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Urgent: hayfever induced Asthma

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Morning all,

For several weeks I have been suffering badly with hayfever. It seems to have triggered an extended Asthma attack. I grew out of this in my teens (40 now) but appears to be back.

I wanted to check some interactions with Tasigna (Nilotinib).

I phoned my GP and she had no clue what I can and can’t take which was extremely unhelpful.

I have emailed my CML consultant and got an auto reply back saying he’s away for the foreseeable future (causing me anxiety too now)

I am taking Beconase nasal spray

Ventolin inhaler (blue one)

I was taking Opticrom eye drops for a couple of times but stopped as it appeared to labour my breathing. I skipped one dose of Tasigna as I was worried an interaction occurred (never skipped before but wanted to be sure I flushed any interactions out) back on the evening dose though.

If anyone please could help as I feel I have nowhere to go. I’ve had a 24 hour Asthma attack on and off which is defo relieved by the blue Ventolin inhaler I used to take as a young man. (It’s in date my kid has Asthma too). Finally that feels under control. It caused me a prolonged anxiety attack also which I have also managed to curb for now.

Any help or recommendations greatly appreciated.

Many thanks

Al

Hi Alex,

I get hay fever, and this time of the year is pretty bad for it! Post-COVID lung problems don't make things any easier, so I have the blue salbutamol inhaler like you, but also Flixotide steroid inhaler which is a great help but is a longer-term preventer inhaler rather than a reliever. You get benefit from it after a few days of using it, rather than right away. That's to help with the lungs, rather than nose though.

For eyes, I use carmellose sodium. It's a lubricant, rather than a drug really so just makes the eyes feel less itchy.

David. 

Hi David,

I really appreciate your reply.

That’s great I’ll continue with the Ventolin for as long as I need it. I am not taking any hayfever meds until a Dr confirms it’s ok with Nilotinib. I just found out yesterday by chance my consultant has moved on and I now have a “new” doctor which is a little anxiety inducing having built up some patient relationship with him. And he’s been a bloody good doctor so I am quite upset I don’t have him anymore. But I guess I have to remember treatment is keeping me alive not the Dr as such. I just hope the next one is as good.

I’ll checkout carmellose sodium.

All the best mate

Al

Hi  Alex and David,

Regarding drug interactions and tkis I have found that the best complete source is an article by a group of Swiss researchers published in Blood in 2011 titled "Drug interactions with the tyrosine kinase inhibitors and imatinib,dasatinib and nilotinib" Haouala et al .Fairly extensive tabulations are presented in the article  and I have found GPs to never have a grasp of interactions with tkis -so it is a useful reference tool when talking with medics.

Summarising, under "Anti asthma drugs" there is no interaction stated between these tkis and both of  Salbutomol or Theophylline. Ventolin is a brand name for salbutomol  which is called Albuterol in USA.

Regarding taking any steroid based application for asthma anything based on Prednisone or Betamethasone does not interact with the three tkis but Dexamethasone will reduce the nilotinib exposure so might be considered as a specific drug to avoid.

Interestingly Dexamethasone has been found to be effective in the treatment of Covid and as well asthma sufferers on a steroid might have more protection against Covid say compared with another condition such as diabetes etc

If you Google tkis and drug interactions various articles come up including the Haouala one.

Best wishes

John

Cheers John that’s great.

I did try several drug interaction sites and found inconclusive information. This is extremely helpful and reassuring to say the least.

I dog sat for a couple of days and it turns out I am allergic to non hypoallergenic dogs it would seem as that’s the only thing that could have brought on quite a severe attack other than the hayfever which has been really bad this year for me.

I found the article providing here for others https://ashpublications.org/blood/article/117/8/e75/28454/Drug-interacti...

As always this site delivers.

Always appreciated

Al