Whilst compiling my input for Sandy, re. Imatinib intolerance, I remembered that my French Consultant had run after me as I was leaving to tell me, in no uncertain terms, never to take Paracetamol, in any form, with Glivec.
I never did nor have I whilst on Dasatinib. Ibuprofen has to be the cure all for me nowadays and has caused me no problems.
I notice that this has been mentioned before but thought I would add my experience on it.
Irene
Hi Irene
When I was on Glivec I was told paracetemol was the only thing I could take and not aspirin or ibuprofen. Makes you wonder how much advice you should listen to sometimes!
K
Just to add a little more confusion to this discussion.
I was told not to take paracetamol at all! Except if I was to show any symptoms of flu and then only take it for a few days only. Till the flu symptoms subsided.
When I asked my to about paracetamol he looked through his books and found two conflicting articles relating to this subject. In the end he found a third article which said if in any doubt ask your GP to which he shrugged his shoulders and said I don't know what to say!
With regards to anti inflamatories I take diclofenac sodium 75mg (nsaid) daily to ease my joint pain caused by arthritis this is the only thing that's gives me any relief as all my other medication I used to take was stopped when the CML started. I have had no side effects from using this drug.
I hope this helps
Stuart
If it helps, the US Surgeon General's advice on this one is not more than 1300mg per day of Paracetamol (called Tylenol in the US) which is 2 and a bit tablets. Not sure how much science there is behind that - all the concern seems to stem from a single patient in the early Glivec trials who was also taking large amounts of paracetamol and unfortunately died of liver failure in a matter of days - which has naturally made evryone rather cautious ever since.
Personally I use Ibuprofen as and when, Naproxen if my gout is really bad and a maximum of 1 dose of paracetamol a day when I have a cold, but that's just my personal view. Both the Naproxen and Ibuprofen may interact with Glivec via the same route as Grapefruit does and thus may take longer to clear than with a normal person / may make Glivec clear more slowly so caution is advised and you shouldn't overdo them.
You pays your money and you takes your choice I'm afraid
I agree with Stuart that you try diclofenac sodium -ask your GP for a box of 60 in number Arthrotec 50 that contains diclofenac sodium 50 milligrams and misoprostol 200 micrograms
In the first 6 months of taking Glivec I experienced severe bone pains as the bone marrow was changing for the better-my consultant said that it was OK to take Arthrotec with Glivec
Suggest you take Arthrotec with food and with water as it can irritate the stomach otherwise and suggest you take it at a different time of day from taking Glivec
I think that normally it is prescribed for arthritis
I have found it good as a general painkiller as well
Hope this helps
John
This is something I keep forgetting to ask my consultant (my GP is unlikely to know). I was told to moderate use of both paracetemol and ibuprofen - the former because of the liver and the latter because of the stomach. I suspect the liver issue is the more important one but i don't know - but I haven't taken any paracetemol since starting Glivec, and only limited amounts of ibuprofen (which I was definitely told could be taken in moderation, short term).
As for aspirin, as I had very high platelets to start with (because of my odd transcript), I was on low dose aspirin for about a month after starting glivec. But that was stopped as soon as my counts were normal.
caroline m
I was diagnosed in March 2005 and have been on Glivec since - so coming up to five years! Thankfully it has worked well for me and long may it continue to do so! A disc in my lower back slipped in August 2008 and trapped my sciatic nerve. I spent a year in pain until August 2009 when I had an operation. I spent most of the year taking a daily dose of painkillers and a lengthy period taking an anti inflammatory. I have taken paracetamol, co codamol, naproxen, codeine, tramadol. Not altogether I hasten to add! This was done with the knowledge of my consultant. It has not effected Glivec absorption and my liver function tests etc have all been normal. I assume that as Glivec "becomes older", consultants may be more comfortable with these other drug combinations being taken alongside Glivec.
In the early days of my CML, I had very painful bursitis, amongst other things, and took maximum quantities of 30/500 co-codamol for several months, to the point that I became dependent on the codeine and had withdrawal symptoms when I stopped. A few months back, I had thoracic surgery, following which I again took copious quantities of paracetamol both in and after leaving hospital. I didn't realise that there could be any problem with this. It doesn't seem to have influenced the working of Glivec and my last PCR test gave 0.002%.
John
Dear John/all,
the reason why you should not take paracetamol is because it one of a class of drugs (a very large class) synthesized by the liver.... as is imatinib.
It is fine to take paracetamol in moderation (as with most pain killers) as long as you do not take it consistently for long periods and do not take more than the maximum recommended dose within 24 hours (read dose warning on pack)
Liver damage caused by too much paracetamol can be life threatening... but you would have to take quite a lot in one go.
There is a herb called Milk Thistle that can support and protect the liver, and can be beneficial in bringing liver proteins down to normal levels.
Sandy
I have taken paracetamol before..I am interested in all your comments and would like to know more about taking the Milk thistle supplement.. should I take this to protect my liver whilst on Imatinib 400mg daily
Hi Michelle,
I cannot specifically recommend that you take any herb as some of them (like St. John's Wort) are contra-indicated if you are taking imatinib. however I know that there are many of us who over the years have taken Milk Thistle when their liver proteins have gone up when taking imatinib. This side effect is not that common but I know that some have seen a drop to normal levels of proteins after taking Milk Thistle.
If your blood counts show that your liver proteins are normal then I would say that you should not worry. Take a look at the FAQ/Glossary on main menu for the normal values of blood counts etc.
Please make sure you thoroughly research all herbal supplements for their effects and contra-indictaions if you are taking imatinib or other TKI.
Just a reminder that grapefruit juice also has contra-indications with both imatinib and nilotinib as it increases the plasma concentrations of both drugs.
Best wishes,
Sandy
