Found this on Sprycel
_Cancer Chemother Pharmacol._
(http://www.ncbi.nlm.nih.gov/pubmed/22147077#) 2012 Apr;69(4):999-1004. doi:
10.1007/s00280-011-1797-3. Epub 2011 Dec
7.
Influence of H2-receptor antagonists and proton pump inhibitors on
dasatinib pharmacokinetics in Japanese leukemia patients.
_Takahashi N_
(http://www.ncbi.nlm.nih.gov/pubmed?term=Takahashi%20N[Author]&cauthor=true&cauthor_uid=22147077)
1, _Miura M_
(http://www.ncbi.nlm.nih.gov/pubmed?term=Miura%20M[Author]&cauthor=true&cauthor_uid=22147077)
,
_Niioka T_
(http://www.ncbi.nlm.nih.gov/pubmed?term=Niioka%20T[Author]&cauthor=true&cauthor_uid=22147077)
, _Sawada K_
(http://www.ncbi.nlm.nih.gov/pubmed?term=Sawada%20K[Author]&cauthor=true&cauthor_uid=22147077)
.
_Author information_ (http://www.ncbi.nlm.nih.gov/pubmed/22147077#)
Abstract
PURPOSE:
The objective of this study was to investigate the drug interaction
between dasatinib and the gastric acid suppressants (H2-receptor antagonists
(H2RA) famotidine and nizatidine and the proton pump inhibitor (PPI)
lansoprazole in leukemia Japanese patients.
METHODS:
Eighteen patients treated with dasatinib and H2RA, PPI or no acid
suppressant from whom were obtained a total of 34 pharmacokinetic profiles
were
enrolled in the study. Dasatinib plasma concentrations from samples obtained
just prior to and 1, 2, and 4 h after oral dasatinib administration were
analyzed by high-performance liquid chromatography.
RESULTS:
There were no significant correlations between the dose-adjusted total
area under the observed plasma concentration-time curve (AUC(0-4)) of
dasatinib and gender, age, weight, or body surface area. The only variable
factor,
the dasatinib dose-adjusted AUC(0-4) for patients administered an H2RA or
PPI, was significantly lower than for patients not administered an acid
suppressant (median (quartile 1-quartile 3) values: 1.47 (0.79-2.29) versus
3.51 (2.50-5.45) ng h/mL/mg, respectively, P = 0.0008). Moreover, the plasma
concentration 2 h (C(2h)) after dasatinib administration gave a high
correlation with the AUC(0-4) of dasatinib (r = 0.9419, P < 0.0001).
CONCLUSION:
Clinicians should be aware that administration of an acid suppressant such
as famotidine, nizatidine, and lansoprazole can decrease the absorption of
dasatinib from the gastrointestinal tract, thereby resulting in a
significant decrease in the plasma concentration of dasatinib. The combination
of
dasatinib and an acid suppressant requires careful therapeutic drug
monitoring of the dasatinib plasma concentration to ensure effective patient
exposure to the drug.
Comment in
* _H2-receptor antagonist influences dasatinib pharmacokinetics in a
patient with Philadelphia-positive acute lymphoblastic leukemia._
(http://www.ncbi.nlm.nih.gov/pubmed/22678358) [Cancer Chemother Pharmacol.
2012]
PMID:
22147077
[PubMed - indexed for MEDLINE]
In a message dated 9/4/2014 5:45:42 P.M. Eastern Daylight Time,
[email protected] writes:
Thanks Marty ... I only post once in while, trying to show that sometimes
all the meds in the world does not mean diddly. Attitude love of life, and
all the things that you say, only reinforces what you have been saying all
along. Lab counts are an indicator yes, but how you feel inside is what
counts, you remember that old saying, "I was complaining about sore feet,
until I met a man without legs". All of the people on these CML pages are
HEROs
SkipD
On Thursday, September 4, 2014 1:21:35 PM, Marty Gartenberg
<[email protected]> wrote:
Hi Skip,
So you say that I have the right idea? Well my friend it is you that has
the right idea. You are the longest living person in the world that has CML
and not on any kinds of TKI's for it yet you still show a log reduction.
I'm sorry that you must go through all of what you have to go through but
the bottom line is that your still alive and functioning in spite of all of
that. Skip I can tell you that you are here for a reason...
18's my friend,
Marty
On Thu, Sep 4, 2014 at 9:10 AM, 'Skip Duffie' via CMLHope
<[email protected]_ (mailto:[email protected]) > wrote:
Hello all.....
just wanted to comment on low/high platelets. I have gone through the
whole range of platelets, from 0(zero) to 380,000. This week last Friday I had
40 platelets and received a bag. I received my report today 3Sept2014 and
I was back down to critical ( in my lab critical is below 30\). In all
my 36 almost 37 years, I do not think the high or low platelets bothered me,
Thank G-d. I have a PCR abl test every three months and yes it it so much
better than BMA, I lost track of how many I have over this last year or
so without meds, a log reduction of 0.5, not sure if that is good or bad.
My RBC is down in the 90's which makes me a bit winded. I go twice a week
for infusions, once week for RBC if below 100, twice week for platelets, I
usually lose between 30 to 50 platelets over the weekend. I wanted to share
this with all of you, it is not the end of the world if you have movement
in your counts, just remind your ONC if your feeling sick. If anyone is
interested I would be willing to send one of my lab reports, if it would
ease your mind. Our bodies are strong and will try to fight this CML, but you
have to help it, try to get rid of stress, eat healthy, any problems talk
it over with friends and family, Marty has sound advice, And remember this
old fellow keep praying for all of us every day.
