Thanks to nstonerocks chat....who advised me that apart from not eating grapefruit, which we know about and was in my Ibrance leaflet, pomegranate was also on the list. I hadn’t heard about this but checked with my oncology nurse today and she confirmed she had heard that too!!! Thanks for telling me, I have been drinking the juice and eating the seeds for the past week!! Eek!
So I ‘surfed’ on the internet and found another Pfizer leaflet site on Ibrance and it listed the following to avoid also....star fruit, Seville oranges and other similar fruit as they may change the amount of Ibrance in your body.
It is all so confusing and no one says anything or alerts you what to avoid.
We seem to have to do our own research.
I am also confused whether to take turmeric or not or dandelion.
Any advice??
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StE72
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I agree about having to do your own research. It is very hard to get the clear facts. I like taking tumeric and was looking into that. I found somewhere that it said you shouldn't and double checked with my doctor who thought it was ok. Argh. Now I have been unable to refund where I first was that you shouldn't take it.
The trouble is docs are taught next to nothing about nutrition. This is a really lacking part in the treatment of people with cancer.
Sloan used to have a checklist for
cross checking with access to everyone but I keep forgetting to look that one up!!
It seems to be a minefield. I also am on Care Across site and have asked them the same question. They tailor made nutrition for your type of cancer. I am waiting for their response.
Asking oncologists is useless, they just done seem interested yet it is a vital part of maintaining good health and boosting immune system. I have just been reading Pfizer’s own site about Ibrance and it seems that Ibrance works better if taken with when having a high fat meal!! No one suggested that!! I take Ibrance in the morning after breakfast which isn’t high fat....porridge and loads of fruit..... so confused again!
Palbociclib absorption and exposure were very low in approximately 13% of the population under the fasted condition. Food intake increased the palbociclib exposure in this small subset of the population, but did not alter palbociclib exposure in the rest of the population to a clinically relevant extent. Compared to palbociclib given under overnight fasted conditions, the AUCinf and Cmax of palbociclib increased by 21% and 38% when given with high-fat food, by 12% and 27% when given with low-fat food, and by 13% and 24% when moderate-fat food was given 1 hour before and 2 hours after palbociclib dosing. In addition, food intake significantly reduced the intersubject and intrasubject variability of palbociclib exposure. Based on these results, palbociclib should be taken with food (see section 4.2).
Look under products, pick up Ibrance.....then read down and pick up .......
If you would like to see the Patient Information Leaflet (PIL) or Summary of Product Characteristics (SPC) for IBRANCE these can be found at the electronic Medicines Compendium (eMC)
Click on the eMC highlight and follow it through.....
I take a relaxed approach to these kinds of issues. Having metastatic cancer is a life threatening diagnosis and I don’t believe any of these things have much significance for drug absorption. Nor do I worry if I have to take a week off Ibrance. It is the OVERALL presence of this drug in our system that will either helps us or not. I’ve been at this 5 1/2 years and have read, read, read what I could and Yes, a lot of the information contradicts itself. We have to accept that MOST of the journey is out of our control. It took me several years ( heh heh) to get to this point. Good luck on your journey.
Yes I agree with what you say....I suppose it’s about us taking control as well and what we can do to help ourselves.....but yes most of this awful journey is managed by the doctors......we are lucky that we now have these new drugs which appear to help and more is being discovered.... xx
Turmeric and other herbs contain natural blood thinning, so if you are on any kind of blood thinners or aspirin therapy, that would be where the problem is. Found an FDA site that "says" they did a study on turmeric and Ibrance over a year on 100 women, and all of them had some kind of side effect. Here's the kicker tho, ALL, every single side effect THEY claim are result of taking turmeric with Ibrance are Ibrance side effects even without any supplements or herbs. So that is BS. When you do your research, always dig deep and understand what they are saying. Don't trust in the pharma company brochures or the FDA, they both have ulterior motives. The FDA, if they had their way, would take ALL supplements and herbs off the shelf, they want you to use drugs THEY have approved and the company has patented, and they get paid big money by pharma to do so. They have no control over natural vitamins and herbs, as they are plants grown in nature, and they can't get any money out of that. They cannot demand a patent on a plant (which is confusing, as the federal gov't holds a patent on marijuana). Ibrance costs about 75 cents a pill to produce, and look what they charge for one month. Big bucks. So you have to get away from the pharma company and the FDA and dig deeper. Will post some sites if you want, and do love that folks are concerned and educating themselves, and you can't believe everything you read online, ESPECIALLY when there is huge money involved to get you to take a drug. Even oncos get paid to prescribe chemo drugs, so big bucks for them. Doctors are not nutritionists, and they are not pharmacists. Yes, there are times that we have to educate them, and have done so many times. If you have a GOOD doctor, he/she will appreciate a print out, saves them a ton of time, if you have a know it all doc, he/she will probably throw it away the second they leave the room. We have to deal with a lot, and it is always, always better to go in armed with lots of real, factual ammunition, not something from any chat site. So just be careful what you believe, think about ulterior motives and money, and if it sounds just ridiculous, ignore it. I am no doc or nurse, but think if you have been taking turmeric, personally I would continue. Yes, grapefruit and pomegranate are no-nos. But think you are fine with the oranges, etc. Just don't eat weird things you never ate before. A lot of folks just have a reaction to the food itself, not the drug interaction. And you may find there are certain foods now that may trigger nausea and/or diarrhea, just avoid them or eat sparingly. Good luck, common sense prevails, and the more intelligent you sound going in, the more your doc is going to pay attention to you.
You may have already found what you are looking for. As someone mentioned, the Memorial Sloan Kettering Cancer Centre website has a lot of information on natural supplements. About turmeric, it says that it can interact with drugs that are metabolized by the enzyme CYP3A4 mskcc.org/cancer-care/integ.... Palbociclib is metabolized by CYP3A4. Sloan Kettering says though that over the short term, it seems that turmeric can be used without affecting the therapy.
In regards to dandelion, besides it also being metabolized by CYP3A4, it also possess estrogenic action and thus should not be used by those with HR+ breast cancers. mskcc.org/cancer-care/integ...
I guess it is ok if you have it once in a while, but not as a regular.
Have you tried carrot juice? It does not interferes with CYP3A4. And the components falcarinol and luteolin are thought to have cancer-fighting properties. There are a few studies published. One of the researchers provided the daily dose as being the juice of 1lb of carrots for every 30 lbs of body mass. It ends up being around 1 liter (2 pints) of juice.
Look for luteolin and falcarinol for more information. Always look to see if the supplement you intend to use is metabolized by the CYP3A4 enzyme, in which case it could either increase the toxicity of palbociclib or reduce its effects.
I was just informed by my dr to stay away from peppermint and fennel seed as well as it can add to side effects because of the way the liver processes it
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