Chemotherapeutic medicine are sturdy medicines designed to focus on quickly dividing most cancers cells. Should you or a cherished one is present process chemotherapy, additional care needs to be taken to debate using any over-the-counter (OTC) medicines and natural dietary supplements along with your well being care crew.
“Medication that an individual usually takes with out a lot concern could be problematic for an individual with most cancers,” stated Ila M. Saunders, PharmD, an assistant scientific professor on the Skaggs College of Pharmacy and Pharmaceutical Sciences on the College of California San Diego and an oncology scientific pharmacist at UC San Diego Well being. “You’ll want to focus on all the pieces you’re taking along with your well being care crew to allow them to provide the finest remedy attainable. Many OTC and natural dietary supplements can harmfully intervene with chemotherapy therapies.”
Masking Signs
One concern with OTC medicines is that they might masks signs, indicating a extra severe underlying well being problem.
“As a result of some varieties of chemotherapeutic medicine weaken the immune system, we’re all the time on the alert for indicators of an infection,” Saunders stated.
Acetaminophen and non-steroidal anti-inflammatory medicine (NSAIDs), corresponding to ibuprofen and naproxen, are sometimes used for ache, however they’re additionally fever reducers. “Should you take an OTC treatment with acetaminophen or an NSAID, it’s best to inform your well being care crew,” she stated. “They could prescribe one other treatment that won’t masks a fever and nonetheless deal with your ache.”
Anti-diarrheal medicines, corresponding to Imodium (loperamide), usually are not suggested with out first speaking to your doctor. “Your well being care crew must know you probably have diarrhea, because it may very well be a aspect impact of chemotherapy, an indication of an infection or one other complication of your remedy or illness,” she stated.
Altering the Dose
One other concern with OTC medicines and natural dietary supplements is that they’ll change the efficient dose of an oral chemotherapy by altering the drug’s absorption within the gastrointestinal tract.
“Choose oral chemotherapies require a sure abdomen acidity to be appropriately absorbed,” Saunders stated.
Prilosec (omeprazole), for instance, is a quite common OTC proton-pump inhibitor for gastroesophageal reflux illness (GERD). It really works by lowering the quantity of acid produced within the abdomen. “This implies a affected person taking Prilosec might get a decrease dose of their chemotherapy than that focused by their oncologist,” she stated.
Aloe vera juice is one other instance. “This natural complement has the potential to lower the intestinal absorption of sure chemotherapeutic brokers as a result of it will possibly act as a stimulant laxative and trigger diarrhea,” she stated.
Risks of Natural Dietary supplements
Although some sufferers with most cancers could also be inquisitive about complementing or substituting their most cancers remedy with natural dietary supplements, Saunders warns in opposition to this.
“In my follow, I discourage natural dietary supplements generally,” she stated. “Not solely can sure dietary supplements change the efficacy of an individual’s remedy, they’ll additionally enhance their treatment’s toxicity.”
Echinacea, curcumin, St. John’s wort, valerian root, and allium (an extract of garlic) — all are examples of natural dietary supplements that may disrupt the toxicity-efficacy stability of chemotherapy. As well as, the doses of natural dietary supplements usually are not standardized. “That being stated, the choice to proceed or discontinue an natural complement is a dialogue between the affected person and the well being care crew that takes the objectives of remedy and the affected person into consideration,” Saunders stated.
A extra particular natural supplement-drug interplay is that of inexperienced tea extract (EGCG) and Velcade (bortezomib), a chemotherapeutic agent used to deal with a number of myeloma, a sort of blood most cancers.
“EGCG has been proven to scale back the anti-tumor results of bortezomib,” she stated. “Sufferers on bortezomib are suggested to abstain from inexperienced tea, particularly any inexperienced tea extracts.”
Inquiries to Ask Your Oncology Pharmacist
Saunders encourages sufferers and members of the family to speak to their oncology pharmacist about their remedy and ask questions, together with:
- Does my chemotherapy work together with any of my different medicines?
- Does my chemotherapy work together with any meals or drinks, corresponding to grapefruit, grapefruit juice, milk or soda?
- What natural dietary supplements, nutritional vitamins, or over-the-counter medicines can I take safely with this drugs?