Drugs to avoid when on TKIs (article)

Being a well behaved patient I religiously took statins for years ( not for high cholesterol but because my GP felt it protected one against heart disease). When I started taking Imatinib on my CML dx nearly 5 years ago all went well for a year or so and then I started getting horrible muscle pains, cramps and a feeling in the soles of my feet as if I was walking on broken glass. Unpleasant to say the least. Off I got sent to the neurology dept at the hospital + tests for diabetes - all negative. I continued for a further couple of years still with pain in my feet and then decided to take myself off statins before we went on a walking holiday in Italy. The difference is amazing - normal feet, no joint aches and pains - such joy! I had given up swimming as I woke the next morning feeling as if a bus had been driven over my hips. No more!

So no statins for me...

Best Chrissie

If you buy the PDF of a published document of this kind (with restrictions on use) you can't publish it or share it on a public platform like this. That is why I could not put it on our home page, I could only post the abstract. Louisa may have a subscription to the Lancet(?) and she may be willing to share it with others but she would need each individual's contact details to do that.

If you scroll down to the second article on the home page you will find a link to another article on this subject published in 'Blood' (ASH journal) in 2011, it is still pretty comprehensive...

Drug interactions with the tyrosine kinase inhibitors imatinib, dasatinib, and nilotinib.
Amina Haouala, Nicolas Widmer, Michel A. Duchosal, Michael Montemurro, Thierry Buclin, and Laurent A. Decosterd

Abstract

Several cancer treatments are shifting from traditional, time-limited, nonspecific cytotoxic chemotherapy cycles to continuous oral treatment with specific protein-targeted therapies. In this line, imatinib mesylate, a selective tyrosine kinases inhibitor (TKI), has excellent efficacy in the treatment of chronic myeloid leukemia. It has opened the way to the development of additional TKIs against chronic myeloid leukemia, including nilotinib and dasatinib. TKIs are prescribed for prolonged periods, often in patients with comorbidities. Therefore, they are regularly co-administered along with treatments at risk of drug-drug interactions. This aspect has been partially addressed so far, calling for a comprehensive review of the published data. We review here the available evidence and pharmacologic mechanisms of interactions between imatinib, dasatinib, and nilotinib and widely prescribed co-medications, including known inhibitors or inducers of cytochromes P450 or drug transporters. Information is mostly available for imatinib mesylate, well introduced in clinical practice. Several pharmacokinetic aspects yet remain insufficiently investigated for these drugs. Regular updates will be mandatory and so is the prospective reporting of unexpected clinical observations.

full article:
http://www.bloodjournal.org/content/117/8/e75.full?sso-checked=1