CBD oil may also interact with ibrutinib similarly to grapefruit juice, which is specifically contraindicated. That's because per Potent inhibition of human cytochrome P450 3A4, 2D6, and 2C9 isoenzymes by grapefruit juice and its furocoumarins pubmed.ncbi.nlm.nih.gov/179... "The cytochrome P450 enzyme family is the most abundant and responsible for the metabolism of more than 60% of currently marketed drugs and is considered central in many clinically important drug interactions. ... Grapefruit and pummelo juices were found to be potent inhibitors of cytochrome CYP3A4 and CYP2C9 isoenzymes at 25% concentration"

The problem is that what's in the CBD oil along with the actual vs claimed strength, varies enormously. with the strength usually overstated. You may well be worsening ibrutinib related side effects.

Neil

[Givemestrength23]

I have trouble sleeping, I asked about cbd oil was told it could react with the ventoclax

[Givemestrength23 in reply to Givemestrength23]

I am on ibrutinib and Ventoclax , 15 cycles I’m about to start cycle 6

[Alshial]

Melatonin is known to interact with Ibutrinib. Your doctor should know about anything else you are taking and approve you using it.

[BeckyLUSA]

My CLL specialist allowed melatonin but when I asked about CBD he said it was contraindicated.

[DoriZett]

I take the same for sleep and was on Acalabrutinib for five years. My onc OK'd them all together. I am back in W&W now for 2 years and still in remission. Wishing you well on your wellness journey.

[Guinness4822 in reply to DoriZett]

Thanks DoriZett I might give up the oil and stick to melatonin, just to see when next bloods taken in 2 weeks time.

[AussieNeil Partner Administrator in reply to Guinness4822]

It will be interesting to hear if you observe any noteworthy changes. Don't be surprised if your lymphocyte count increases - ironically, that's what we want to see - movement of CLL cells out of nodes and the bone marrow into your blood where they eventually die. Note that two weeks may not be enough, particularly for improvements in your haemoglobin, platelets, neutrophils and other white blood cells as your bone marrow gains more capacity to make them from the reduction in CLL infiltration.

Neil

[Guinness4822 in reply to AussieNeil]

Thanks Neil. My white count went from 104 down to 50 after 2 weeks on Ibrutinib no change in Haemaglobyn.

[Kingfish6]

Taking ibrutinib w/ melatonin, & CBD only with THC. CBD plain is useless.

[alexask]

Are you still taking melatonin? Seems it might be helpful for CLL itself?ncbi.nlm.nih.gov/pmc/articl...