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Tarceva and supplements/vits

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Best to ask your doctor. There is also a 800 number you can call if you go to tarceva.com to ask questions. Below is more info on it.

http://www.drugdigest.org/DD/DVH/Uses/0 ... teractions

What drug(s) may interact with Erlotinib?



•antiviral medicines for the treatment of HIV or AIDS


•certain medicines for fungal infections (such as fluconazole, itraconazole, ketoconazole, or voriconazole)

•certain medicines for high blood pressure



•grapefruit juice

•medicines for depression

•non-steroidal anti-inflammatory drugs (NSAIDs such as ibuprofen or naproxen)







•St. John's wort or any herbal products containing St. John's wort


Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

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  • 3 weeks later...

It would be better if a doctor answered, but I am on Tarceva and have looked into these questions quite a bit. On average, Tarceva appears to be less effective with current smokers than with lifelong non-smokers (with ex-smokers falling somewhere in the middle, depending in part upon how long since they stopped smoking). Even among smokers, though, Tarceva is effective in a small percentage of patients (in terms of shrinking tumors) and holds things steady in a somewhat larger percentage (though perhaps less than other second-line treatments).

There appear to be two problems with Tarceva and smoking (though the experts are divided on this). First, smokers (for reasons I don't quite understand) eliminate Tarceva from the body more quickly than non-smokers (and thus get a lower effective dose). This would explain differences in effectiveness between current smokers (and very recent quitters) on the one hand, and lifelong non-smokers (and long-time quitters) on the other hand.

The other issue with smoking and Tarceva is that non-smokers are more likely to have a mutation that is more responsive to Tarceva treatment (I think I haven't stated this exactly right), the EGFR mutation. They are also less likely to have a mutation (k-ras) that makes them unlikely to respond to Tarceva. This mutation issue appears to help explain why Tarceva is more effective in lifelong non-smokers than in both current and former smokers (though again the time since quitting may be a factor).

There is nothing that prevents smokers from trying Tarceva. It's just that the evidence is that while it is, on average, as good as other second-line treatments, it appears to better (more likely to "work") than other second-line treatments for non-smokers, and worse (less likely to "work") than other second-line treatments for smokers.

Hope this helps (and I hope I've got it right!).--neilb

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As I understand it, that's exactly what they mean by second-line treatment. While Tarceva is technically only approved in the US for second (and later)-line treatment, it is my understanding that there are some oncologists who try it before traditional chemo with lifelong non-smokers who have adenocarcinoma (or at least with some subset of them, considerign other factors including sex, ethnicity, and current condition). Doctors have some flexibility in using drugs approved in one setting in a somewhat different setting. And I'm getting a sense from reading these boards that some oncologists may also try it instead of traditional chemo if they think that the patient is too weak for traditional chemo (I'm less certain about that).--Neil

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