Piqray suspended with COVID?

[Dragonfly2]

Piqray 250 was working well until my scratchy throat was diagnosed as Covid the day after thanksgiving. I wasn’t feeling too poorly but I had no one to talk to because of the weekend. On Monday, the ONC who was consulted in my regular doctor’s absence, said to go ahead with my Piqray. The next day, I got a notice in my portal that my ONC says to stop Piqray fo4 7 days. Ugh, I didn’t want to hear that! People here have shared that they have Piqray withdrawal pains ….and then there’s the return to Piqray with all its loading problems. I’m thinking of taking half doses during my Covid time…admittedly my ONC is not very familiar with Piqray symptoms and withdrawal effects.

Is anyone out there who had to suspend their Piqray due to a viral infection?

Did you have withdrawal symptoms ?

I don’t want to undermine my oncologist’s directions but she only has 2 patients 9n oiqray and may not be well versed in how the drug behaves….or misbehaves 🙄.

thank you in advance…and BTW I was just two days away from getting my Covid vaccine 🤨. And I’m not taking paxlovid because I dint take it last January and recovered quickly while my husband stayed sick for days after.

best wishes!🙏❤️‍🩹

[awesome4ever]

If it were me I would stop the Piqray but perhaps only do the 4 -5 days. You aren't going to have withdrawal and/or loading issues with minimal time off. When I had the Covid vaccine I was under the weather for 4 days to be honest so I can't imagine you having taken the vaccine and on top of that already likely having Covid in your system. Your body needs time to fight and your immunity is key. I'm on Everolimus and Exemestane so my immunity isn't affected at all. I'm also going to recommend the usual to drink tons of fluid and chicken soup does wonders. Hope you feel better soon. Take care.

[Dragonfly2 in reply to awesome4ever]

Thank yiu…I have stopped. It am watching m6 glucose numbers with the metformin…may have to cut back on that as well 🙏🤷🏼‍♀️

[awesome4ever in reply to Dragonfly2]

If you are taking the metformin purely for the Piqray induced hyperglycemia then stopping the Piqray cold turkey so to speak can cause hypoglycemia so yes please monitor. I'm not sure what does you take...I myself am taking Metformin but only 500mg once a day. I can stop anytime and not have any issues. As a matter of fact I'm sure you know that it is recommended to stop Metformin for 48 hours after you have a CT with dye in order to allow the kidneys an easier time to excrete the dye. I did that with my last scan 3 weeks ago and then restarted on the 3rd day following. Depending on who ordered your metformin I would ask them about what to do with your Metformin too. If you take it more than once per day I probably would cut back on at least one of the doses but again check with your doctor. I know it must be a pain getting this all settled when all you feel like is resting with your feet up. Take care.

[Dragonfly2 in reply to awesome4ever]

Wow I did not know about cutting metformin before a CT scan. No one mentioned it! Ok, do now I’m monitoring my glucose numbers to be sure I don’t get too low. Numbers are hovering on either side of 100 before and after eating. ONC is hands off on metformin and PCP has no experience with Piqray. I’m in the middle trying to use common sense and your help. Thankfully I’m feeling good so I’ll just stay the course unless numbers redd as I’ll shift. Thank you so much for your help🙌🙏🏻🙏🏻

[Laskia in reply to Dragonfly2]

There is no need to stop metformin before or after a CT scan with dye unless your kidney function is severely compromised as in eGFR of below 40. If this was the case, the doctors would advise you. Whenever I have a CT done, my eGFR is written on the consent form. Yours should be too or at least the radiologist would ask to see it before performing the scan.

They will tell you to stop before a PET because it can affect the results.

[awesome4ever in reply to Laskia]

Hi Laskia. It would seem that facilities use different criteria. My radiologist feels that if your eGFR is near to the normal range which is >59 here, if you are taking the Metformin for medication induced hyperglycemia they prefer you to give your kidneys an extra break and not take it for 2 days following. The eGFR that you mention of below 40 means the person is already in stage 3 of chronic kidney disease so that's a totally different matter. My oncologist errs on the cautious side and I agree with her. All the drugs we take for MBC and otherwise are hard on the kidneys and we will all see our eGFR(lowered) & Creatinine levels (increase) as we continue on this path.

I think the takeaway is that each individual should check with their own radiology department for their recommendations if they can't get advice from their own oncologist. Take care.

