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TKIs and Alcohol ?

Hello, despite having read content that seems to indicate that alcohol-ethanol does not interfere with the effectiveness of TKIs, I would like to know the opinions, experiences and knowledge of more people on the subject. My doctor does not seem to be clear about it, at first he told me that no alcohol in case it reduced the effectiveness of Imatinib, then he told me that I could lead a normal life including alcohol later and then he said to be careful because although alcohol does not interfere as However, the liver enzymes responsible for metabolizing alcohol such as TKIs could do it, I am doing a lot of research on the subject (inductions and inhibitions of the CYP3a4 enzyme, cyp2e1, MEOS system, etc.), however I also considered it appropriate open thread in this forum.
Since I was diagnosed 5 months ago I have not tried a drop of alcohol at the moment, since I am also responding slowly to Imatinib and it is likely that I will be switched to another TKI in a month so I prefer to be cautious at least until they stabilize more things, (which I hope will happen since it is a complicated situation in the first months of diagnosis ..) At the moment I do not want to risk that the TKI see its effectiveness affected by alcohol and more so considering that I am responding slowly .. But I also do not want to live in fear and without being able to lead a normal life in terms of going out from time to time to drink with friends later if everything goes well, especially considering that I am a 22-year-old young man and in a country where the Alcohol is the order of the day, thanks for reading me and I hope I can clarify a little more by reading your opinions, greetings from Spain.

Hi. I have been on imatinib for nearly 15 years. I stopped drinking when I started, but have returned happily to moderate consumption for many years. I always have at least 3 days per week when I don't drink alcohol, and don't drink to excess. A couple of glasses of beer after exercise, or a couple of glasses of wine with dinner have not been an issue for me. Hope that helps.

I have a drink here and there. I would not recommend binge drinking. If you stress your liver it may interfere indirectly with metabolism of your medication. If you are researching online to find an excuse to drink multiple drinks on a daily basis you won’t find what you are looking for. 

Thanks for your answer, it has been helpful, greetings.

I do not intend to drink daily, it would not be a good idea for a normal person even less for someone sick, but maybe a day or maybe two a week why not, I do not know, I do not think it is good to give up completely certain things in life, when it comes to searching for information, I like to know how things work in general (especially when it comes to your own body) and not simply take things for granted without inquiring further about the subject, I will certainly follow the recommendations of my doctor but I appreciate knowing the opinions of other people, thank you very much for your response, greetings

My doc categorically told me Alcohol does not effect efficacy of TKI in moderation but will affect your liver if you abuse it.

I don’t drink hardly as much as I used to because when I do it takes me days to feel with it. I am guessing that because of TKI. But if there is a celebration of sorts or an arranged night out I act like normal. I think the key is be balanced like all things. I have prob had 2 sessions in 3 years where I may have drunk more than I should have and had stinking hangovers but don’t beat yourself up it never effected my response as far as I am aware. Might have affected my liver but my liver readings have all been spot on which should be monitored when you have bloods anyway. Your doc will know before you do if you’ve had too much to drink from your bloods and liver tests :-)

Evening.

When I was first diagnosed about 3 years ago, I abstained from alcohol for a short while. After I spoke to my doctor, and he assured me that it wouldn't have any effects on my treatment. I pretty much returned to my usual drinking habits. Nothing too excessive but probably more so than the average person.

You mentioned that it's part of your daily life and I can relate to that. In the military, alcohol has always been a way of life.
Even so, I haven't experienced any unusual liver readings and achieved MMR around 6 months ago.
I suppose this may have been quicker had I not consumed alcohol but I refuse, maybe foolishly in some eyes, to let this condition control my every day life even more than it already does.

Evening.

When I was first diagnosed about 3 years ago, I abstained from alcohol for a short while. After I spoke to my doctor, and he assured me that it wouldn't have any effects on my treatment. I pretty much returned to my usual drinking habits. Nothing too excessive but probably more so than the average person.