Skip D
37 years this Dec
On Thursday, September 4, 2014 9:31:55 AM, ICANDOALLTTC via CMLHope
<[email protected]_ (mailto:[email protected]) > wrote:
Thanks Marty, being positive is one of our healing factors, but sometimes
when we feel so bad and know we have to take our chemo every day, our mind
gets bogged down with our illness. Our ability to focus sometimes gets a
little blurry when we are in pain, but somehow we will get lifted up again
and be ready to fight one more day. I love the inscription on my g
grandfather's grave. It says, "He Fought The Brave Fight." So let us all
fight
bravely each day, and uplift each other with words of love and encouragement.
You are one of the bravest warriors I have ever known.
Blessings,
Jeanie<3
In a message dated 9/3/2014 8:37:01 A.M. Eastern Daylight Time,
[email protected]_ (mailto:[email protected]) writes:
Maria, good luck with your blood test.
Here are some words to live by...
EXPECT THE BEST, MIND OVER MATTER. SUCCESS IS A FUNCTION OF SELF
CONFIDENCE. TO HAVE SUCCESS AT ANYTHING YOU MUST FIRST LEARN TO BELIEVE IN
YOURSELF.
IF YOU EXPECT THE WORSE THEN THAT IS EXACTLY WHAT YOU WILL GET (MIND OVER
MATTER) IF YOU EXPECT THE BEST THEN THAT IS WHAT YOU WILL GET.
WHAT WE HAVE TO LEARN TO DO IS TO CHANGE OUR MENTAL HABITS, OUR STATES OF
MIND. LEARN TO EXPECT AND NOT TO DOUBT. BY DOING THIS YOU BRING EVERYTHING
INTO THE REALM OF POSSIBILITY. WHEN YOU LEARN TO BELIEVE THEN WHAT YOU
THOUGHT TO BE IMPOSSIBLE THEN MOVES INTO THE AREA OF POSSIBILITY.
EVERY GREAT THING EVENTUALLY BECOMES POSSIBLE FOR YOU. MY BELIEF AT THE
BEGINNING OF A DOUBTFUL UNDERTAKING IS THE ONE THING THAT INSURES THE
SUCCESSFUL OUTCOME...
FOCUS...
Please look me up. Google Marty Gartenberg. Open CML hope then go to “The
Window”
18's
Marty
On Wed, Sep 3, 2014 at 8:22 AM, Maria Cashion <[email protected]_
(mailto:[email protected]) > wrote:
Thanks both of you, Richard and Marty for your concern!!! I am doing OK
and plan to have a CBC done in an hour or so. I will start back on my
Sprycel as soon as they draw the blood!!!
Life is beautiful no matter what. As I look back, I know that I am lucky
and strong, and I wil never give up!!!!!
Love you all!!!
Maria
On Wed, Sep 3, 2014 at 6:14 AM, <[email protected]_
(mailto:[email protected]) > wrote:
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Maria Cashion <[email protected]_ (mailto:[email protected]) >:
Sep 02 10:24PM -0400
Hello everyone!!!! God bless you all!!! I have been out of touch for a
while. My situation is still complicated, but rather uneventfull. I went
to my appointment and my oncologist for the day told me that I might need
another bone marrow aspiration and biopsy soon. She was worried because my
platelets went down. The problem is that I have not been able to take my
sprycel steadily. I have skipped some days. Sprycel acts really strongly
on my platelet count, and I know this is what is happenning. Apparently, I
have an infection also running around my system. To make it more
interesting, I have been out of medication for a whole week due to
insurance red tape...
I will resume my Sprycel 70 mcg dose daily tomorrow after I do another CBC.
I have an appointment in two weeks...
Well, please take care!!!! Love you!!!!
Blessings!!! :)
Maria
Richard H <[email protected]_
(mailto:[email protected]) >: Sep 02 09:11PM -0700
Hope you receive good news after your CBC. My ONC has a lab in his office
and I have my results after about a 1/32 hour wait. I have Iron Deficient
Anemia that was found after I was diagnosised with CML. He doesn't like to
have a patient do a bone marrow biopsy because it is too painful. I was on
Gleevec for 5 + years and off for almost 6. In Oct. I will do the mutation
testing as I have something happening in my medical life. I have several
things can be causing my blood test to be out of sync, so we must do some
elinination testing to find what tand who should be the lead Dr. to manage
treatment.
My favorite response to the question "How are you doing?". "I stood up
this morning looked around and said "Thank you God. Its going to be a
great day. I hope you are having one also."
Richard H.
On Tuesday, September 2, 2014 9:24:59 PM UTC-5, Maria Cashion wrote:
Marty Gartenberg <[email protected]_ (mailto:[email protected]) >: Sep 03
04:47AM -0400
Hi Richard and Maria,
Richard, whenever we can get out of bed then it really is a good day. When
I was a young child my father taught me that every day is a good day unless
someone that we love dies.
Maria, isn't it a shame that we all have to be dealing with insurance
companies that may denigh us some life saving medications? This is simply
unacceptable. I do hope that all of this will be worked out for you and
everyone else that this may be happening to.
18's,
Marty
On Wed, Sep 3, 2014 at 12:11 AM, Richard H <[email protected]_
(mailto:[email protected]) >
wrote:
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