[13plus]

I can’t answer your question directly but I think they want you to stop any immune-lowering meds while recovering from Covid. And tbh having mild Covid one time doesn’t mean it can’t be worse another time, so if it were me I would be following the doctor’s advice.

Frustrating for you that you caught Covid before getting your booked vaccine! It is a challenge to know the best timing. Hopefully you’ll get over it fast and can resume your treatment again soon

[Dragonfly2 in reply to 13plus]

Thank you…I’m hanging in there and feeling comfortable…🙏 it’s a mild case with minimal symptoms! 😍

[Nocillo]

It’s too bad you have covid. I have felt the same way, not knowing what drug to take, not knowing if the onc is right, etc. It’s hard to know what to do sometimes. That’s why this forum is so helpful!! Only people with our issues really understand what we go through. I’ve not had Piqray, but it helps to know that whatever the drug, we all have questions. Hope you feel better soon!

[Dragonfly2 in reply to Nocillo]

I agree! Too often something comes up on a Friday. And there’s no one to turn to… but you ladies are always ready to jump in and quiet our anxiety. Bless you all !🙌🙌🙌

[HelenWi]

I stopped Piqray, took Paxlovid and resumed Piqray after a week and I had no issues. Maybe nice to have a break from Piqray…😊

[Dragonfly2 in reply to HelenWi]

Thank you. It’s good to hear that all is good despite the unplanned interruption. I appreciate your kind words 🙌🙌

[HelenWi in reply to Dragonfly2]

Just an aside… I started a different therapy in September which has been working great, really knocked down markers for the first time and then I had to stop because of surgery on femur to fix a small fracture. I will probably be off for a total of 4 weeks so I’m a little concerned about that myself but then I figure if the Drs are ok with it, I should just relax!🤣

[1711JPD]

Talk to your onc and share your concerns..

[Dragonfly2 in reply to 1711JPD]

Next week for sure! Lots to talk about 🙌🙌

[love2golfwell]

I'm glad the Piqray has been working well for you along with the Metformin. I'm sorry you have Covid and have to come off the meds while your body heals. Hopefully you will not have issues when you go back on the meds and that the Covid symptoms will remain mild. Lots to deal with. Please take care of yourself, feel better soon. Sending hugs and prayers.

[Dragonfly2 in reply to love2golfwell]

Aww thank you dear! It’s a dreary time without the golf … yes, I’m feeling better for sure… mostly just fatigue do bring off the Piqray is helpful 🙏🏻🙏🏻

[love2golfwell in reply to Dragonfly2]

You are welcome. I still have been playing often. Trying to get as many rounds in as I can as I realize someday I may not be able to play. Glad you are feeling better. I know you had some struggles awhile back and were not sure what the next treatment would be. Glad your doctor found something to help. Hope you have good holidays and that the New Year will bring you healing and happiness. Hugs

[Totheriver]

Hope you feel better soon and get everything sorted out 💕

[Dragonfly2 in reply to Totheriver]

Thank you 🙏🏻🙏🏻🙏🏻

[RLN-overcomer]

Greeting Sister/yessss Warrior🙂 I am happy to know you got to enjoy your Thanksgiving with your loved ones. I am also happy to hear you have mild symptoms from the Covid diagnosis. 😇. Happy Holidays Amen XoXo

[Dragonfly2 in reply to RLN-overcomer]

Thank you kindly…I’m feeling better…just am sooooooo fatigued. 😇

[Timtam56]

I had that type of covid with not just a scratchy throat, but a razor sharp throat!. But I don’t remember whether I was taken off piqray. I think I was. But that was not too mu h of a problem for me.

[Dragonfly2 in reply to Timtam56]

Ugh…that kind of sore throat is just awful…sorry…I’m dealing with fatigue but thankfully comfortable 🙏🙏

[Laskia]

I have stopped Piqray several times - covid, surgery etc and never experienced anything like a withdrawal pain or any symptons whatsoever. In fact, i felt so much better!

I carried on with 2,000 metformin daily but stopped the Jardiance. Metformin wont affect glucose levels too much as it acts mainly to regulate insulin. I was taking metformin as an 'off-label' before going on piqray anyway. i dont have diabetes but metformin has anti-cancer properties.

[Dragonfly2 in reply to Laskia]

Yes…that metformin is a great drug….though some have gut issues from it. But that yiu…I’m back in the saddle and feeling better, thanks again!

[Moonfry]

I am on piqkay 250 and the flosvanr shot