CAN RITUBIMAB +VENETOCLAX treatment causes yellowish loose poop

[unairdefamille]

I started the RV treatment and I rarely have normal lookin stools. They are often loose and of a yellowish or greenish color. Sorry for speaking about this topic. I was hoping it was only a side effect that would disappear sooner than later. 🙃 Any comments most welcome 🙏🏼🙄

[SofiaDeo]

Any drugs we take orally can affect our gut. Are you taking the venetoclax shortly after eating a meal with some fat in it? Studies show more of the venetoclax gets into our bloodstream with a high fat meal. A few people here, including me, have commented we take our venetoclax with foods having some fat. Like buttered toast instead of dry, or buttered vegetables instead of plain.

If you are already eating a lot of fat, the yellow may mean you are eating too much. The green may mean food is moving too quickly through your GI tract, especially if you suddenly have started eating a lot of leafy greens. How much fiber is in your diet? Are you getting a mix of both soluble and insoluble?

So play around with the types of foods you are eating, and the timing. FWIW, I was taught "with a meal" means start eating, and either take the medication partway through or at the end of the meal. Then drink water. If you are taking the pill on an empty stomach before the food, this may be a contributor.

People report nausea and diarrhea as venetoclax side effects, so having strange changes to stool is likely due to the venetoclax.

But is it at all possible you have some sort of GI infection? Do you have any history of persistent GI infection? Those color changes can also be associated with it, but people generally have additional signs & symptoms.

Speak to your doc, they may want to test it. Report it so they are aware. Better to be safe than sorry if you have an infection, if they decide you have symptoms to investigate.

[unairdefamille in reply to SofiaDeo]

Thank you so much, Sona Deo. I will mention it to my oncologist. Best wishes to you

[roszika]

It could be the food you are eating- do you eat a lot of green veges like asparagus, broccoli etc ? I was on Veneteclax for 2 years and Rituxa for 6 months and never had a problem. I would check with your CLL doctor anyway

[DriedSeaweed]

I actually recall experiencing this once I finally ramped up to 400mg. It subsided after a few days. Has this been going on long? Hope you get relief soon.

[unairdefamille in reply to DriedSeaweed]

THANKS!

[humanfly]

I'm 10 months into my V + R regime and I've been suffering with all sorts of GI problems but I've now learned to live with the daily loose stools. At first everything was fine but at about the 3 month mark it started to kick in. I mentioned it to my consultant which prompted a lot of test. I have no gut infections and a colonoscopy revealed everything was fine in that department - so it's all down to side effects. I feel sure there's a dietary answer somewhere but I haven't found it yet! In the meantime I take 1 loperamide a day just to slow things down.

[unairdefamille]

Thank you humanfly. Yes side effect is more like it. Best outome forward!!!👍

[MN1999]

I have found that avoiding processed foods and gluten as much as possible have been helpful. I also take a colostrum-based supplement. Good luck finding your best way thru this problem.

[BgChiLL]

What a timely question you asked! I am in an O+V clinical trial but finished the O in October. I take 400mg of V after breakfast each day yesterday had an early eye doctor appointment so I took the V with water as I left home, ate a small apple on the way, then ate a scone in the waiting room. I have had burning abdominal pain session followed by diarrhea ever since. I was up 5 times last night. After reading these comments, I will never take the V before breakfast again.

[SofiaDeo in reply to BgChiLL]

My GI tract was so sensitive, I had this regimen where I had to eat an early dinner, finish by 4:30pm. It had to include a cup of well-buttered vegetables, and I took the venetoclax 1/2 hour after eating with a full glass of water, sipped over maybe 10 minutes. I sat upright for at least a few hours, and could not eat anything else the rest of the night. Otherwise I got nauseous/acid stomach.

[BgChiLL in reply to SofiaDeo]

I will pay more attention from here on out. The V part of the trial goes on for 3 more cycles and then ends if the blood tests come out well. I think I have missed the possibility that the V has been causing milder versions of the side effect since I started taking it.

[SofiaDeo in reply to BgChiLL]

It's possible the lower doses don't affect you as much as the higher dose. Or that the longer you take it, the more the gut biome reacts to drug exposure. I was trying the mixed vegetables, to give my gut bacteria a variety of fiber to help it. I am sure these drugs affect gut bacteria somewhat, and that we all differ a bit in our response. I'm just thankful I was not experiencing the awful diarrhea some do.

[BgChiLL in reply to SofiaDeo]

I will definitely be talking to my CLL doctor about this at the next appointment.