Well I am on Tasigna now but my dental problems "erupted" while I was on 
Gleevec -3 broken teeth  = 2 extractions. When I asked my first oncologist his 
response was something like, "oh yeah Gleevec can cause all kinds of dental 
problems, that's why I told you to take a calcium supplement." He of course had 
said nothing of the sort. GRRRRNote, I would never take a calcium supplement 
without vitamin D because vitamin D is necessary for absorption of the calcium 
and taking calcium without it can contribute to calcification of the 
heart.Patrick

--- On Sun, 2/3/13, Suzan Collins <[email protected]> wrote:

From: Suzan Collins <[email protected]>
Subject: [CMLHope] dental problems
To: [email protected]
Date: Sunday, February 3, 2013, 10:43 PM


Has anyone had any dental problems etc cavities or any other sincebeibg on 
leevecor Tasigna?
--- On Sun, 2/3/13, Marty Gartenberg <[email protected]> wrote:


From: Marty Gartenberg <[email protected]>
Subject: [CMLHope] Gleevec Interactions
To: [email protected]
Date: Sunday, February 3, 2013, 1:56 AM


I did some research and here is what I found out about what to avoid while 
taking Gleevec. Please remember that I have never been on any TKI's because I 
had a bone marrow transplant many years ago. I just do a lot of research.

Hopefully this will be able to help you, and others as well.

Gleevec Interactions
GLEEVEC IS METABOLIZED IN THE LIVER BY CYP3A4. This is the basis 
for most interactions, if CYP3A4 is affected by other drugs or foods. A 
pharmacist can use computer programs available to pharmacists to check 
whether other drugs would interact with Gleevec. 
The NCCN Task Force Report on GIST Management includes a table of Gleevec 
interactions on pages S12-S13. Download 
the pdf at the above link to read this. This table does not name every 
possible interaction. 
The Gleevec prescribing information from Novartis also details some 
interactions. Go to Gleevec.com and click "prescribing information" at the top 
of the screen. 
________________________________


GRAPEFRUIT, POMEGRANATE, OTHER CITRUS FRUIT 
Due to the metabolism of Gleevec, Novartis recommends that grapefruit and 
grapefruit juice be avoided by patients taking Gleevec. 
The new NCCN Task Force Report mentions grapefruit juice and 
names a quantity of 200-250 ml as increasing blood levels of Gleevec. 
That is over 3/4 cup of juice. A smaller quantity might not raise 
Gleevec levels much. 
Grapefruit juice INHIBITS the liver enzyme (CYP3A4) that 
processes Gleevec. If you eat a lot of grapefruit then Gleevec stays in your 
blood LONGER. It does not decrease the effectiveness of Gleevec, 
as it raises the blood levels of Gleevec. This could potentially 
increase side effects. However, if you have no trouble with
 side 
effects, then it would not seem that popping the occasional strawberry, 
grapefruit section, or 1/4 cup of pomegranate juice would hurt... 
Tangelos are a hybrid of grapefruit and mandarin orange: Some 
doctors say to stay away from Tangelos. There have been several 
studies, one being the USDA Agricultural Research Service, "....have so 
far shown that unlike grapefruit, interactions with STATINS are not 
likely with tangelos, even though it is derived from a grapefruit 
crossed with a tangerine. This is apparently because the furocoumarins 
in grapefruit are not expressed in tangelo. " 
http://www.ars.usda.gov/research/publications/publications.htm?seq_no_115=175058
 
POMEGRANATE juice also affects CYP3A, but not in exactly the same way as 
grapefruit. For some medical papers discussing pomegranate 
efects on drug disposition see this PubMed search. 
________________________________

ST. JOHN'S WORT
ON THE OTHER HAND, St. John's wort does the opposite, increasing 
enzyme activity to get Gleevec out of the body faster. Therefore, it is a clear 
no-no since it decreases blood levels of Gleevec, thereby 
decreasing the drug's effectiveness. 
________________________________

STATIN DRUGS
Gleevec raises the level of statins in the blood. Patients who take 
statins with Gleevec need to be very cautious, as very serious side 
effects such as muscle damage (rhabdomyolysis) may result from excess 
statins. Statin dose should be reduced when taking Gleevec.
 Discuss 
this with your pharmacist and doctors. 
________________________________

MILK THISTLE
Caution! Milk thistle decreases the activity of CYP3A4, which is the major 
enzyme responsible for the metabolism of Gleevec and Sutent. DO 
NOT take milk thistle while on these drugs and check with your doctor if on 
other drugs. 
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