You mentioned that it's part of your daily life and I can relate to that. In the military, alcohol has always been a way of life.
Even so, I haven't experienced any unusual liver readings and achieved MMR around 6 months ago.
I suppose this may have been quicker had I not consumed alcohol but I refuse, maybe foolishly in some eyes, to let this condition control my every day life even more than it already does.

My hematologist told me when first diagnosed and during the weekly blood draws to absolutely not drink alcohol. She wanted no compromise of the weekly blood draws until I got out of the newly diagnosed and "let's get your counts under control" phase.  It took 3 months for my cbc numbers to stabilize, including a 2 week hiatus off of Imatinib due to depressed neutrophils, wbc, rbc, and platelets, etc. Since then she has said, "limit yourself to 1 glass of wine." I have not always followed that, but when I have more than one glass of wine or beer, I do feel it. On the positive side, I have been in DMR for 2 years now and am having conversations about TFR.  

To me, all of our choices are about quality of life issues with this disease none of us wanted to have.

 

 

Hello, thank you for answering Alex and Mrt1987, I share your attitude, this situation is already too difficult on a mental level to live obsessed with everything you drink, eat or do .. Although sometimes I feel guilty when I think about wanting to recover my ¨ messy ¨ previous lifestyle, and even more so seeing how prudent and moderate almost all the people in this forum are, I will continue to be prudent and obey my doctor, even so I hope that if things go well later I can normalize my life a little and being able to have a few drinks on the weekend, I have almost completely stopped smoking and have improved my diet a lot, which I suppose is good in terms of overall health, but as I said I don't think it's good to give up completely either to certain things, it helps me to know your opinion and the words of your doctor regarding this issue, greetings.
Thank you also for your response Rick, from what I have seen on this subject, each doctor seems to have a different opinion on this matter, and there does not seem to be an absolute 100 percent truth about it, thanks for sharing your experience and opinion, greetings.

Thankfully the range of lower alcohol beer is much better than it was years ago and some of it actually tastes like beer so I stick to this. Unfortunately the same cannot be said for wine, unless it's out there but I am unaware. As wine has much higher alcohol levels I always have it with food and a glass of water.

Regards

I believe that no alcohol can be taken during treatment, and I can't tell you if it can affect TKIs. But I am so categorical about alcohol because I almost died because of alcohol addiction for about 5 years. I drank whiskey every day, and I was constantly drunk. I lost everything I could. Then my friend decided to save me and enrolled me in Online Alcohol Support Groups on this site -- https://www.theluckiestclub.com/join-community. At first, I was sceptical about this, but then I realized that all these conversations helped me, and now I don't drink alcohol and treat it very badly. I consider alcohol a drug.

At my very first consultation after diagnosis my then consultant said about going on imatinib that “the good thing is you can still drink wine, so long as it’s Spanish wine”. He’s Spanish. Obviously I liked him!  Like others I did drink rather less at first - mainly because I just didn’t feel like it. Once things settled, I eased back into moderate alcohol consumption though mindful that both imatinib and alcohol are metabolised in the liver so I was a bit careful. However, it was certainly clear that alcohol is ok on imatinib. 

Since being in TFR I have worried rather less -I have alcohol free days each week but my social life does involve a couple of nights in the pub with friends. I’m pretty fit - I run and cycle a lot, and do strength and conditioning sessions - all of which helps to off set it - and my liver function numbers are excellent now. I do think it’s important to try to maintain as normal a life as you possibly can. 
 

 

I believe that no alcohol can be taken during treatment, and I can't tell you if it can affect TKIs.

You believe absolutely wrong! Alcohol with TKIs is absolutely fine, like anyone else in moderation. 

When newly diagnosed it’s probably a good idea to stick away from it mainly, for several reasons. But a well-responding patient should consider alcohol just like someone without CML, in general. There will be exceptions, but that’s why we have biochemistry tests which your doctor will tell you about if you have poor liver function for example.

For so many people CML = Continue My Life.

David.