James c Posted January 12, 2023 Share Posted January 12, 2023 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 Quote Link to comment Share on other sites More sharing options...
JHP Posted January 12, 2023 Share Posted January 12, 2023 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. Tom Galli 1 Quote Link to comment Share on other sites More sharing options...
LilyMir Posted January 12, 2023 Share Posted January 12, 2023 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! Tom Galli 1 Quote Link to comment Share on other sites More sharing options...
James c Posted January 13, 2023 Author Share Posted January 13, 2023 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. Quote Link to comment Share on other sites More sharing options...
JHP Posted January 13, 2023 Share Posted January 13, 2023 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 LilyMir and Tom Galli 2 Quote Link to comment Share on other sites More sharing options...
LilyMir Posted January 13, 2023 Share Posted January 13, 2023 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, Tom Galli 1 Quote Link to comment Share on other sites More sharing options...
James c Posted January 13, 2023 Author Share Posted January 13, 2023 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. Tom Galli 1 Quote Link to comment Share on other sites More sharing options...
LilyMir Posted January 13, 2023 Share Posted January 13, 2023 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! BridgetO 1 Quote Link to comment Share on other sites More sharing options...
Judy M2 Posted January 21, 2023 Share Posted January 21, 2023 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. Quote Link to comment Share on other sites More sharing options...
GBean Posted April 16, 2023 Share Posted April 16, 2023 Might I ask what dose you are all at? My husband is at 120mg and doctor wants him up to 160mg for BBB penetration due to brain mets. Thanks in advance! All the best to all of you warriors! Quote Link to comment Share on other sites More sharing options...
LilyMir Posted April 16, 2023 Share Posted April 16, 2023 Most EGFR LC patients are put at 80mg, the regular dose, as far as I hear. Some are put on a half dose, 40mg, if they suffer severe side effects at the regular dose that they cannot tolerate. I just googled a bit and though there seems to be no guidelines for double dose, 160mg, it seems that at least some cases were observed where double dose much increases effectiveness/durability of Tagrisso in controlling the cancer when there are brain mets: https://www.jto.org/article/S1556-0864(21)02914-2/fulltext. Hope this gives you hope but I recommend you always ask the oncology team treating your husband all the questions you guys are wondering about including asking for resources to better understand their treatment plan if you have any doubts. Second opinions are always a good idea in cancer too, especially if you do not feel confident/comfortable with the first opinion. Tom Galli 1 Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You can post now and register later. If you have an account, sign in now to post with your account.