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Tagrisso, starting today


James c

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Hi, everyone.  My name is James and I am the primary caregiver to my beautiful wife.  She was diagnosed with nslc and she is Stage 4.  

We are starting Tagrisso today and any suggestions on what foods or herbs can help her absorb Tag? 

 

Any suggestions would be greatly appreciated.

Thank you in advance

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I spoke with the pharmacist about dad's tagrisso and you can check with yours about what specific supplements you're considering. You want to be wary of cyp3A4 enzyme inhibitors which might mean absorbing too little of the tagrisso. Grapefruit is a known strong inhibitor. Many other herbal sources are also inhibitors to varying degrees theoretically but the pharmacist said if it's occasional and part of a normal diet to not worry about it. They're more worried about extracts in higher doses taken or things taken on a continual basis. Inducers may mean absorbing too much which increases adverse events. MSK supplements is a good resource to check.

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Welcome to team Tagrisso James though sorry you have to be here! I have  been on Tagrisso since September, quite well tolerated though I have a number of side effects that I continue  to deal with but nothing like chemo etc.  Everyone is different and some people never have side effects, others have a lot, some have them in waves that ebb then return  in cycles.

I do not  think your wife needs to eat anything specific, just live normal life as tolerated. However she should be careful with herbal drinks and should not eat grapefruit (the only thing  my pharmacist told me not to consume). All her medications need to be checked for Tagrisso interactions. Wishing her the best  of outcomes!

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Lily and Jhp

thank you guys for the info.

I make a Cinnamon, Ginger, Temeric, Clove and Ginseng herbal tea and will discontinue it until I check with her Drand msk. 

Wish you the best. 

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About curcumin (the supplement, not turmeric spice for cooking) and ginseng tea, the pharmacist warned me that curcumin had the potential to be an inducer and cause over-absorbtion which would increase adverse event risk. If you're just using a normal amount in cooking occasionally, that should be okay but check with your doctor. Turmeric's curcumin is very poorly bioavailable and clears out very quickly which you can get around via supplement form. They try to increase its bioavailability with black pepper or by a nano-sized water soluble formula. You'd have to eat a huge amount of its spice form to equal the supplement form.

Regarding ginseng, the pharmacist recommended against taking it because they just know know for sure yet how it works in humans. The pharmacist said it could be an inhibitor or an inducer or it may clear drugs out too quickly, they just don't know. It's a theoretical reaction same with curcumin. Fyi, imatinib is another TKI drug just like tagrisso. MSK states:

Imatinib: A case report indicates that P. ginseng may increase risk of hepatotoxicity (24).
CYP3A4 substrates: Certain ginsenosides can induce CYP3A4 and may increase the clearance of substrate drugs. However, effects in humans may not be clinically significant

https://www.mskcc.org/cancer-care/integrative-medicine/herbs/ginseng-asian

Both curcumin and ginseng have mentions about potential to overcome TKI drug resistance in research papers.

Best wishes

 

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My cancer centre pharmacist found contra indications with loads of herbal supplements, even cranberry and mint. She said pill form is not good but small quantities like tea or cooking should be fine, as it is theoretical risk that did not prove clinically relevant in reality. I stay away from any supplements, only take vitamin D but drink occasion mint or sage tea. Everyone best check any pills with their pharmacist/cancer centre first,

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She took her first pill last night @8.00pm!!!  This morning no issues.  I am hopeful her body will accept Tag.

We will stopped drinking the tea and taking Curcumin supplements.

She takes D3, Citrus Pectin, and a daily multi vitamin.  Lmk any concerns on these items.

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Didn't the  pharmacy that dispensed Tagrisso  call and ask about all meds and supplements your  wife are taking? Mine did and we  spent almost  an hour going through  everything. If they are not thorough, I am sure  your cancer centre has a pharmacy info line and they  are usually very knowledgable and thorough. Best  of luck!

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James, D3 and a multivitamin are fine to take with Tagrisso. I also take calcium and B-12 as recommended by my primary care doctor for other conditions.

Your wife should have received literature with her Tag. It's very extensive and should be read. 

I get my Tag directly from Astra Zeneca through their AZandMe financial assistance program. I've never spoken with a pharmacist. 

I'm also in San Diego, in Rancho Bernardo. Who is your wife's oncologist? I go to cCare in 4S Ranch and see Dr. Steven Eisenberg. 

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