Hi all and just wanted to say a few words about  Prilosec.  The Sprycel 
leaflet does say specifically do not take proton  pump inhibitors.  I had to 
fight with my doctors while in the hospital as  they were giving me this twice 
a day and the meds I was on for CML were not  working.  I finally told the 
nurse when she brought them in that I would  not be taking them anymore and 
showed her the leaflet.
And I had no indigestion or anything just the pain in my right  side that I 
always had.
We are all different so maybe some people can take them  without any side 
effects.
Happy Thanksgiving Everyone,
Jeanie<3
 
 
In a message dated 11/25/2013 3:58:03 P.M. Eastern Standard Time,  
[email protected] writes:

 
Hi Peg and thank you.  As for the Prilosec, all of my doctors and I  have 
discussed it and feel that the benefits of me continuing to take it  outweigh 
the risk.  I don't take the prilosec with the TKIs, there's at  least a 
couple of hours in between.  Given my health history, it's an  unfortunate 
necessity.  
 
I agree with you and have been battling my doctors since March regarding  
the whole "minimal effective dosing" issue.  I see no need to take the  
maximum dose if the minimum is doing what it needs to be doing.  At this  point 
of my life, it's quality over quantity and if I can't actually live and  
enjoy my life, I really don't see much point.  Being sick and living in  the 
shadows isn't really my way.  
 
Suzanne
 

On Monday, November 25, 2013 2:31:42 PM UTC-5, peg wrote:

Hi Suzanne,

Like you I have been on Gleevec (8 mos),  Sprycel (3 yrs) and have just 
recently switched to a low dose Tasigna (200mg  once daily).  When on Sprycel I 
 had esophageal spasms, where what  I swallowed would not go down.  This 
may be similar to what you are  experiencing.  I do use liquid Donnatal for 
this and other stomach  problems, but I use it sparingly as it can inhibit the 
metabolism of  Tasigna!  There is not much point in taking a TKI, and 
suffering the  side effects, if you take another drug for the side effects that 
renders the  TKI useless!  Which brings up a concern...your Prilosec.  While 
I  will use that only very occasionally, acid inhibitors like prilosec are  
contraindicated with TKI drugs as they impair the absorbtion.  There is  
mounting evidence that too little stomach acid will result in too little  
absorbtion of the TKI's.  

As far as your oncologist wanting to  increase your dose to the standard 
recommended dose, there is also growing  evidence that dosage can be tailored 
to the actual need for each patient,  but because CML is absolutely fatal 
without treatment and too low a dose can  sometime lead to resistance, many 
oncologists are afraid to reduce the dose  below the standard in the absence 
of absolute medical necessity.   However, were medical necessity has 
prevailed many patients are being  maintained fine on lower than standard 
dosing, 
myself included.   

Since you are already on a low dose, you might want to ask your  oncologist 
to wait through at least 2 or 3 PCR's to see what your numbers  are doing.  
They recommend at least 2 PCR's before making any changes  as PCR's can 
fluctuate, so you would not ever want to make a change based on  any one, but 
rather a trend of two or three, and they must be from the same  lab!!! You 
cannot compare a PCR from one lab to that of another.  It is  like apples and 
oranges.  However, if your numbers are good, there may  be no need to put 
you on a higher dose.  Just one school of  thought...you may find others who 
disagree.  I have just had such  extreme side effects on TKI's that I have to 
hope and pray that low dosing  will work.  I PCR every month to monitor 
this.  

Like you I  also have a complicated diagnosis, and balancing drugs and side 
effects is  at the least challenging and sometimes depressing.  I have had 
Multiple  Sclerosis for 25 years, was diagnosed with CML and Melanoma at 
almost  exactly the same time, almost four years ago, and this year have been  
diagnosed with an unrelated abdominal tumor and possible lung tumors.   
Through all the years of my MS I barely took any medication, but now pop  
handfuls of pills several times a day...very disheartening.  I  encourage you 
to 
find the lowest dose of everything that works for you and  try to find a way 
to make it all work for your life. Some times for me this  has taken a bit 
of life modification.  I know first hand how tired and  worn out you are...I 
get there too.  Try to take one day at a  time...and when that doesn't work, 
one hour at a time.  Know that you  are not in this alone.  

Fight  on,
Peg







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